Alcoholism. Images, impairments, interventions

Diagnosis of alcoholism requires a vigilant attitude and aggressive pursuit of supporting evidence by the primary care physician. Because the alcoholic is characteristically defensive and commonly denies the diagnosis, the physician must be persistent and honest when confronting the patient. Effective treatment is available through programs comprising patient and family education, psychotherapy, medical supervision, involvement in Alcoholics Anonymous, use of disulfiram (Antabuse), and follow-up care. Since the recovering alcoholic is vulnerable to relapse, long-term maintenance of sobriety requires not only abstinence from alcohol but also avoidance of psychoactive and narcotic drugs.