Tinsley J A, Finlayson R E, Morse R M
Department of Psychiatry and Psychology, Mayo Clinic Rochester, Minnesota 55905, USA.
Mayo Clin Proc. 1998 Sep;73(9):857-63. doi: 10.4065/73.9.857.
The treatment of alcoholism has changed during the past 2 decades. Notable developments have occurred in pharmacotherapy, psychotherapy, and health-care delivery. A better understanding of the biologic basis for addiction has led to clinical trials of medications that target neuroreceptors. One such medication is the opiate antagonist naltrexone, which decreases the craving for alcohol. Psychosocial interventions continue to be the mainstay of alcohol treatment programs. The efficacy of three different therapies was demonstrated in a study called Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity). This study, however, did not prove the patient-treatment "matching" hypothesis. In addition to therapies provided by addiction specialists, interest is growing in the use of brief motivational techniques in primary-care settings. As the field of addiction responds to an unfolding health-care delivery system, a broader range of treatment options in conjunction with a greater opportunity to individualize patient care is evolving.
在过去20年里，酒精成瘾的治疗方法发生了变化。药物治疗、心理治疗和医疗服务提供方面都有显著进展。对成瘾生物学基础的更深入理解促使了针对神经受体的药物进行临床试验。一种这样的药物是阿片类拮抗剂纳曲酮，它能减少对酒精的渴望。社会心理干预仍然是酒精治疗项目的支柱。一项名为“匹配项目”（将酒精成瘾治疗与患者异质性相匹配）的研究证明了三种不同疗法的疗效。然而，这项研究并未证实患者与治疗“匹配”的假设。除了成瘾专家提供的治疗外，在初级保健环境中使用简短激励技术的兴趣也在增加。随着成瘾领域对不断发展的医疗服务体系做出回应，一系列更广泛的治疗选择以及更多个性化患者护理的机会正在不断涌现。
