Harm Reduction as “Continuum Care” in Alcohol Abuse Disorder

Icro Maremmani, Mauro Cibin, Pier Paolo Pani, Alessandro Rossi and Giuseppe Turchetti
Additional contact information
Icro Maremmani: Vincent P. Dole Dual Disorders Unit, Department of Neurosciences, Santa Chiara University Hospital, University of Pisa, Pisa 56126, Italy
Mauro Cibin: Mental Health and Addictive Behaviors Department, Local Health Authority, Venice 30010, Italy
Pier Paolo Pani: Social and Health Services, Health District 8 (Local Health Authority), Cagliari 09121, Italy
Alessandro Rossi: Italian Society of General Practitioners, Firenze 50142, Italy
Giuseppe Turchetti: Institute of Management, ©Scuola Superiore Sant’Anna, Pisa 56126, Italy

IJERPH, 2015, vol. 12, issue 11, 1-14

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.

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 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2015
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