ABSTRACT
This chapter addresses some of the clinical aspects which have encountered while treating alcoholics in an inpatient setting. It summarizes some of the philosophical and practical aspects of Alcoholics Anonymous (AA) treatment. An understanding of this treatment modality is crucial for the physician to effectively treat psychiatric illness in an alcoholic. The use of medications by alcoholics can symbolically recruit memories of self-medication with alcohol, and often causes friction with AA groups. The chapter addresses the identification and treatment of alcoholics with coexisting major depressive illness. Physicians are well aware that alcohol intoxication can mimic acute mania, and detoxification should be completed before a manic diagnosis is entertained. The schizophrenic patient with alcoholism presents a very difficult and often tragic treatment dilemma. Most alcoholics complain of anxiety and have used alcohol to deal with this feeling. Many alcoholics, however, have panic disorder with incapacitating panic attacks and anticipatory anxiety.
