7. Alcohol-Use Disorders – Treatment and Management

  1. Hamid Ghodse3,
  2. Helen Herrman4,
  3. Mario Maj5 and
  4. Norman Sartorius6
  1. Filippo Passetti1 and
  2. Colin Drummond2

Published Online: 18 MAR 2011

DOI: 10.1002/9780470975084.ch12

Substance Abuse Disorders

Substance Abuse Disorders

How to Cite

Passetti, F. and Drummond, C. (2009) Alcohol-Use Disorders – Treatment and Management, in Substance Abuse Disorders (eds H. Ghodse, H. Herrman, M. Maj and N. Sartorius), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470975084.ch12

Editor Information

  1. 3

    International Centre for Drug Policy, St George's University of London, London, UK

  2. 4

    Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia

  3. 5

    Department of Psychiatry, University of Naples SUN, Naples, Italy

  4. 6

    Association for the Improvement of Mental Health Programmes, Geneva, Switzerland

Author Information

  1. 1

    Division of Mental Health, St George's University of London, London SW17 0RE, UK

  2. 2

    National Addiction Centre, Institute of Psychiatry, King's College London, London SE5 8BB, UK

Publication History

  1. Published Online: 18 MAR 2011
  2. Published Print: 18 MAR 2009

Book Series:

  1. World Psychiatric Association Evidence and Experience in Psychiatry Series

Book Series Editors:

  1. Helen Herrman

Series Editor Information

  1. WPA Secretary for Publications, University of Melbourne, Australia

ISBN Information

Print ISBN: 9780470745106

Online ISBN: 9780470975084



  • alcohol-use disorders - treatment and management;
  • alcohol-use disorders, along continuum of severity - hazardous drinkers, at risk of experiencing alcohol-related problems;
  • notion of a spectrum of severity - and range of treatment approaches;
  • range of severity of alcohol problems - and treatment approaches;
  • stepped care for alcohol-use disorders - in nonspecialist health services;
  • personal responsibility and informed choice - acronym FRAMES, effective brief interventions;
  • Alcohol Use Disorders Identification Test (AUDIT) - primary care, accident and emergency departments;
  • treatment of alcohol dependence - treatment of harmful/hazardous drinkers, realm of specialist services;
  • pharmacological interventions - maintenance of abstinence or attenuation of drinking behaviour;
  • treatment of alcohol dependence - shifting towards community-based services


Alcohol use disorders exist on a continuum of severity from hazardous and harmful drinking through to varying degrees of alcohol dependence. It therefore follows that people with alcohol use disorders presenting to a wide range of medical and social care settings have a wide spectrum of need which requires a spectrum of responses. There is good evidence that hazardous and harmful drinkers who are identified in medical settings by opportunistic screening respond well to brief interventions, which can range from 5 min of advice through to 30 min of extended counselling. People presenting with alcohol dependence will usually require more intensive specialist treatments which include psychosocial and pharmacological interventions either in the community or residential settings. The benefits of stepped care intervention, in which intensive treatments are reserved for people not responding to less intensive interventions, are emphasized as a resource efficient clinical pathway for treatment of alcohol use disorders.