Treating Alcoholism between Harm Reduction and Immediate Abstinence

Dear Colleagues,

Alcohol is one of the most important risk factors for health and is a major cause of death and morbidity; notwithstanding, 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 reduction of damage”.
What can represent a partial result for the operator (e.g., reduction of alcohol consumption rather than abstinence) is the only objective, which is, for the patient, at this moment, possible.
For years, these two strategies have been considered as opposite poles of different philosophies of intervention, one bound to the search for methods that lead the subject to complete abstinence, while the other prioritises a decrease in the use, with maximum reduction in the damage correlated with its use.
Reducing alcohol consumption has an immediate positive impact on the health of the at-risk-drinker.
Reduction of alcohol intake does not require any particular setting, but does require the collaboration between the general practitioner, specialized services for addiction, alcohology services, and psychiatry.
In patients who reach this target, significant savings in terms of health and social costs can be achieved. Reduction of harm 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, to remove the shadows of social judgment and to aim for a course of treatment towards absolute abstention. In fact, when abstention is not considered the ideal therapeutic target for a given patient because he/she is unwilling to accept it, which therefore represents a de facto barrier to treatment, new therapeutic modalities should be identified and integrated approaches that motivate patients towards a path of individualized treatment should be considered.

This Special Issue is open to any subject area of public health, economics and policy related to the alcohol treatment focusing on the importance of a “harm reduction” strategy. The listed keywords suggest just a few of the many possibilities.

Prof. Dr. Icro Maremmani
Guest Editor

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