Treatment Of Alcohol-related Problems Research Articles

Prevention and treatment of alcohol-related problems: an international medical education model.

Alcohol abuse and alcoholism are among the world's most pressing public health concerns. Research has shown that while primary care physicians are in a good position to screen for alcohol-use disorders and to aid in treating these problems, they tend to identify only a small percentage of patients with such disorders and they rarely intervene with these persons. This situation is probably attributable to the fact that medical students worldwide are taught very little about alcohol-related problems. Clearly there is an urgent need to educate the world's doctors about preventing, diagnosing, and treating alcohol abuse and addiction. In this paper, the authors describe a model international program for educating physicians about alcohol-related problems that was developed by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in cooperation with the Center for Addiction Research and Education (CARE) at the University of Wisconsin-Madison. They describe the components of the initiative's "trainer-development" approach and critical issues in implementing the program in other countries. Finally, they discuss how the program was successfully implemented in Poland and describe the NIAAA's plans for introducing the model in several other countries.

Role of Gangliosides in Behavioral and Biochemical Actions of Alcohol: Cell Membrane Structure and Function

Alcohol exerts its pharmacological effects in adult brain by altering the physicochemical properties of cellular plasma membranes. Although alcohol does induce changes in membrane lipid composition, studies to relate these alterations to the development of behavioral tolerance to alcohol and the withdrawal effects have been unsuccessful. Actions of alcohol on developing brain are even more complex. Some of the reported effects include inhibition of embryogenesis, cell migration, and differentiation, including synaptogenesis. Gangliosides have neuroprotective action against a variety of neural insults (e.g., mechanical injury, drug toxicity, or hypoxic insult). This review addresses the role and significance of gangliosides in the CNS pathophysiology of alcohol exposure, as well as the effect of changes in endogenous gangliosides on membrane structure and function. We also describe the role of exogenous gangliosides in prevention of alcohol (acute and/or chronic)-induced CNS (prenatal and postnatal) neurotoxicity through their action on cellular plasma membranes. We propose that ganglioside's neuroprotective effects against alcohol neurotoxicity involve protection and restoration of plasma membrane structure (proteins and lipids) and thereby its function (ionic homeostasis, neurotransmitter receptor-mediated signal transduction). Thus gangliosides may have potential therapeutic use in treatment of alcohol-related problems.

Prevention and treatment of alcohol-related problems: research opportunities. Committee to Identify Research Opportunities in the Prevention and Treatment of Alcohol-Related Problems.

This article summarizes the major themes, conclusions and recommendations of a 2-year study conducted for the National Institute on Alcohol Abuse and Alcoholism by the Institute of Medicine. The study is devoted to the identification of research opportunities that will improve knowledge about the prevention and treatment of alcohol problems. In the first part of the report, the study committee examines the social and personal aspects of alcohol-related problems toward which prevention efforts are directed; delineates the features of a public health orientation that it deems most appropriate for the prevention task; discusses individual vulnerability to alcohol misuse; and reviews genetic, developmental and social learning perspectives on prevention. In the second part of the report, which is devoted to treatment research, the committee considers the underlying philosophical issues as well as the formidable methodological problems in conducting treatment research. Central to this is a broad review of promising treatment modalities and the research needed for developing effective patient-treatment matching schemes. In the final part of the report, the committee concludes that cooperative multisite research efforts are indispensable to the implementation of the research directions it recommends.

THE FACTOR STRUCTURE OF THE DSM-III-R AND ICD-10 CONCEPTS OF ALCOHOL DEPENDENCE*

This paper describes the factor structure of the concept of alcohol dependence as proposed in two psychiatric classifications, the DSM-III-R and the ICD-10. Subjects are 219 men and 162 women who were interviewed while in treatment for alcohol-related problems in nine different treatment programs in Contra Costa county, California. Tests of hypotheses supporting a single factor and a dual factor structure of dependence were rejected by confirmatory factor analysis. Results from exploratory factor analysis show a four factor structure for the concept of dependence in DSM-III-R. For ICD-10 there is a four factor solution among men and a three factor solution among women. The item composition of these factors vary by gender and across the two classifications. However, there is good agreement between dependence as measured by DSM-III-R and ICD-10 criteria. Since work on DSM-IV is now under way, the present research aims to provide some empirical base for how future changes should be made.

A comparison of the structure of two models of treatment for alcoholism

A comparison is made between the services offered by a District General Hospital and a Community-based Centre, for the treatment of alcohol related problems. The two treatment models are discussed in terms of their structure and their approach to problem drinking. Differences between the Hospital and the Centre are noted, and some conclusions are drawn regarding service developments.

SOME CLINICAL AND BEHAVIOURAL ASPECTS OF PATIENTS WITH ALCOHOL DEPENDENCE PROBLEMS IN KUWAIT PSYCHIATRIC HOSPITAL

One hundred patients undergoing treatment for alcohol-related problems in Kuwait's only psychiatric hospital were studied. Eighty-three Kuwaitis and 17 non-Kuwaitis (78 inpatients and 22 outpatients) were compared on two variables, i.e. nationality and drinking category. Kuwaiti patients were more likely to be violent while drunk and to receive benzodiazepine prescriptions while non-Kuwaiti patients were better educated and suffered more alcohol withdrawal seizures. Heavy drinkers were prescribed more benzodiazepines. Light drinkers were involved in more road accidents and were more likely to be prescribed major tranquillizers. The relationship between benzodiazepines use and alcohol withdrawal symptoms is discussed and its implications in patient care in Kuwait are stressed.