Alcohol dependence treatment in the EU: A literature search and expert consultation about the availability and use of guidelines in all EU countries plus Iceland, Norway, and Switzerland

Jürgen Rehm, Maximilien Rehm, Hannu Alho, Allaman Allamani, Henri-Jean Aubin, Gerhard Bühringer, Jean-Bernard Daeppen, Ulrich Frick, Antoni Gual, Nick Heather

Abstract


Rehm, J., Rehm, M. X., Alho, H., Allamani, A., Aubin, H., Bühringerm G,m Daeppen, J., Frick, U., Gual, A., & Heather, N. (2013). Alcohol dependence treatment in the EU: A literature search and expert consultation about the availability and use of guidelines in all EU countries plus Iceland, Norway, and Switzerland. International Journal of Alcohol and Drug Research, 2(2), 53-67. doi: 10.7895/ijadr.v2i2.89 (http://dx.doi.org/10.7895/ijadr.v2i2.89)

Aim: To describe guidelines and common practices for alcohol dependence treatment in Europe.

Design: Systematic and qualitative review; for each country, guidelines were identified via systematic literature research, followed by interviews with treatment experts.

Setting: European Union (EU) countries plus Iceland, Norway, and Switzerland.

Participants: Experts in alcohol dependence treatments and treatment systems.

Measure: Semi-structured questionnaire for interviews.

Findings: While fewer than half of EU countries have formal national guidelines for alcohol dependence treatment, a majority of these countries have guidelines by professional organizations such as psychiatric or neuropsychopharmacologic societies, and several are currently developing such guidelines. Abstinence is the usual treatment goal, but the majority of countries accept reduction of drinking as an intermediate or secondary goal, in practice even more than in the guidelines. Psychotherapy, mainly cognitive-behavioral approaches, motivational interviewing, and family therapy, is the most common treatment for relapse prevention, in part accompanied by pharmacotherapy (disulfiram, acamprosate and naltrexone being used most often).

Conclusions: There are differences in treatment for alcohol dependence in Europe. The introduction of reduction of drinking as one treatment goal may attract more patients.


Keywords


alcohol dependence, treatment, abstinence, reduced drinking, pharmacotherapy

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DOI: http://dx.doi.org/10.7895/ijadr.v2i2.89

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