Substance misuseAdvances in the treatment of alcohol dependenceSchmidt, Lutz G.Author Information Department of Psychiatry, University of Mainz, Mainz, Germany Correspondence to Prof. Dr Lutz G. Schmidt, Department of Psychiatry, University of Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany. Tel: +49 6131 177335; fax: +49 6131 229974; e-mail: [email protected] Abbreviations CBT: cognitive-behavioral treatment MATCH: Matching Alcoholism Treatments to Client Heterogeneity Current Opinion in Psychiatry: May 2002 - Volume 15 - Issue 3 - p 255-260 Buy Abstract Psychosocial therapies can help many alcohol-dependent patients reduce their drinking and maintain abstinence. These approaches alone, however, are not effective for all patients. Advances in neuroscience have helped identify many of the mechanisms underlying transition to dependence, paving the way for improved treatment options through the use of medication. Recent treatment studies with alcoholics have improved our knowledge on how to use therapeutic measures more precisely. Matching of anticraving/antidipsotropic drugs with treatment settings could improve therapeutic outcome. Naltrexone (blocking positive reinforcement by ethanol) seems to be especially effective when used in conjunction with instructions on drinking (harm) reduction; however, acamprosate (blocking negative reinforcement of conditioned alcohol withdrawal) seems to work well in settings with strict abstinence goals. Investigations are currently under way to test the efficacy of combinations like naltrexone/acamprosate with antidepressants. Psychosocial co-intervention trials and practice require further standardization. © 2002 Lippincott Williams & Wilkins, Inc.