Nihon Arukoru Yakubutsu Igakkai zasshi = Japanese journal of alcohol studies & drug dependence最新文献

{"title":"[Reduction in alcohol consumption as a treatment goal of alcohol dependence: actual conditions in Okinawa].","authors":"Takahiro Fukuda,&nbsp;Minori Nakai,&nbsp;Masaru Murakami","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In Japan, abstinence has traditionally been considered the sole method of treatment for alcohol dependence. In recent years there have also been reports that a small percentage of alcoholics are able to regain control of their drinking, but thus far there have been few reports in Japan on reducing the amount of alcohol consumed in alcohol dependence. In the present study we therefore conducted a survey of outpatients who were examined on a certain day at 4 general hospitals in Okinawa Prefecture. Of the 421 examinees, 5% of the males and 4% of the females had a score of 20 or more on the Alcohol Use Disorders Identification Test (AUDIT) and were suspected of alcohol dependence. When those suspected of alcohol dependence were asked if they wanted to decrease their level of alcohol consumption, 90% of the males and 78% of the females replied that they wanted to reduce it. We also conducted a survey of the post-discharge outcome of alcohol-dependent inpatients at the National Hospital Organization Ryukyu Hospital. The Hospital is a psychiatric hospital that has a specialized unit for alcohol dependence, and treatment based on cognitive behavioral therapy is conducted there. The results for the outcome 1 year after their discharge from the Hospital of the 116 patients admitted for the treatment of alcohol dependence showed that 31% were able to remain abstinent, 61% were unable to remain abstinent, and 8% had died. The alcohol-related problems of some of those who were unable to remain abstinent had become mild, i.e., they had been able to return to work, their violent behavior while inebriated had improved, etc. Many alcoholics want to reduce the amount of alcohol they consume as a goal of treatment, and some of them actually are able to reduce their alcohol consumption. The details will be left to future research, but it may be possible for a reduction in alcohol consumption to be the goal of treatment for a certain type of alcoholics.</p>","PeriodicalId":79450,"journal":{"name":"Nihon Arukoru Yakubutsu Igakkai zasshi = Japanese journal of alcohol studies & drug dependence","volume":"48 1","pages":"58-63"},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31417434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A survey of alcoholics and their families on controlled drinking as a treatment goal: discussions on new treatment approaches].","authors":"Naotomo Kimura,&nbsp;Tomohiro Shirasaka,&nbsp;Tomonobu Shirasaka,&nbsp;Yuuji Sasaki,&nbsp;Chihiro Kawazoe,&nbsp;Toshikazu Saito","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>To encourage persons with alcoholism to seek treatment or to overcome denial is an important issue to be addressed in the treatment of alcoholism. Recognizing one's own addiction might be the first step in overcoming alcohol abuse. Abstaining from alcohol consumption was found to be the only effective treatment in Japan. Efforts are in place to introduce abstinence therapy as a first step towards overcoming denial. Abstinence therapy is very popular worldwide: however, many people oppose its introduction in Japan. Concern about relapse is the main reason for this apprehension. Therefore, we conducted a survey to assess awareness of sobriety treatment among persons with alcoholism and their families.</p><p><strong>Methods: </strong>Subjects were 109 patients with a diagnosis of alcohol dependence and their families who attended family therapy. To examine the consideration of alcoholics and their families for sobriety treatment, we administered a questionnaire that measured awareness of sobriety treatment.</p><p><strong>Results: </strong>Based on the results of the survey, 24% of workshop participants and 25% of hospital patients were admitted for sobriety treatment. According to the sobriety treatment, 41% of patients and 53% of family members realized the need \"not to drink too much\" (patients who have control over their drinking limit), while 67% of patients and 53% of family members acknowledged \"not to pull out the healthy problem.\" For sobriety treatment, the patients' families tended to focus on the \"patient's attitude toward sobriety,\" \"social status,\" and \"extent of mental dependence.\" The results of \"liver dysfunction,\" \"history of alcohol abuse,\" \"treatment history,\" and \"extent of mental dependence\" are considered important in the decision to initiate sobriety treatment.