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. 1992 Mar;156(3):273–277.

Management of alcoholism in the primary care setting.

K A Bradley 1
PMCID: PMC1003233  PMID: 1595243

Abstract

Primary care physicians can play an important role in managing alcoholic patients. Identifying and treating alcoholism early, before it has interfered with patients' relationships and work, may increase the likelihood of prolonged recovery. Simple office interventions can help motivate patients to abstain and seek treatment. People who abuse alcohol and are unwilling to abstain can benefit from a recommendation to reduce their intake of alcohol. For alcohol-dependent patients who decide to stop drinking, primary care physicians often can manage withdrawal on an outpatient basis. Selecting an appropriate treatment program for each alcoholic patient is important, and referral to a specialist to assist in matching patients to treatments is often necessary. Primary care physicians also can help prevent relapse. Although disulfiram is of limited value, primary care physicians can support recovery by identifying coexistent psychosocial problems, helping patients to restructure their lives, and ensuring continuity of care.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bradley K. A. Screening and diagnosis of alcoholism in the primary care setting. West J Med. 1992 Feb;156(2):166–171. [PMC free article] [PubMed] [Google Scholar]
  2. Chick J., Lloyd G., Crombie E. Counselling problem drinkers in medical wards: a controlled study. Br Med J (Clin Res Ed) 1985 Mar 30;290(6473):965–967. doi: 10.1136/bmj.290.6473.965. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Disulfiram treatment of alcoholism. American College of Physicians. Ann Intern Med. 1989 Dec 1;111(11):943–945. doi: 10.7326/0003-4819-111-11-943. [DOI] [PubMed] [Google Scholar]
  4. Dorus W., Ostrow D. G., Anton R., Cushman P., Collins J. F., Schaefer M., Charles H. L., Desai P., Hayashida M., Malkerneker U. Lithium treatment of depressed and nondepressed alcoholics. JAMA. 1989 Sep 22;262(12):1646–1652. [PubMed] [Google Scholar]
  5. Edwards G., Orford J., Egert S., Guthrie S., Hawker A., Hensman C., Mitcheson M., Oppenheimer E., Taylor C. Alcoholism: a controlled trial of "treatment" and "advice". J Stud Alcohol. 1977 May;38(5):1004–1031. doi: 10.15288/jsa.1977.38.1004. [DOI] [PubMed] [Google Scholar]
  6. Emrick C. D. A review of psychologically oriented treatment of alcoholism. II. The relative effectiveness of different treatment approaches and the effectiveness of treatment versus no treatment. J Stud Alcohol. 1975 Jan;36(1):88–108. doi: 10.15288/jsa.1975.36.88. [DOI] [PubMed] [Google Scholar]
  7. Fuller R. K., Branchey L., Brightwell D. R., Derman R. M., Emrick C. D., Iber F. L., James K. E., Lacoursiere R. B., Lee K. K., Lowenstam I. Disulfiram treatment of alcoholism. A Veterans Administration cooperative study. JAMA. 1986 Sep 19;256(11):1449–1455. [PubMed] [Google Scholar]
  8. Hayashida M., Alterman A. I., McLellan A. T., O'Brien C. P., Purtill J. J., Volpicelli J. R., Raphaelson A. H., Hall C. P. Comparative effectiveness and costs of inpatient and outpatient detoxification of patients with mild-to-moderate alcohol withdrawal syndrome. N Engl J Med. 1989 Feb 9;320(6):358–365. doi: 10.1056/NEJM198902093200605. [DOI] [PubMed] [Google Scholar]
  9. Holder H. D., Blose J. O. Alcoholism treatment and total health care utilization and costs. A four-year longitudinal analysis of federal employees. JAMA. 1986 Sep 19;256(11):1456–1460. [PubMed] [Google Scholar]
  10. Kraus M. L., Gottlieb L. D., Horwitz R. I., Anscher M. Randomized clinical trial of atenolol in patients with alcohol withdrawal. N Engl J Med. 1985 Oct 10;313(15):905–909. doi: 10.1056/NEJM198510103131501. [DOI] [PubMed] [Google Scholar]
  11. Kwentus J., Major L. F. Disulfiram in the treatment of alcoholism; a review. J Stud Alcohol. 1979 May;40(5):428–446. doi: 10.15288/jsa.1979.40.428. [DOI] [PubMed] [Google Scholar]
  12. McLellan A. T., Luborsky L., O'Brien C. P., Woody G. E., Druley K. A. Is treatment for substance abuse effective? JAMA. 1982 Mar 12;247(10):1423–1428. [PubMed] [Google Scholar]
  13. Miller W. R. Motivation for treatment: a review with special emphasis on alcoholism. Psychol Bull. 1985 Jul;98(1):84–107. doi: 10.1037/0033-2909.98.1.84. [DOI] [PubMed] [Google Scholar]
  14. Pendery M. L., Maltzman I. M., West L. J. Controlled drinking by alcoholics? New findings and a reevaluation of a major affirmative study. Science. 1982 Jul 9;217(4555):169–175. doi: 10.1126/science.7089552. [DOI] [PubMed] [Google Scholar]
  15. Rounsaville B. J., Dolinsky Z. S., Babor T. F., Meyer R. E. Psychopathology as a predictor of treatment outcome in alcoholics. Arch Gen Psychiatry. 1987 Jun;44(6):505–513. doi: 10.1001/archpsyc.1987.01800180015002. [DOI] [PubMed] [Google Scholar]
  16. Rund D. A., Summers W. K., Levin M. Alcohol use and psychiatric illness in emergency patients. JAMA. 1981 Mar 27;245(12):1240–1241. [PubMed] [Google Scholar]
  17. Schuckit M. A. The clinical implications of primary diagnostic groups among alcoholics. Arch Gen Psychiatry. 1985 Nov;42(11):1043–1049. doi: 10.1001/archpsyc.1985.01790340021003. [DOI] [PubMed] [Google Scholar]
  18. Sellers E. M., Naranjo C. A., Peachey J. E. Drug therapy: Drugs to decrease alcohol consumption. N Engl J Med. 1981 Nov 19;305(21):1255–1262. doi: 10.1056/NEJM198111193052105. [DOI] [PubMed] [Google Scholar]
  19. Vaillant G. E. What can long-term follow-up teach us about relapse and prevention of relapse in addiction? Br J Addict. 1988 Oct;83(10):1147–1157. doi: 10.1111/j.1360-0443.1988.tb03021.x. [DOI] [PubMed] [Google Scholar]
  20. Wallace J. Controlled drinking, treatment effectiveness, and the disease model of addiction: a commentary on the ideological wishes of Stanton Peele. J Psychoactive Drugs. 1990 Jul-Sep;22(3):261–284. doi: 10.1080/02791072.1990.10472550. [DOI] [PubMed] [Google Scholar]
  21. Wallace P., Cutler S., Haines A. Randomised controlled trial of general practitioner intervention in patients with excessive alcohol consumption. BMJ. 1988 Sep 10;297(6649):663–668. doi: 10.1136/bmj.297.6649.663. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Whitfield C. L., Thompson G., Lamb A., Spencer V., Pfeifer M., Browning-Ferrando M. Detoxification of 1,024 alcoholic patients without psychoactive drugs. JAMA. 1978 Apr 3;239(14):1409–1410. [PubMed] [Google Scholar]

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