Gaps in the treatment for alcohol-related problems in primary care settings

Abstract

Traditionally, the medical approach to the management of alcohol-related problems has been limited to the treatment of ‘alcoholism’, based on intensive medical and social rehabilitation, made by psychiatrists with a specialization in ‘addiction’, often in inpatient settings and for long periods of time. Treatment was given for those with presenting symptoms of dependence and withdrawal, several medical and psychiatric problems, asking for help or brought by the family, after a long ‘career’ of heavy alcohol consumption and numerous attempts at stopping alcohol use without any success. However, at the beginning of the 1980s, the need for a public health approach to reduce the impact of alcohol use in society led to the development of earlier and low-cost interventions which could benefit a larger number of people and be delivered before dependence and chronic disability had been established. It was realized that the burden of illness imposed on society by heavy drinkers was comparable to that imposed by al...