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Coronavirus disease 2019 (COVID-19) first emerged in China in November 2019. Most governments have responded to the COVID-19 pandemic by imposing a lockdown. Some evidence suggests that a period of isolation might have led to a spike in alcohol misuse, and in the case of patients with alcohol use disorder (AUD), social isolation can favour lapse and relapse. The aim of our position paper is to provide specialists in the alcohol addiction field, in psychopharmacology, gastroenterology and in internal medicine, with appropriate tools to better manage patients with AUD and COVID-19,considering some important topics: (a) the susceptibility of AUD patients to infection; (b) the pharmacological interaction between medications used to treat AUD and to treat COVID-19; (c) the reorganization of the Centre for Alcohol Addiction Treatment for the management of AUD patients in the COVID-19 era (group activities, telemedicine, outpatients treatment, alcohol-related liver disease and liver transplantation, collecting samples); (d) AUD and SARS-CoV-2 vaccination. Telemedicine/telehealth will undoubtedly be useful/practical tools even though it remains at an elementary level; the contribution of the family and of caregivers in the management of AUD patients will play a significant role; the multidisciplinary intervention involving experts in the treatment of AUD with specialists in the treatment of COVID-19 disease will need implementation. Thus, the COVID-19 pandemic is rapidly leading addiction specialists towards a new governance scenario of AUD, which necessarily needs an in-depth reconsideration, focusing attention on a safe approach in combination with the efficacy of treatment. [ABSTRACT FROM AUTHOR]

The article offers an overview of research paper that discussed the women-focused topics including the epidemiology of alcohol use among women, health and behavioral consequences of drinking, prenatal alcohol use and interventions, and enhanced alcohol treatment services. It also mentions the objectives of research to examine the harmful physiological and behavioral effects of alcohol in women.

Non-English-speaking people do not always seek medical care through established institutions. This paper reports a series of deaths in unlicensed alcohol rehabilitation facilities serving Spanish-speaking men. These facilities are informal groups of alcohol abusing men who live together. New members receive various treatments, including administration of ethanol or isopropanol, restraint, and seclusion. We reviewed 42 deaths in unlicensed alcohol rehabilitation facilities in Los Angeles County during the years 2003-2014. Data gathered included age, length of time spent in the facility, blood alcohol and drugs at autopsy, and cause and manner of death. Causes of death included acute alcohol poisoning, alcohol withdrawal, and a variety of other causes. Three cases were considered homicides from restraint asphyxia. The Department of Medical Examiner-Coroner has worked with the police, district attorney, and State Department of Health Services to try to prevent additional deaths in unlicensed alcohol rehabilitation facilities. Nevertheless, prevention has been difficult. [ABSTRACT FROM AUTHOR]

An important factor that has thus far limited the effectiveness of pharmacotherapies for patients with alcohol and opioid dependence is poor adherence to medication regimens. This paper presents a review of issues related to medication adherence in patients with these substance use disorders.A literature review was conducted of English language publications relating to medication adherence among patients with alcohol or opioid dependence.The paper places the topic in the context of adherence difficulties among patients with a variety of chronic medical and psychiatric illnesses. Difficulties measuring adherence are discussed, and strategies to improve medication adherence are reviewed. These include specific interventions that prescribing clinicians can implement in their individual meetings with patients; the use of external reinforcers, such as positive and negative contingencies, and involvement of family members or significant others; and specific prescribing and dosing practices that may improve adherence.As the use of pharmacotherapy for substance-dependent patients increases, rigorous and innovative approaches to encourage medication adherence should be sought. [ABSTRACT FROM AUTHOR]

Background Despite harmful drinking causing a significant burden on global health, there is a large treatment gap, especially in low- and middle-income countries. A major barrier to care is the lack of adequately skilled human resources to deliver contextually appropriate treatments. This paper describes the systematic process used to develop Counselling for Alcohol Problems ( CAP), a brief psychological treatment (PT) for delivery by lay counselors in routine primary care settings to men with harmful drinking in India. Methods CAP was developed using a methodology involving 3 sequential steps: (i) identifying potential treatment strategies; (ii) developing a theoretical framework for the treatment; and (iii) evaluating the acceptability and feasibility of the treatment. Results CAP is a 3-phase treatment delivered over 1 to 4 sessions based on a motivational interviewing ( MI) stance and involves the following strategies: assessment and personalized feedback, family engagement, drink refusal skills, skills to address drinking urges, problem-solving skills and handling difficult emotions, and relapse prevention and management. Data from a case series were used to inform several adaptations to enhance the acceptability of CAP to the recipients and feasibility of delivery by lay counselors of the treatment, for example expansion of the target group to include alcohol-dependent patients and the extension of the delivery settings to include home-based delivery. There was preliminary evidence of the effectiveness of CAP. Conclusions CAP is an acceptable brief PT for harmful drinking delivered by lay counselors in primary care whose effectiveness is currently being tested in a randomized controlled trial based in primary care in Goa, India. [ABSTRACT FROM AUTHOR]

