Although alcohol-dependent patients treated by SERTs have increased over the years, they represent only a small proportion of those who would need specific treatment for alcohol-related problems.
- Too many patients (about 95%) are hospitalized for organic diseases associated with alcohol abuse and do not get to the observation of the SERTs, whose users would seem to be characterized by a low prevalence of organic diseases.
- The care of these patients probably takes place within diagnostic-therapeutic paths that focus their attention above all on organic damage, paying little attention to the specific treatment of abusive behavior.
In addition, about 85% of detoxification treatments in a hospital
Setting are not planned by SERTs, but are probably managed by other subjects involved in the treatment of alcohol addiction: general practitioners, gastroenterology services, psychiatry, etc.
There is no doubt that the identification and treatment of subjects with alcohol-related problems are particularly complex, on the one hand due to the ambiguity of the biological action carried out by alcohol, between food, luxury substance and drugs, from other for the difficulty of defining the acceptable daily dose, due to the high variability of the individual biological response.
- Probably, alcoholics turn to health facilities soon and late, usually when the damage manifests itself as organ pathologies and with strong reluctance towards SERTs, whose role is most frequently recognized in the exclusive treatment of illegal substance abuse.
- The services should equip themselves to anticipate the request for treatment, identifying, in close collaboration with general practitioners, those subjects for whom the consumption of alcohol becomes problematic.
However, the poor perception of the problem by the alcohol-dependent subject clashes with the difficulty of identifying univocal and appropriate interlocutors in the area for the integrated management of this type of patient.
In recent years, the paths of access to diagnosis, as well as to the rehabilitative treatment of alcohol-related problems, have been the most varied: psychiatry services, SERTs, hospital, social services, private social and groups of volunteering, such as Alcoholics in Treatment Clubs or Alcoholics Anonymous.
The need for greater integration between the various subjects involved has found a partial response in recent years with the establishment of the alcoholic working groups, but as these data show, much still needs to be done to ensure that the offer is adequate to treatment needs.
Laboratory of Epidemiology and Biostatistics
Higher Institute of Health. Rome
The identification of the prevalence of problems related to alcohol abuse is one of the epidemiological and public health aspects most discussed in recent years. Much of the information available in Italy is linked to estimates of alcohol consumption made starting from data relating to national budget statistics (ISTAT calculations based on import and export data, etc.), to estimates based on family consumption (ISTAT sample surveys on household spending on consumer goods) and, on lifestyles (through multipurpose surveys).