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 Centre for Addiction and Mental Health; University of Toronto; Technische Universitaet Dresden
  • Maximilien Rehm Ryerson University
  • Hannu Alho University of Helsinki
  • Allaman Allamani Agenzia Regionale di Sanità
  • Henri-Jean Aubin Hôpitaux Universitaires Paris-Sud
  • Gerhard Bühringer Technische Universitaet Dresden; IFT Institut für Therapieforschung
  • Jean-Bernard Daeppen Lausanne University Medical School
  • Ulrich Frick Psychiatric University Hospital
  • Antoni Gual Unitat d'Alcohologia, Hospital Clinic
  • Nick Heather Northumbria University
Keywords: alcohol dependence, treatment, abstinence, reduced drinking, pharmacotherapy

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.

Author Biographies

Jürgen Rehm, Centre for Addiction and Mental Health; University of Toronto; Technische Universitaet Dresden

Social and Epidemiological Research (SER) Department, Centre for Addiction and Mental Health, Toronto, Canada

Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada

Institute of Medical Science, University of Toronto, Toronto, Canada

Technische Universitaet Dresden, Klinische Psychologie & Psychotherapie, Dresden, Germany

Maximilien Rehm, Ryerson University
Ryerson University, Faculty of Arts and Sciences/Politics and Governance, Toronto, Canada
Hannu Alho, University of Helsinki

Unit of Substance Abuse Medicine, Faculty of Medicine and Helsinki University Hospital, University of Helsinki, Helsinki, Finland

Allaman Allamani, Agenzia Regionale di Sanità
Agenzia Regionale di Sanità, Firenze, Italy
Henri-Jean Aubin, Hôpitaux Universitaires Paris-Sud
Hôpital Paul Brousse, Hôpitaux Universitaires Paris-Sud, AP-HP, INSERM U 669, University Paris-Sud, Paris, France
Gerhard Bühringer, Technische Universitaet Dresden; IFT Institut für Therapieforschung
Technische Universitaet Dresden, Klinische Psychologie & Psychotherapie, Dresden, Germany
IFT Institut für Therapieforschung, Munich, Germany
Jean-Bernard Daeppen, Lausanne University Medical School

Alcohol Treatment Center, Lausanne University Medical School, Lausanne, Switzerland 

Ulrich Frick, Psychiatric University Hospital
Psychiatric University Hospital, Regensburg, Germany
Antoni Gual, Unitat d'Alcohologia, Hospital Clinic
Unitat d'Alcohologia, Hospital Clinic, Barcelona, Spain
Nick Heather, Northumbria University
Faculty of Health & Life Sciences, Northumbria University, Newcastle Upon Tyne, United Kingdom
Published
2013-03-26
How to Cite
Rehm, J., Rehm, M., Alho, H., Allamani, A., Aubin, H.-J., Bühringer, G., Daeppen, J.-B., 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. https://doi.org/10.7895/ijadr.v2i2.89
Section
Article