About 2 billion people worldwide currently consume alcoholic beverages, and 76.3 million of those have alcohol-use disorders. Due to its devastating consequences on health, society, and economies, the burden related to alcohol dependence, in respect of both morbidity and mortality, is quite large in most parts of the world. It is estimated that 4% of the overall global burden of disease is attributable to alcohol. The rate of alcohol and drug or substance use throughout the world has gradually increased. This trend is particularly noticeable in middle-income countries. Existing services aimed at reducing demand are prevention, screening, treatment, care and rehabilitation.

Alcoholism is a complex disorder affecting modern society in many ways, yet there are few effective treatment strategies currently available. Almost 19 million Americans have an “alcohol problem”; however, only 2.4 million have been diagnosed and just 139,000 receive medication to treat it. It is estimated that in the United States alone, taxpayers spend over $180 billion annually to deal with alcohol-related problems. Alcohol abuse contributes to cardiovascular illnesses, liver disease, cancer, and psychiatric disorders. Alcohol produces several physiological effects in human.

International surveys suggest that young people in the United Kingdom are now among the heaviest drinkers in the world. The United Kingdom most closely resembles Ireland and Denmark and is well ahead of the United States, where rates of youth drinking appear similar in some respects to France and the Mediterranean countries.

The American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders as:

Alcohol abuse

"A maladaptive pattern of alcohol use leading to ...clinically significant impairment or distress ... failure to fulfill major role obligations at work, school or home; recurrent use in situations where it is physically hazardous; legal disorder; persistent or recurrent social or interpersonal disorder caused or exacerbated by alcohol."

Alcohol dependence

"...Tolerance, withdrawal; drinking larger amounts than intended; unsuccessful efforts to cut down; a great deal of time spent obtaining or using alcohol; important activities given up because of alcohol use; continued use despite physical or psychological disorder likely to have been caused or exacerbated by alcohol."

Alcoholism is associated with a range of cognitive impairments such as attention, memory and executive deficits. Different neuropsychological models have been postulated to explain the cognitive profile of alcoholics. Approximately 50–70% of alcoholics show signs of brain dysfunction. Volume loss was observed in the cerebellum, the corpus callosum, the mammillary bodies, the hippocampus, the nucleus accumbens, the thalamus, the putamen and the caudate. This changes are important when we talking about alcohol rehabilitation, mainly because the social cognition difficulties of alcoholics—affect perception deficits, a negative bias in affect perception, significantly higher intensity ratings, theory of mind as well as humor processing deficits—may lead to discomfort and stress in social situations, which may result in turn in alcohol consumption and relapse. Additionally when people think on alcohol rehabilitation, it is important keep in mind that other factors are important also. Alcoholics with a family history of alcoholism tend to show more severe impairments, and family history and substance use may be separate risk factors for poorer cognitive outcome and social cognition impairments.

The programs of alcohol rehabilitation must know that alcoholics suffer from basic social cognition deficits, which contribute to interpersonal problems and may play a role in relapse. The strategies which are included so far in current social skills training may thus not be sufficient for the effective treatment of alcoholism and the investigation of the relationship between social cognition deficits and interpersonal problem-solving would be necessary to arrive at better treatment approaches.

Other important issue in the alcohol rehabilitation program includes the detection of risk factor de begin this dependence. In early- to mid-adolescence, the potential for alcohol abuse or dependence is raised in high-risk groups that are partially identifiable even at an early age. In particular, many children aged 16 and under who drink heavily also exhibit symptoms of conduct disorder. This is a prominent manifestation of a genetically influenced predisposition or phenotype that overlaps with that of alcohol abuse and dependence. Its characteristic symptoms (e.g., defiance, telling lies, and disruptive behavior in school, truancy and fighting), co morbidities (hyperactivity, learning disabilities and social impairments) and combined genetic and environmental etiology are familiar to pediatricians and others who work with children and young people. Adolescent boys with symptoms of conduct disorder exhibit an early onset of and rapid increase in drinking, whereas those without demonstrate rates that remain low throughout the follow-up period. Among those acknowledging a combination of early adolescent drinking and conduct disorder symptoms, the majority are said to become abusers of or dependent on alcohol by 17 years of age. Childhood conduct disorder also predicts adult alcohol dependence. However, anxiety also predicts onset and persistence of problem use of alcohol, and a quarter of those with childhood major depressions, even in the absence of co-occurring conduct disorder, develop adult alcoholism.

Treatment for alcohol dependence and alcohol rehabilitation involves at least two major stages – detoxification and relapse prevention. Benzodiazepines are now considered the treatment of choice for alcohol withdrawal therapies. Relapse prevention strategies are still unsatisfactory, however, and many alcohol-dependent individuals continue to relapse and deteriorate despite multiple courses of treatment.

At present, three medications – disulfiram, naltrexone, and acamprosate – have been approved by the US Food and Drug Administration for the treatment of alcohol dependence. Naltrexone is an opioid-receptor antagonist, whose efficacy in the treatment of alcohol dependence in conjunction with psychosocial interventions has been demonstrated by several clinical trials. Some studies have not shown favorable effects, however, and some have further found that the benefits of naltrexone seemed to decline over time after cessation.

Over the past decade, the safety and efficacy of acamprosate for alcohol dependence has been well established. Patients treated with acamprosate achieved greater rates of complete abstinence, longer times to first drink and/or increased duration of cumulative abstinence when compared with placebo. A systematic review concluded that acamprosate is suitable for treatment programs aimed at achieving abstinence, while naltrexone is better in programs aimed at controlling drinking – both drugs are safe and well tolerated

Despite progress in pharmacological treatments of alcohol dependence and alcohol rehabilitation, psychosocial interventions are still an essential component in most standard treatment settings. Recent treatment research on psychosocial interventions has been mainly concerned with outpatient treatments. The dissemination of outpatient treatments is quite varied in different countries