How good is....

❝ alcohol is the most commonly used drug - by some way ❞

What can I expect from an alcohol treatment programme?

Benchmark :: UK Alcohol Treatment

This benchmark shows the outcomes from a large multi-centre study in UK alcohol treatment services.  The study compared a motivational intervention and a social network intervention combined with some CBT elements, considered the best treatments available. All the charts show averages - some people do much better and some not so well. After treatment people tended to drink less on their drinking days.

The charts show dependence reducing over time. On average, consumption, that is drinks per drinking day (DDD), are reduced and more or less hold steady (a drink = 1 unit of alcohol).

In our opinion...

❝ a motivational style should be the norm for all practitioners ❞

❝ practitioners in the USA more often aim for an abstinence goal ❞

❝ good outcomes are far more likely with support from family and friends ❞

What if depression is part of my addiction?

Benchmark :: Treatment of Psychological Distress

Psychological distress, may mimic depression or be a consequence of dependence, and commonly co-exists with drug and alcohol use. This study looked at the use of two psychological treatments for depression in a busy community setting. The charts show significant improvements in both percentage of days abstinent (PDA) and depression (PHQ9) scores. Further improvement would be expected over time.

In our opinion...

❝ dependence often causes psychological distress - abstinence is usually the best first step ❞

❝ experienced practitioners are needed to make accurate diagnoses ❞

❝ antidepressants are rarely a solution to this kind of depression ❞

What medications are available?

Benchmark :: Pharmacological Relapse Prevention Medication

There are three accepted relapse prevention medications for alcohol.

  • Acamprosate (Campral™️) mimics some of the effects of alcohol in the brain and it is claimed thereby reduces craving. There are no negative effects from drinking on top of acamprosate.

  • Naltrexone (Nalorex™) blunts the pleasurable effects of drinking and thereby makes continued drinking less likely. The main pharmacological effects only happen during periods of drinking.

  • Disulfiram (Antabuse™) takes away the desire to drink by changing expectations about drinking. Drinking on top of disulfiram causes an unpleasant, potentially dangerous reaction (sweating, heart pounding, nausea).

The charts compare the three relapse prevention medications. The differences are described as small, moderate or large as compared to taking a placebo (inactive tablets).

In our opinion...

❝ disulfiram is the best medication to support an abstinence goal ❞

❝ one reason people drop out of abstinence programmes is that they decide against abstinence ❞

❝ it is helpful to take naltrexone in anticipation of a high risk situation or planned drinking ❞

How good are medications to stop me drinking?

Benchmark :: Pharmacological Aids to Abstinence

The research looked at best practice (a psychological treatment + medication). The charts show the number of days abstinence and drinking for supervised (best practice) and self administered medication.

In our opinion...

❝ the side effect profile of disulfiram is not a barrier❞

❝ dietary constraints of disulfiram are not a barrier ❞

❝ taking of relapse prevention medications should be supervised ❞

❝ relapse prevention medications are not interchangeable - each has its use ❞