Treatment of alcohol use disorder: position paper of the Società Italiana di Alcologia (SIA)

1Italian Society of Alcohology

2Rimini Addiction Treatment Unit, Department of Mental Health and Addiction, Romagna Local Health Agency, Italy

3Centre for the Study and Treatment of Alcohol-Related Diseases, Department of Translational Medicine, University of Ferrara, Ferrara, Italy

4Department of Internal Medicine, SS Annunziata Hospital, University of Ferrara, Cento (Ferrara), Italy

5Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato (CA), Italy

6Alcohol Unit, Addiction Department, Torino, Italy

7Gastroenterology Unit, Mauriziano Hospital, Turin, Italy

8Salerno Addiction Treatment Unit, Department of Addiction, Local Health Agency, Italy

9Unit of Addiction and Hepatology, Alcohological Regional Center, ASL3 c/o Polyclinic San Martino Hospital, Genova, Italy

10Alcohol Unit, Bari, Italy

11Unit of Health Promotion, Epidemiology, and Government of Territorial Demand, ASST Fatebenefratelli, Milan, Italy

12National Observatory on Alcohol, National Institute of Health, Rome, Italy

13Alcohol Unit, ASL2 Savonese, Savona, Italy

14Addiction Rehab Unit, Department of Rehabilitation, Santa Marta Hospital, Rivolta d’Adda, ASST Crema, Italy

15Alcohol Unit, Pordenone, Italy

16Parco dei Tigli Nursing Home, Teolo-Padova, Italy

17Addiction Unit, Department of Addiction, Bergamo, Italy

18Urbino Addiction Treatment Unit, Department of Addiction, AST Pesaro Urbino, Italy

19Alcohol Department Unit of Alcohol and Life Style, and Tuscany Regional Alcohol Centre, Careggi University Hospital of Firenze

20Department of Internal Medicine, Mater Dei Hospital, Bari, Italy

21Alcohol Unit, ASST Fatebenefratelli, Sacco Hospital, Milan, Italy

22Addiction Unit, Department of Addiction, Local Health Agency, Torino, Italy

Alcohol use disorder (AUD) is frequent globally and is responsible for more than 5% of the global burden of disease and mortality. Despite this, less than 10% of people with AUD receive specialist treatment and less than 10% of people with risky drinking receive specific medical advice. The present paper highlights the recommendations of the Italian Society of Alcohology (SIA) for the treatment of AUD.

Multidisciplinary treatment in the outpatient setting is considered the best therapeutic option for AUD to improve recovery and reduce or eliminate alcohol consumption.

Several psychosocial treatments have proven efficacy, in particular brief intervention, motivational enhancement treatment, and various behavioral treatments; moreover, systemic family psychotherapy can play a key role when a patient’s family is involved.

Different pharmacological treatments are approved for the treatment of AUD in developed countries, and some off-label treatments have good levels of evidence. Since these pharmacological agents have different characteristics and present evidence of efficacy for different therapeutic goals, personalized pharmacotherapy is necessary. For this purpose, a specific algorithm of choice is presented.

For patients resistant to outpatient treatment and with severe AUD, inpatient treatment in specific alcohol rehabilitation centers can be useful to improve recovery.

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Publication history:

Submission date: 16th Oct, 2023
Revised on: 2nd Nov, 2023
Accepted on: 4th Dec, 2023
Published online: 2nd May, 2024

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