Despite a perception that is often pessimistic, the management of alcohol-related disorders is most often successful. About 50 to 60% of patients are improved one year after treatment, and such a change most often has good stability over three to five years. Although all our patients are likely to improve, some seem to be more likely to cope well; Not surprisingly, these are the patients with the least severe alcohol problems, benefiting from the most intensive treatments, with the least cognitive impairment (attention, memory, reasoning …), being the most confident in their ability to progress or freedom from associated mental disorders
Psychotherapies and medications
The psychotherapeutic approaches currently the most common and the best validated are brief interventions, motivational interviewing and cognitive-behavioral therapies. More rarely, systemic or psychodynamic approaches are proposed. Patient-centered approaches favor the choice left for abstinence or a substantial reduction in consumption. Most often, abstinence will be the target ultimately chosen by the most dependent patients.
Drug treatments that are currently indicated for the treatment of alcohol dependence are essentially part of an abstinence strategy. In this case, the drug treatment is currently designed in two phases: the treatment of withdrawal syndrome, then the prevention of relapse or help to maintain abstinence
The treatment of withdrawal syndrome is only for people who develop signs of withdrawal (or withdrawal), or about half of people with alcohol dependence: tremor, sweating, nausea or vomiting, anxiety, agitation, insomnia, and sometimes seizures. In patients developing signs of withdrawal, the first-line treatment is based on the benzodiazepine-type tranquilizers prescribed for a few days.
Prevention of relapse
The second phase of pharmacological treatment is aimed at preventing relapse or maintaining abstinence. This is a prolonged treatment, from a few months to a year. Three drugs currently have this indication: These three treatments are for weaned people who want to maintain abstinence. Dillon rehab reduces the recovery of a first glass by 16%, naltrexone reduces by 12% the return to excessive consumption after a first drink. Disulfiram works by a deterrent mechanism since it causes very uncomfortable symptoms in case of alcohol intake. It allows.