Getting alcoholics out of your office, into treatment, and back to your office

There have been important expansions in knowledge about alcohol recently. In this chapter a number of advances pertinent to the family practitioner are summarized. However, technology is not our focus. We are talking first about troubled people. The applications of research may help such people in practice. However, our main concern is for the patients and their families as a primary care practitioner rightly should be. Therefore, scientific study results are interspersed among the sections on a variety of clinical concerns. Alcohol abuse and alcoholism are family affairs. Families are complex interactive systems that serve to maintain themselves and their members. Under certain conditions the powerful forces at work within a family can promote the use of alcohol as an effort to solve problems. This chapter has discussed some methods which may be used to change them. Alcohol also presents a number of specialized problems that may occur in family practice. We include recent modifications in the treatment of withdrawal. Another syndrome increasingly observed is that of the effects of alcohol on the human fetus. The interesting but less usual manifestations of alcoholism are also noted in passing.