Treatment of alcohol problems: where are we at?

Cate Swannell
Med J Aust
Published online: 4 October 2021

SCALING up the treatment of alcohol problems will lead to considerable health benefits across the nation, according to the authors of an editorial and Supplement published today by the Medical Journal of Australia.

Professor Paul Haber, Clinical Director of Drug Health Services, Sydney Local Health District, and professor of Addiction Medicine at the University of Sydney’s Central Clinical School, and colleagues, wrote that unhealthy alcohol use “is linked to about 150 000 hospital admissions and 6000 deaths per annum, and remains the most common substance use problem seen in specialist treatment services” in Australia.

“Therefore, identifying and effectively managing alcohol problems remains critical.”

Australian guidelines for the treatment of alcohol problems have been updated recently, with a recognition that certain population groups had not been carefully considered in previous versions.

“Alcohol problems are not distributed equally through the population, being more common among those with a family history, in men, among those living outside the metropolitan areas, and among individuals and populations exposed to high levels of trauma and stress, especially adverse childhood experiences,” wrote Haber and colleagues.

“Routine clinical assessment typically detects severe cases but misses out on the less severely affected. It is the treatment of less severe cases that has the greatest potential to prevent lifethreatening complications.

“Treatment of alcohol use disorders can be undertaken in primary care settings. Brief interventions are easily offered in primary care or other health care settings and can be effectively delivered online.

“Furthermore, a number of culturally specific strategies for engagement have evolved to assist members of specific communities with alcohol problems. Thus, the full guidelines include sections on screening, brief interventions, and eight chapters dedicated to the treatment of specific populations.”

The MJA Supplement -- New Australian guidelines for the treatment of alcohol problems: an overview of recommendations – has five sections:

  • Guidelines for the treatment of alcohol problems: an introduction – by Benjamin Riordan, Post Doctoral Researcher in Addiction Medicine at the University of Sydney and the Centre for Alcohol Policy Research at La Trobe University, and colleagues;
  • Screening and assessment for unhealthy alcohol use – by Professor John Saunders, a consultant physician in internal medicine and addiction medicine, and colleagues;
  • Caring for and managing patients with alcohol problems: interventions, treatments, relapse prevention, aftercare, and long term follow-up – by Professor Leanne Hides, Chair of Alcohol, Drugs and Mental Health at the University of Queensland, and colleagues;
  • Providing appropriate treatment and care to people with alcohol problems: a summary for key specific populations – by Associate Professor Carolyn Day, from the University of Sydney, and colleagues; and,
  • Understanding and managing comorbidities for people with alcohol problems: polydrug use and dependence, co-occurring mental disorders, and physical comorbidities – by Associate Professor Michael McDonough, Director of Outpatient Services at Drug and Alcohol Services SA, and colleagues.

“Improving the efficacy and implementation of comprehensive and effective treatment is a priority and has the potential to save lives and return value to the community,” Haber and colleagues wrote.

“This will require expansion of discovery and translational research, clinical training and advocacy.

“Clinicians, services and government now face the challenge to implement the treatment recommended in the guidelines. With almost 5% of the national burden of disease and injury attributable to alcohol, investing in scaling up treatment of alcohol problems will undoubtedly be associated with considerable health benefit across the nation,” they concluded.

The full guidelines for the treatment of alcohol problems are available at:  

  • Cate Swannell



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