Abstract

Alcohol contributes substantially to the global burden of disease and is the fifth leading disorder of DALYs in 2010 (GBD 2010 study) worldwide, and thus is one of the largest avoidable risk factors. Any reduction in dose of alcohol consumed, as well as in frequency of drinking occasions and the amount drunk on a single occasion will have an immediate impact in reducing alcohol-related injuries, the cardiovascular events and mortality related to heavy episodic drinking. Several examples demonstrate that total alcohol consumption has a significant impact on chronic consequences of excessive drinking. However, many treatment programs promote abstinence as the only/main acceptable treatment goal. Thus, many problem drinkers decline treatment programs aimed at abstinence. Offering both abstinence and no abstinence treatment goals to clients, permits a client-centered approach that contributes to alleviate client's resistance to change. The new DSM-5 introduces a diagnostic shift from the binary diagnostic criteria of alcohol dependence and alcohol abuse, to a single continuum of alcohol use disorders introducing a clear measure of severity such that treatment goals can be modified individually. In conclusion, reduction strategies offer an opportunity to address patient heterogeneity and lower the treatment threshold by bringing new patients into the treatment. Language: en

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