</p><p><strong>Conclusions: </strong>Attitude toward sobriety, abstinence of patients, and social stability were found to be important factors in the choice of treatment focus. Further investigation is needed for the successful introduction of new treatment methods.</p>","PeriodicalId":79450,"journal":{"name":"Nihon Arukoru Yakubutsu Igakkai zasshi = Japanese journal of alcohol studies & drug dependence","volume":"48 1","pages":"76-84"},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31417436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Reduction in alcohol consumption: therapeutic goal in alcohol dependence treatment].","authors":"Susumu Higuchi,&nbsp;Toshikazu Saito","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Mean per capita consumption of alcohol for Japanese adults has been gradually decreasing for more than15 years, while it still remains at a high level. It is pointed out that those who consume alcoholic beverages become more diversified and that the proportion of male drinkers tends to gradually decrease. On the other hand, it is estimated that the proportion of female drinkers, especially, young generation, remarkably increases. The existing cross-sectional and longitudinal studies suggest that alcohol consumption causes a variety of health- and social-related problems with accelerating increase over the past few decades except for some exceptions. The results from a patient survey show that the number of patients with alcohol dependence who receive medical treatment tends to increase. However, the percentage of patients who receive medical care is estimated to be only 5% of total number of patients with the disease, which means that there exist many untreated patients or potential patients who undergo treatment for complications only. Treatment for alcohol dependence can be divided into psychosocial and pharmacological treatment. The former is a mainstream of the treatment. Although medications available in Japanese clinical practice are limited to so called anti-alcoholic drugs, disulfiram and cyanamide, pharmacological treatment is expected to become more accessible because many potential patients can benefit from pharmacotherapy. Treatment outcomes for alcohol dependence are not necessarily high in Japan as shown by the fact that abstinence rate 1 - 3 years after treatment is 7% - 30%, while mortality rate is extremely high. However, not a few individuals are able to maintain a reduced alcohol consumption, and some are able to do so for a long period of time. It is shown that many risks of health-related problems including cancer, hypertension and intra cerebral haemorrhage and social-related problems including suicide increase with the increasing alcohol consumption in a dose-dependent manner. A certain types of disease including ischemic heart disease and cerebral infarction are indicated to have a J-shaped relationship with alcohol consumption. On the other hand, once alcohol consumption exceeds a certain level, the risks increase with the amount of alcohol consumed. Thus, reduction in alcohol consumption can lead to decrease in a large number of health-related and social-related problems in general population. Many studies indicate that reduction in alcohol consumption in patients with alcohol dependence can also lead to the improvement of these problems. In recent years, in Japan, there have been some discussions as to whether \"harm reduction\" approaches that target reduction in alcohol consumption are needed and the approaches should be aggressively introduced into clinical practice, stimulated by requests from clinicians, the established efficacy of novel therapeutic approaches on reduction in alcohol consumption and trend of va","PeriodicalId":79450,"journal":{"name":"Nihon Arukoru Yakubutsu Igakkai zasshi = Japanese journal of alcohol studies & drug dependence","volume":"48 1","pages":"17-31"},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31419035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effects of alcohol reduction in patients with alcoholic liver disease].","authors":"Naoki Fujita,&nbsp;Motoh Iwasa,&nbsp;Tetsuji Cho,&nbsp;Yasuhiro Saka,&nbsp;Masanori Harada,&nbsp;Yoshiyuki Takei","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79450,"journal":{"name":"Nihon Arukoru Yakubutsu Igakkai zasshi = Japanese journal of alcohol studies & drug dependence","volume":"48 1","pages":"32-8"},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31419036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Survey of physicians and alcohol-dependent patients in regard to the goals of treatment of alcohol dependence].","authors":"Hitoshi Maesato,&nbsp;Hiroshi Sakuma,&nbsp;Mitsuru Kimura,&nbsp;Hideki Nakayama,&nbsp;Tsuyoshi Takimura,&nbsp;Atsushi Yoshimura,&nbsp;Kouji Azukizawa,&nbsp;Minori Nakai,&nbsp;Atsumi Tounai,&nbsp;Takahiro Fukuda,&nbsp;Masatomo Fujie,&nbsp;Masaru Murakami,&nbsp;Takefumi Yuzuriha,&nbsp;Susumu Higuchi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We