Structured Preparation before Alcohol Detoxification; A Shift from the Current Treatment Paradigm

Abstract

The current treatment paradigm for alcohol dependence of planned medically assisted detoxification and aftercare has two main limitations; (i) only a percentage of people are engaged and exposed to aftercare, which is considered to be the effective treatment component; and (ii) does not take into account the accumulating evidence of the adverse effect of repeated medically assisted detoxifications. The proposed new treatment paradigm of Structured Preparation before Alcohol Detoxification (SPADe) is based on the most recent cognitive theories of addiction and aims to reverse the automatized decision making process, support lifestyle changes and conscious decision making, while amount of alcohol and pattern of drinking are kept stable, before proceeding to medically assisted detoxification. The current paper comments on the Abstinence Preparation Group, which is one of those interventions developed and evaluated following the SPADe paradigm.