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- 23 Июн 2007
- Сообщения
- 3,161
www.healthinsite.gov.au/topics/Trea...lcohol_Problems
www.aihw.gov.au/publications/index.cfm/title/11500
www.dassa.sa.gov.au/webdata/resourc...onograph_17.pdf
www.bap.org.uk/pdfs/BAP_Guidelines.pdf
Despite its long and widespread use in alcohol dependence
treatment, there are few controlled clinical trials. In recent reviews,
disulfiram was reported to reduce the number of drinking days and
reduce the quantity of alcohol consumed, but not increase
abstinence (Hughes and Cook, 1997; Garbutt et al., 1999) (1b).
However, there was diversity in the subjects studied and methodologies
used, making comparisons and recommendations difficult.
Witnessing, or supervising, the taking of disulfiram is important
for its efficacy (Chick et al., 1992; Hughes and Cook, 1997;
Slattery et al., 2003) (1a). When prescribed with no supervision,
disulfiram is no better than basic support. There is little evidence
to guide how long patients should receive disulfiram but, generally,
3–6 months is advocated, or for as long any benefits are
maintained.
Evidence does not support the use of disulfiram implants,
although there are now newer formulations that may deliver higher
doses of disulfiram (Hughes and Cook et al., 1997; Garbutt et
al., 1999) (1b).
***
Alcoholics Anonymous (AA) is the most ubiquitous form of
self-help group available worldwide. Project MATCH found AA
attendance predicted a better long-term outcome, particularly
in those lacking a non-drinking support network (Project
MATCH, 1998). However, a meta-analysis of randomized and
non-randomized trials showed that attending AA resulted in worse
outcomes than comparator treatments or no treatment (Kownacki
and Shadish, 1999). Critically, this result was heavily influenced
by trials in which patients were mandated to attend AA. In light of
this, Slattery et al. (2003) gave a strong recommendation that
patients should be introduced to AA, and encouraged to attend, but
not mandated to attend.
_______________________________________________
Дисульфирам назначают в разнообразных комбинациях с другими, в основном, психоактивными веществами, но не "кодируют с провокацией", как это практикуется в странах экс-СССР. Сожалею, если тебе "не по зубам" АА, то обратись просто к наркологу/аддиктологу, таблеточки назначат, детокс и реабилитацию проведут. А там, глядишь, и controlled drinking'у научат- результат неясен.
Одно могу обещать однозначно: "лёгкого пути" типа "укола на 5 лет, с провокацией" не будет и в России. Результат любого лечения (как и посещений АА) будет зависеть от твоего желания:
захочешь бросить, мотивация появится и желание искреннее- обязательно бросишь. Пока не напилась- будешь пить; зависимость так просто никого не отпустит- к старым временам возврата нет.
Удачи!
www.aihw.gov.au/publications/index.cfm/title/11500
www.dassa.sa.gov.au/webdata/resourc...onograph_17.pdf
www.bap.org.uk/pdfs/BAP_Guidelines.pdf
Despite its long and widespread use in alcohol dependence
treatment, there are few controlled clinical trials. In recent reviews,
disulfiram was reported to reduce the number of drinking days and
reduce the quantity of alcohol consumed, but not increase
abstinence (Hughes and Cook, 1997; Garbutt et al., 1999) (1b).
However, there was diversity in the subjects studied and methodologies
used, making comparisons and recommendations difficult.
Witnessing, or supervising, the taking of disulfiram is important
for its efficacy (Chick et al., 1992; Hughes and Cook, 1997;
Slattery et al., 2003) (1a). When prescribed with no supervision,
disulfiram is no better than basic support. There is little evidence
to guide how long patients should receive disulfiram but, generally,
3–6 months is advocated, or for as long any benefits are
maintained.
Evidence does not support the use of disulfiram implants,
although there are now newer formulations that may deliver higher
doses of disulfiram (Hughes and Cook et al., 1997; Garbutt et
al., 1999) (1b).
***
Alcoholics Anonymous (AA) is the most ubiquitous form of
self-help group available worldwide. Project MATCH found AA
attendance predicted a better long-term outcome, particularly
in those lacking a non-drinking support network (Project
MATCH, 1998). However, a meta-analysis of randomized and
non-randomized trials showed that attending AA resulted in worse
outcomes than comparator treatments or no treatment (Kownacki
and Shadish, 1999). Critically, this result was heavily influenced
by trials in which patients were mandated to attend AA. In light of
this, Slattery et al. (2003) gave a strong recommendation that
patients should be introduced to AA, and encouraged to attend, but
not mandated to attend.
_______________________________________________
Дисульфирам назначают в разнообразных комбинациях с другими, в основном, психоактивными веществами, но не "кодируют с провокацией", как это практикуется в странах экс-СССР. Сожалею, если тебе "не по зубам" АА, то обратись просто к наркологу/аддиктологу, таблеточки назначат, детокс и реабилитацию проведут. А там, глядишь, и controlled drinking'у научат- результат неясен.
Одно могу обещать однозначно: "лёгкого пути" типа "укола на 5 лет, с провокацией" не будет и в России. Результат любого лечения (как и посещений АА) будет зависеть от твоего желания:
захочешь бросить, мотивация появится и желание искреннее- обязательно бросишь. Пока не напилась- будешь пить; зависимость так просто никого не отпустит- к старым временам возврата нет.
Удачи!