The endogenous opioid system has been implicated in the pathophysiology of alcoholism as it modulates the neurobehavioral effects of alcohol. A variant in the mu opioid receptor gene ( OPRM1), the Asn40Asp polymorphism, has received attention as a functional variant that may influence a host of behavioral phenotypes for alcoholism as well as clinical response to opioid antagonists. This paper will review converging lines of evidence on the effect of the Asn40Asp SNP on alcoholism phenotypes, including: (i) genetic association studies; (ii) behavioral studies of alcoholism; (iii) neuroimaging studies; (iv) pharmacogenetic studies and clinical trials; and (v) preclinical animal studies. Together, these lines of research seek to elucidate the effects of this functional polymorphism on alcoholism etiology and treatment response. [ABSTRACT FROM AUTHOR]

Although comorbid substance use is a common problem in bipolar disorder, there has been little research into options for psychological therapy. Studies to date have concentrated on purely cognitive-behavioural approaches, which are not equipped to deal with the ambivalence to change exhibited by many towards therapy designed to change substance use. This paper provides the first report of an integrated psychological treatment approach for bipolar disorder with comorbid substance use. The intervention reported combines motivational interviewing and cognitive-behavioural therapy to address ambivalence and equips individuals with strategies to address substance use. Across five individual case studies, preliminary evidence is reported to support the acceptability and the feasibility of this approach. Despite most participants not highlighting their substance use as a primary therapy target, all but one exhibited reduced use of drugs or alcohol at the end of therapy, sustained at 6 months' follow-up. There was some evidence for improvements in mood symptoms and impulsiveness, but this was less clear-cut. The impact of social and relationship issues on therapy process and outcome is discussed. The implications of the current findings for future intervention research in this area are considered. Copyright © 2011 John Wiley & Sons, Ltd. Key Practitioner Message [ABSTRACT FROM AUTHOR]

The Addiction Severity Index (ASI) is a multi-dimensional interview used to measure the substance use, health, and social problems of those with alcohol and other drug problems, both at admission to treatment and subsequently at follow-up contacts. This article first discusses the conceptual and practical importance of the ASI's multi-dimensional approach to measuring addiction severity, as illustrated by two case presentations. The second section of the paper reviews how this measurement approach has led to some important findings regarding the prediction and measurement of addiction treatment effectiveness. The third section describes the historical and practical considerations that have changed the instrument over time, details the problems with the instrument, and describes our efforts to correct those problems with the ASI-6. Finally, some recent ASI data collected from over 8,400 patients admitted to a nationally representative sample of U.S. addiction treatment programs are presented. [ABSTRACT FROM AUTHOR]

When Freud first advanced the death drive it was considered a highly controversial theoretical idea. However, with the passage of time it has been slowly gaining support in certain psychoanalytical quarters. This paper aims to demonstrate the clinical usefulness of this theory in accordance with the Freudian and Kleinian model. Although the case history to be discussed is a severe case of alcohol dependence which had, previously, been unresponsive to treatment, many other maladies, both mental and physical, can be better understood in the context of the death drive being the principal motivating factor. [ABSTRACT FROM AUTHOR]

This paper reports on the development and validation of an automated referral system. While a complete answer to the question posed earlier requires a demonstration that treatment gains are maximized, the current study only considers the efficacy of an automated procedure relative to clinical staff assignment. In short, the hypothesis examined is that treatment assignment of inpatient alcoholics can be accomplished via automation without a loss of effectiveness and with greater efficiency, when compared to assignment by a clinical treatment team. Establishing the efficacy of an automated referral system is an initial step toward the maximization of treatment benefits and, consequently, is the focus of the discussion.

This paper describes an inpatient treatment programme specifically designed for normal- weight bulimia nervosa patients who have a co-morbidity marked by alcohol and drug abuse, ’cutting’, repeated overdosing or stealing, or sexual disinhibition (multi- impulsive bulimia). The programme uses a rigorous ward regime and simple behavioural counselling, under the direction of a nurse-counsellor to bring control to the many addictive and self-damaging behaviours. The underlying emotional and personality issues are addressed by focal-interpretive (psychodynamic) and cognitive techniques in both group and individual sessions. Major use is made of creative therapies and reality-orientated therapies. General psychodynamic groups are mixed with focal groups using cognitive techniques. Patients respond well and the improvement in symptomatology is maintained during follow-up. Those patients who describe poor peer relationships in adolescence and who find engagement in psychotherapy difficult, do poorly. [ABSTRACT FROM AUTHOR]

This paper focuses on the specific problem of alcoholism in the husband/father member of the family. Disturbed personality and decompensation hypotheses were not supported by the data. Systems theory alone is inadequate to conceptualize the inconsistency of the alcoholic, and his impact on the family. A combination of systems theory and Hill's (1949) crisis theory was suggested as one view of the alcoholic marriage. Therapeutic implications were derived from this combined theoretical perspective, and were briefly discussed. [ABSTRACT FROM AUTHOR]

Seventy-five years after its first medical use was described, disulfiram's place in treatment is being favourably re-evaluated. This paper reviews its discovery and subsequent development. [Ellis PM, Dronsfield AT. Antabuse's diamond anniversary: Still sparkling on? Drug Alcohol Rev 2013;32:342-344] [ABSTRACT FROM AUTHOR]