conducted a survey of alcohol-dependent patients at the time of their first visit and physicians in regard to the goals of treatment of alcohol dependence. There were 99 replies from patients, and replies from physicians related to 64 of the patients' replies were also received, and in 25.0% of them it was judged possible to make reducing the amount of alcohol consumed a temporary or final goal. Having a mild drinking problem, the absence of a personality disorder or mental retardation, the presence of a strong motivation in regard to treatment, etc., were cited as reasons for the physicians' judgments. In addition, the number of diagnostic criteria of the ICD-10 for dependence syndrome that applied was shown to be significantly related to the judgments regarding treatment goals. However, as for Alcohol Dependence Scale (ADS), there was no significant relationship with the treatment goal.</p>","PeriodicalId":79450,"journal":{"name":"Nihon Arukoru Yakubutsu Igakkai zasshi = Japanese journal of alcohol studies & drug dependence","volume":"48 1","pages":"64-9; quiz 70-5"},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31417435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Treatment processes of pre-alcoholism and alcohol dependence targeted towards drinking reduction].","authors":"Atsushi Yoshimura,&nbsp;Hitoshi Maesato,&nbsp;Nobuko Hisatomi,&nbsp;Susumu Higuchi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Since the 1990s, we have suggested the concept of pre-alcoholism which encompasses patients who have drunk a great deal of alcohol leading to alcohol related problems such as health issues, domestic violence, drunken driving and black-outs. Pre-alcoholism excludes alcohol-dependent patients who have experienced continuous drinking or withdrawal symptoms. We have treated many outpatients with pre-alcoholism for several years. Our regimen demands that the patients must be abstinent for half a year at the beginning of their treatment. After half a year they can choose whether they will continue to be abstinent or they will resume drinking with the aim of reducing their total alcohol consumption. The study clarified the character of pre-alcoholism by investigation of the patients' background and re-diagnosis of the patients based on the International Classification of Diseases, 10th Revision (ICD-10). A remarkable ratio of pre-alcoholic patients was diagnosed with alcohol dependence under ICD-10. We classified pre-alcoholic patients into two groups, one diagnosed as having ICD-10-classed alcohol dependence and the other which did not fulfill the ICD-10 diagnostic criteria of alcohol dependence, and examined the therapeutic processes of the two groups. It was shown that most pre-alcoholic patients could finally take required courses of treatment by themselves without regard to diagnosis under ICD-10, even if they chose any treatment and made alcohol related mistakes on the way. Our findings suggested that pre-alcoholic patients, a portion of whom may have exhibited mild alcohol dependence, could select drinking reduction as a primary goal of treatment after a certain period of abstinence.</p>","PeriodicalId":79450,"journal":{"name":"Nihon Arukoru Yakubutsu Igakkai zasshi = Japanese journal of alcohol studies & drug dependence","volume":"48 1","pages":"39-46"},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31417432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Treatment goal of alcohol dependence: reduction in alcohol consumption introduction of the special issue].","authors":"Susumu Higuchi","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79450,"journal":{"name":"Nihon Arukoru Yakubutsu Igakkai zasshi = Japanese journal of alcohol studies & drug dependence","volume":"48 1","pages":"15-6"},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31419034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Treatment outcome of alcoholics in a general hospital alcoholic clinic: effects of adopting moderation as a practical treatment goal].","authors":"Takeo Muto,&nbsp;Takashi Sunami,&nbsp;Sachiko Cho,&nbsp;Aya Miyashita,&nbsp;Aiko Tsurumaru,&nbsp;Takefumi Yuzuriha","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>It's almost 50 years since medical treatment for alcoholism began to be practiced in Japan in 1960s. Since then, treatment goal for alcohol use disorders has always been absolute abstinence, and only severe cases have been treated. Recently, many people are concerned about lifestyle-related diseases, suicides, depression, and drunken-driving accidents. Reduction in alcohol consumption of heavy drinkers began to draw attention, and brief motivational intervention study was launched at last in 2007 in Japan. In 2009 we set up alcohol clinic in a general hospital in order that the alcoholics may get easier access to their treatments. The basic roles of our alcohol satellite clinicare as follows: 1. Assessment and diagnosis of patient's alcohol-related problem are our primary role. 2. Referral to a specialized hospital is offered in case special treatments for alcohol dependence are needed. 