How to Treat Hazardous Alcohol Consumption? Which Method is Better, Combination of Pharmacotherapy and Brief Psychological Intervention OR Pharmacotherapy Alone?
2018
Aim Since 1980, WHO recommended primary-care-physicians to offer “brief intervention (BI).” From 1990 onwards, family therapist started improving various methods of BI. We wanted to evaluate the effect when BI and medicines are given simultaneously. Dilemma prevailed on the selection of the type of BI, because of lack of available study. Materials and Methods Patients were selected randomly from out-patient department (OPD) to undertake a pilot study. A total of 40 patients were included from the consecutive 3 months’ OPD. Patients were divided into six groups, depending on history and clinical picture of patient at the time of inclusion (similar to “project matching”). One group was treated by only pharmacotherapy, while other five groups were treated by different types of BIs along with pharmacotherapy. Immediate and maintenance (till 6 months) effect of therapeutic intervention were noted. Change in hazardous alcohol drinking to sensible drinking was aimed at. However, an assessment criterion was set as abstinence or no abstinence from alcohol drinking. Results About 10 patients were dropped out of 40, 13 were offered only pharmacotherapy and remaining 27 were offered psychotherapy and pharmacotherapy jointly. Out of 27, motivational interview was offered to 13, eclectic therapy to five, dialectic behavioral therapy to four, brief systemic family therapy to three, and paradoxical intervention to two. Among them, five out of 13 patients and 21 out of 27 patients showed immediate abstinence and one out of 13, 12 out of 27 patients maintained abstinence for 6 months. Discussion Decreased dropout rate and increased relief were attributed to BI when used with medicine. Which mean that BI works synergistically with medicine. Motivational interview was the result-oriented technique among other types. The motivational interview was a better technique than eclectic therapy which is commonly used. Conclusion This study encourages larger study worth to be undertaken to evaluate many details of conjoint effect of MI and pharmacotherapy to treat alcohol addiction.
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