Summary

• Alcohol abuse is a term commonly used to refer to the misuse of alcohol. A number of specifically defined conditions better categorise patterns of alcohol misuse. These include alcohol abuse and dependence (as defined by DSM-IV-TR) and harmful use of alcohol and alcohol dependence (as defined by ICD-10).
• Alcohol dependence is a common psychiatric disorder that is multifactorial in aetiology, chronic in nature, and is associated with a wide variety of medical and psychiatric sequelae.
• Tolerance, withdrawal, impaired control of drinking behaviour, and continued alcohol use despite adverse consequences are some important features of alcohol dependence.
• Alcohol withdrawal syndrome (AWS) can follow cessation or reduction in alcohol consumption. Withdrawal can be a serious medical condition. It is best monitored by use of a structured instrument: the CIWA-Ar. Benzodiazepines are the definitive medical treatment.
• Binge-drinking, alcohol abuse, and mild alcohol dependence may be addressed by brief physician-based interventions.
• Moderate or severe alcohol dependence requires multi-modal treatment. Detoxification in an inpatient or outpatient setting may be necessary. The goal of detoxification is to minimise withdrawal symptoms and to facilitate entry into an ongoing, multi-modal treatment programme directed towards assisting the patient in maintaining abstinence.
• Medications, including naltrexone, acamprosate, and disulfiram, can be successfully utilised for selected patients to improve their chances of initiating and maintaining abstinence.