Management of Patients with Alcohol Dependence in Recovery: Options for Maintenance and Anticipating and Managing Relapse in Primary Care

In this chapter we focus our discussion on the challenges primary care clinicians face while identifying those in recovery and facilitating maintenance of sobriety (or at least low risk drinking) in patients with urgent, early, or longer-term recovery from alcohol dependence. We review specific techniques that primary care clinicians can use to help patients with alcohol-related problems and recent studies of technology-based interventions and patient outreach that can be integrated into the primary care patient-centered medical home [(1) Friedmann PD, Saitz R, Samet JH. Management of the patient recovering from alcohol or other drug problems. Relapse prevention in primary care. JAMA. 1998;279;1227–1231. (2) Friedmann PD, Charuvastra A, Herman DS, Dube C, DeSantiago S, Freedman S, Stein MD. PRIMECare. Promote Recovery in Medical Care. A Guideline for the Maintenance Care of Medical Patients in Recovery from Alcohol Abuse or Dependence. Providence: Division of General Internal Medicine, Rhode Island Hospital, 2001.].