Psychosocial and Pharmacological Therapies to Reduce Alcohol Consumption in Severe Alcohol-Related Hepatitis Patients: A Case Report

Abstract

Alcohol-related hepatitis (ARH) is an inflammatory liver disease caused by excessive alcohol intake over time. This represents a major health burden with a high mortality and poor prognosis. Reducing alcohol consumption is key to improving health outcomes and long-term mortality. Therefore, various measures have been implemented to aid in the reduction of alcohol consumption. On a population level, this includes minimum unit pricing to reduce alcohol purchases. On a patient level, evidence-based psychosocial and pharmacological therapies aid in achieving and maintaining alcohol abstinence, which will be explored through this case report.A 39-year-old male with a four-year history of alcohol excess was admitted to a regional hospital. He presented with acute onset jaundice and examination findings were consistent with signs of chronic liver disease including abdominal distension and confusion. Investigations supported a diagnosis of severe ARH in this alcohol-dependent patient. Upon discharge, the patient received regular online cognitive behavioral therapy (CBT) sessions to aid in his abstinence.Psychosocial therapy for alcohol abstinence can be categorized into brief and extended interventions. Brief interventions are short counseling sessions, which may be most effective in non-alcohol-dependent patients, whereas extended therapies including CBT, motivational enhancement therapy, and 12-step facilitation are longer regular therapies that may be more effective for alcohol-dependent patients. Some pharmacotherapies are contraindicated in ARH patients due to their hepatotoxicity and liver metabolism. However, acamprosate and baclofen are appropriate and effective treatments. Combining psychosocial and pharmacological therapy may be more beneficial than individual treatments to achieve and maintain abstinence.

Effect of family intervention on relapse rate of Chinese patients with alcohol-dependent

“…Alcohol dependence syndrome caused by drinking is also an important psychosocial problem, which is one of the common diseases in psychiatry ( 10 ). It has a high incidence rate, great harm, easy recurrence, and other characteristics, causing a serious economic and psychological burden on families and society ( 11 ). Research has shown that patients with alcohol dependence syndrome generally have depressive emotions and are not easily identifiable, increasing the risk of suicide for patients ( 12 ).…”