[Maintaining abstinence after alcohol detoxification].
"To quit drinking" is not the panacea of alcohol dependence treatment; it is only its first step. Abstinence should be considered more as a mean than a purpose of the after-withdrawal cares. The frequent resistance of the alcoholic patient to undertake in a long term abstinence can be by-passed by suggesting to fix himself renewable terms for periods during which he feels rather confident to raise the bet of a "most accomplished possible" abstinence. To facilitate the realization and the preservation of this abstinence in the best conditions (potentiation of the profits and minimization of the difficulties), a "therapeutic menu" will be proposed to the patient besides a "minimum plan" containing a medical follow-up over one year, with variable frequency of visits according to the evolution and the prescription of one or two anti-craving drugs registered. Psychotherapies using different techniques as Cognitive Behavioural Therapy, group therapy or psychoanalysis could be proposed after a necessary clarification to the patients of the mechanism of action of each and the waited profits. In the final, two thirds of the patients with alcohol dependence fire in one year a profit of their treatments; the practitioner takes, actually, no risk and should propose systematically a project to the only 20% of them who come to consult him.
Batel
Philippe
P
Traitement ambulatoire des maladies de l'alcool, hôpital Beaujon, Clichy. philippe.batel@bjn.aphp.fr
Balester-Mouret
Sylvain
S
D000077443:Acamprosate; D000427:Alcohol Deterrents / Q000627:therapeutic use; D000428:Alcohol Drinking / Q000517:prevention & control*; D000437:Alcoholism / Q000628:therapy*; D000553:Ambulatory Care; D001521:Behavior Therapy; D002985:Clinical Protocols; D015928:Cognitive Behavioral Therapy; D004221:Disulfiram / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D009271:Naltrexone / Q000627:therapeutic use; D010347:Patient Care Planning; D011575:Psychoanalytic Therapy; D011615:Psychotherapy, Group; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012944:Social Support; D013654:Taurine / Q000031:analogs & derivatives / Q000627:therapeutic use; D013695:Temperance
D000427:Alcohol Deterrents; D011619:Psychotropic Drugs; D013654:Taurine; D009271:Naltrexone; D000077443:Acamprosate; D004221:Disulfiram