title: Harm Reduction as "Continuum Care" in Alcohol Abuse Disorder.
abstract: Alcohol abuse is one of the most important risk factors for health and is a major cause of death and morbidity. Despite this, only about one-tenth of individuals with alcohol abuse disorders receive therapeutic intervention and specific rehabilitation. Among the various dichotomies that limit an effective approach to the problem of alcohol use disorder treatment, one of the most prominent is integrated treatment versus harm reduction. For years, these two divergent strategies have been considered to be opposite poles of different philosophies of intervention. One is bound to the search for methods that aim to lead the subject to complete abstinence; the other prioritizes a progressive decline in substance use, with maximum reduction in the damage that is correlated with curtailing that use. Reduction of alcohol intake does not require any particular setting, but does require close collaboration between the general practitioner, specialized services for addiction, alcohology services and psychiatry. In patients who reach that target, significant savings in terms of health and social costs can be achieved. Harm reduction is a desirable target, even from an economic point of view. At the present state of neuroscientific knowledge, it is possible to go one step further in the logic that led to the integration of psychosocial and pharmacological approaches, by attempting to remove the shadows of social judgment that, at present, are aiming for a course of treatment that is directed towards absolute abstention.
authors.affiliation: Vincent P. Dole Dual Disorders Unit, Department of Neurosciences, Santa Chiara University Hospital, University of Pisa, Pisa 56126, Italy. icro.maremmani@med.unipi.it.|Association for the Application of Neuroscientific Knowledge to Social Aims, AU-CNS, Pietrasanta, Lucca 55045, Italy. icro.maremmani@med.unipi.it.|De Lisio Institute of Behavioral Sciences, Pisa 56126, Italy. icro.maremmani@med.unipi.it.
authors.forename: Icro
authors.initials: I
authors.lastname: Maremmani
authors.affiliation: Mental Health and Addictive Behaviors Department, Local Health Authority, Venice 30010, Italy. m.cibin@libero.it.
authors.forename: Mauro
authors.initials: M
authors.lastname: Cibin
authors.affiliation: Social and Health Services, Health District 8 (Local Health Authority), Cagliari 09121, Italy. pallolo@tin.it.
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Pani
authors.affiliation: Italian Society of General Practitioners, Firenze 50142, Italy. rossi.alessandro@simg.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rossi
authors.affiliation: Institute of Management, ©Scuola Superiore Sant'Anna, Pisa 56126, Italy. giuseppe.turchetti@sssup.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Turchetti
mesh_terms: D000428:Alcohol Drinking; D019973:Alcohol-Related Disorders; D000437:Alcoholism / Q000628:therapy*; D001521:Behavior Therapy; D016739:Behavior, Addictive; D003266:Continuity of Patient Care; D040261:Harm Reduction; D006801:Humans; D009042:Motivation; D011320:Primary Health Care; D011570:Psychiatry; D012307:Risk Factors; D019966:Substance-Related Disorders
keywords: alcohol dependence; alcoholism; anti-craving medications; compliance with treatment; comprehensive treatment; detoxification; economic costs; harm reduction strategy; opioid receptors; public health; reduction in alcohol consumption; stigma