SY21-2 * CAN ALCOHOL DEPENDENT PATIENTS REDUCE THEIR ALCOHOL CONSUMPTION?

Abstinence has been the predominant treatment goal in alcoholism. There is no doubt that this approach has helped very many people around the world to overcome their alcohol problems. On the other hand, the abstinence goal is a very high threshold which may be one reason why we reach only about 10% of patients in need for treatment. A large US survey shows that 42% of potential patients do not initiate treatment because they are not willing to quit alcohol completely. Against this background reduction of alcohol consumption is increasingly recognised as a valid and needed option. The presentation will review diverse studies which deliberately went for a reduction (or control) of drinking as well as other studies which did not pursue this specific goal but which report various drinking outcomes including reduced drinking. The overview contains controlled psychotherapy trials as well as pharmacotherapy studies. On the background of these data the European Medicines Agency (EMA) published guidelines in 2010 where the reduction of alcohol consumption is accepted as a valid goal in the treatment of alcohol dependent patients. So far several studies have been performed in this context, others are underway. DSM 5 has collapsed the dependence and abuse categories. Therefore the reduction of alcohol consumption will have to be an integrated part of the management of patients with “alcohol use disorders”.