Which detoxified alcoholic keeps the first clinic appointment?

Anticraving therapy for alcohol use disorder: A clinical review

Aim

In this review, the author focused on anticraving therapy for alcohol use disorder (AUD) defined by DMS‐5. A comprehensive review was carried out on the available published papers on anticraving drugs for treating AUD patients.

Methods

The author described all drugs with anticraving benefits for treating AUD patients approved by the Food and Drug Administration of the United States (US FDA) and European Medicines Agency of the European Union. Then, the commonly prescribed anticraving drugs and those under development were also described.

Results

The US FDA‐approved anticraving drugs included acamprosate and naltrexone, and those approved by European Medicines Agency were gamma‐hydroxybutyrate and nalmefene. The author also highlighted topiramate, gabapentin, ondansetron, LY196044, ifenprodil, varenicline, ABT‐436, mifepristone, citicoline, and baclofen. The putative mechanisms of action of and the use in clinical practice of those anticraving drugs were also described.

Conclusion

Although slowly developing, the field of anticraving drugs is getting into shape as a promising entity of a pharmaceutical class of drugs. Then, the author addressed on the underused issues of those recommended, and suggested anticraving drugs by the practice guideline of the American Psychiatric Association. The author urges that clinicians should be more “adventurous” in prescribing those promising drugs because benefits of those anticraving drugs are far‐outweighing the possible side effects of anticraving drugs, or the harms of untreated AUD itself.

Verbal Participation in Group Therapy: A Comparative Study on New Mexico Ethnic Groups

This study examined the verbal participation of Anglos, Mexican Americans and Native Americans in group therapy sessions for alcoholic patients. Fifteen therapy groups with a total number of 265 alcoholic inpatients, were recorded for the patients' verbal participation. The data are analyzed in ethnic categories and show that the Anglo patients have significantly higher verbal participation than either of the two other ethnic groups in the study. The need to reconsider the advantage and disadvantage of homogeneous or heterogeneous ethnic groupings in therapy is discussed.

Entering treatment for alcohol abuse: a stress and coping model

This study used a stress and coping model to examine the process of entering treatment among 515 problem drinkers without prior formal treatment for alcohol abuse who were recruited at alcoholism information/referral (I&R) and detoxification centers. Over a 1-year follow-up period, 76% of the individuals in the sample entered some form of treatment, including Alcoholics Anonymous. People were more likely to enter treatment if they perceived their drinking problem as more severe, had more dependence symptoms, experienced more adverse consequences as a result of drinking, had more symptoms of depression, were more self-derogating, experienced more negative life events in the past year, and/or experienced more stressors in various life domains. Facilitative factors also related positively to treatment entry: people who had sought help from non-formal treatment sources before, who recalled being referred to treatment programs by an I&R center, and/or who received detoxification at a center that had treatment services available on-site, also were more likely to enter treatment. For people with greater resources in multiple life domains the positive effects of days intoxicated, dependence symptoms and stressors on help-seeking were intensified. Overall, the findings suggest that perceived severity of drinking problem plays a central role in the treatment entry process and mediates the effects of many other intrapersonal and environmental variables in generating an impetus or readiness to seek treatment.