3. Our standard treatment is a brief intervention, not exceeding 3 sessions, to enhance the patients' self-efficacy. 4. Our treatment goal is not limited to total abstinence. Moderation of drinking can also be a goal. We examined the treatment outcome to verify these roles and meanings. Of all the patients visited this hospital from 2009 to 2011, 77 patients were diagnosed as alcohol dependent. Out of those 77 patients, 21 patients set up a moderation of drinking as their temporal treatment goal and 10 achieved good outcome at the inquiry point of 8 to 41 (average: 22) months after intervention. This result suggests that moderation can be a practical treatment goal in some alcoholics.</p>","PeriodicalId":79450,"journal":{"name":"Nihon Arukoru Yakubutsu Igakkai zasshi = Japanese journal of alcohol studies & drug dependence","volume":"48 1","pages":"47-57"},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31417433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Does participating in AA decrease the risk for suicide in alcohol dependence?].","authors":"Shogo Hashimoto,&nbsp;Takeshi Ashizawa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>It is well-known that presence of alcohol dependence increases the risk for suicide. But it is not understood how the risk for suicide in alcohol dependence is decreased. This study aimed to show that participating in Alcoholics Anonymous (AA) decreased, the risk for suicide in alcohol dependence. Sixty four participants in this survey were collected from voluntary AA members in Hokkaido area. They answered self-reporting questionnaires with regard to gender, age, living with family, marriage, jobs, histories of attending AA meetings, familial histories about alcohol dependence, duration of abstinence, and suicidal phenomena which were pre-suicidal thoughts, suicidal thoughts, suicidal plans, suicidal attempts were retrospectively asked before and after becoming AA members. Participating in AA caused a significant decrease (p < 0.001) in the risk for suicidal phenomena in alcohol dependence. Psychosocial treatments usually acknowledged spirituality, but might not address them directly. We referred to spirituality in AA and Japanese spirituality. We discussed the relation between spirituality in AA and prevention of suicide.</p>","PeriodicalId":79450,"journal":{"name":"Nihon Arukoru Yakubutsu Igakkai zasshi = Japanese journal of alcohol studies & drug dependence","volume":"47 6","pages":"308-16"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31282219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Investigation of patients suspected of drinking, who visited emergency department, and their negative influence on emergency medical system].","authors":"Mikine Shibayama,&nbsp;Tetsuji Cho,&nbsp;Aro Ino","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We investigated the nature of patients who have a pathological drinking problem visiting the emergency department (ED). During the investigation period, 107 (1.2%) of 8,812 referred patients, including children, were suspected of having consumed alcohol by the medical staff in the ED on the basis of the interview, the smell of alcohol on the patient's breath, pre-hospital information, etc. One hundred and seven patients were divided into either of the two groups, \"problem drinkers\" or \"others\". When the patient fulfilled at least one of the following conditions, he/she was categorized as a \"problem drinker\". The conditions were either drunken patients who did not cooperate with the staff in the ED, who came to the ED after drinking more than two times during the investigation period, who usually consumed over 60 g of ethanol in a day, or who injured themselves intentionally after having consumed alcohol. Statistical significance was revealed with regard to \"arrival time\" and \"diagnosis\" between both groups. In the \"problem drinkers\" group, a larger number of patients visited the ED during the day (08:00-18:00 hrs.) and almost half the illness were diagnosed as trauma-related. The tendency of statistical significance was noted with regard to \"sex\" and \"transportation\". There was no statistical significance with regard to \"age\", \"health insurance\", \"severity of illness\", \"opportunity to drink\", or \"CAGE questionnaire.</p>","PeriodicalId":79450,"journal":{"name":"Nihon Arukoru Yakubutsu Igakkai zasshi = Japanese journal of alcohol studies & drug dependence","volume":"47 6","pages":"331-40"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31373810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}