chapter  30
14 Pages

Alcohol misuse

Pharmacological and psychosocial interventions
WithG. Hussein Rassool

The models of care for alcohol misusers identify four main categories of alcohol misusers who may benefit from some kind of intervention: hazardous drinkers; harmful drinkers; moderately dependent drinkers and severely dependent drinkers. A number of screening tools are available to identify current or potential alcohol problems among service users. The AUDIT can be embedded in a general health questionnaire and is an efficient tool for the detection of hazardous drinking; the FAST is an efficient screening tool for detecting alcohol misuse in the A & E settings and clinical history and physical examination can be used to detect harmful drinking. It is important to carry out an initial or comprehensive assessment to determine the nature and severity of the drinking problems and this would determine the selection of a problem drinker to have detoxification at home or in a community or in-patient detoxification unit. The main objectives of pharmacological interventions in alcohol withdrawal are the relief of subjective withdrawal symptoms, the prevention and management of more serious complications and preparation for more structured psychosocial and educational interventions. The goals of the psychosocial interventions are to complement pharmacological interventions (for example, in detoxification or relapse prevention) and to enable clients to regain stability and a healthier lifestyle.