General Strategies for Relapse Prevention
A major decision that occurs after a patient completes detox is whether or not to utilize medication in the prevention of relapse in addition to psychological care such as counseling, group therapy and educational programs.
Patients who cut down and stop on their own also need follow-up therapy which may or may not include pharmacotherapy. This can be an important patient preference: some are convinced that the problem is “chemicals” and very much want to maintain sobriety without medications. And there is a rationale for this: in controlled trials of alcoholism treatment before the introduction of naltrexone and acamprosate, the overall rate of maintaining sobriety was around 30%. Some patients simply quit drinking and stay sober entirely on their own. However, for other patients, medications can help by reducing craving or by reducing the positive rewards from drug or alcohol use.