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Study Says Doctors, Nurses Can Curtail Patients' Problem Drinking

Posted on: Saturday, 6 May 2006, 12:00 CDT

By Diana Heil, The Santa Fe New Mexican

May 6--Doctors and nurses can achieve the same results as specialized outpatient-treatment programs in curtailing problem drinking, according to an article published this week in The Journal of the American Medical Association .

"There's a whole lot that can be done in primary care," said William Miller, a distinguished professor of psychology and psychiatry at The University of New Mexico who helped with the research. "Nine out of 10 people never get to a specialized treatment program, but they do get to a doctor."

"It's about options," Miller continued. "It really opens up another way, an effective way, for treating a life-threatening illness that might otherwise go untreated."

During the study of 1,300 patients at 11 sites, including UNM's Center of Alcohol and Substance Abuse Addictions, researchers tried various approaches for treating people with alcohol dependence over 16 weeks, then followed up with participants a year later to find out what worked.

Patients who had nine brief visits with a doctor or nurse while taking naltrexone -- a prescription drug that blocks the feeling of pleasure associated with alcohol -- and patients who received up to 20 sessions of specialized alcohol counseling demonstrated the best outcomes, according to the study. During specialized alcohol treatment, patients learned skills for living without alcohol from behavioral-health counselors, and they were encouraged to attend Alcoholics Anonymous meetings. On average, patients in the study attended 10 sessions. Under the medical-management model, patients received medications to curb alcohol cravings from a doctor and returned for a series of 15-minute visits, during which a doctor or a nurse monitored the effects of the medication and encouraged the patients to attend AA meetings.

Both strategies worked equally well, Miller said.

What didn't work at all was acamprosate, a drug used to treat alcoholism that had tested well in numerous European studies.

Miller said alcoholism is a chronic condition that should be addressed by doctors, though doing so will require a change in thinking in the United States. The prevalence of alcohol dependence in patients who see a primary-care or family-practice doctor ranges from 20 percent to 36 percent; most of those patients are never treated, according to the article.

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Copyright (c) 2006, The Santa Fe New Mexican

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Source: The Santa Fe New Mexican

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