Information for doctors and institutions on the treatment of alcohol dependence

Information for family physicians

If you suspect that a patient is abusing alcohol, use the AUDIT test and explain the effects of alcohol to the patient and the possible links to their health disorder. Research confirms the effectiveness of about 15 minutes of short counselling, even in patients with mild dependence. However, if this is not possible for some reason, recommend visiting www.alkoinfo.ee and encourage them to contact us. A referral from a family physician is not required to receive psychiatric care services, including treatment for an alcohol use disorder. 

Alcohol use disorder is highly stigmatised and some patients try to hide their drinking behaviour from their family physicians. Despite the fact that we always encourage patients to be open with their family physician and family nurse, we remain discreet at their request. To find out more about the service, send an email to kte@regionaalhaigla.ee. If you want the opinion and advice of our psychiatrist to treat a specific patient, we recommend that you use e-consultation. 

Information for medical specialists

If your prescribed treatment does not produce the desired results within the expected time, consider the possibility that the patient is an alcohol abuser. We recommend using the AUDIT test, which is recognised by the World Health Organisation and is the most widely used method internationally. The questions of the AUDIT test help the patient themselves to better understand the severity of their condition and stop denying their problems resulting from drinking. If necessary, advise patients to use self-help programmes or contact our clinic, where trained professionals can explain the effects of alcohol on their health and recovery and help them change their drinking habits. 

Information for prosecutors, judges, and probation supervisors

Alcohol abuse is a mental health disorder and the success of its treatment depends on the motivation of the patient. If a patient seeks treatment to escape punishment and does not see a problem with their alcohol use, it is not possible to set an adequate treatment goal and prepare a treatment plan. The more convinced a patient is that they will avoid punishment by simply going to a medical institution, the more difficult it will be to motivate them to change their drinking behaviour. The purpose of punishment and probation supervision is to prevent the recurrence of an act committed while intoxicated. Therefore, punishment and treatment must be kept separate and the person must understand that they will not be able to escape the ‘system of mischief and punishment’ until they stop abusing alcohol. The desire to not end up in court or prison again may motivate them to start treatment. Starting treatment is an opportunity for a person to avoid trouble in the future – it is not a lighter punishment for their wrongdoings. 

Mutual trust is a prerequisite for successful treatment. The statutory right to receive information about a patient from a medical institution should only be used in cases where this is unavoidable and there are no other options. In this case, send an official REQUEST FOR INFORMATION to psyhhiaatriainfo@regionaalhaigla.ee with a specific question. Expert assessments of the condition of a patient are not provided in the context of the treatment of an alcohol use disorder. 

We are happy to work with probation supervisors to help a patient make the right choices in life. It is possible to work efficiently and effectively with the consent of the patient and with the help of web-based communication channels. To contact us, send an email to kte@regionaalhaigla.ee 

Information for the Estonian Unemployment Insurance Fund

For a variety of reasons, it can take a long time before drinking alcohol interferes with work. Colleagues and employers are often reluctant to realise that alcohol consumption is a cause of work-related problems. Lack of knowledge about the effects of alcohol on the human brain and its behaviour contributes to the denial of the problem. On the other hand, once a person has lost their job due to alcohol abuse, it is difficult to find a new job that suits their abilities. The brain of a long-term alcohol user has undergone changes that affect the ability of the person to understand and perform work tasks. In addition, they have problems with self-discipline, making it unlikely that they will be able to keep their job without additional help.

Unfortunately, it is not possible to change harmful behavioural habits with a few counselling sessions. Continuous targeted activity is essential to overcome alcohol use disorder. When starting treatment, realistic goals that are important for the patient must be set. Linking the treatment process to job search and work helps to find and maintain motivation, gives better results, and saves time for all parties. 

We recommend that you talk to your patient openly and without stigmatisation about alcohol consumption, using the AUDIT test if necessary. If the patient is unable to control their alcohol consumption, introduce them to modern treatment options and suggest involving our specialist. Cooperation makes it possible to set common practical and achievable goals. To contact us, send an email to kte@regionaalhaigla.ee With the consent of the patient, we hold joint web meetings. 

Assessments of the work ability of a patient are not provided in the context of the treatment of an alcohol use disorder. If you need a patient’s summary to make your decisions, please send a formal inquiry to psyhhiaatriainfo@regionaalhaigla.ee

The ‘Soberer and healthier Estonia’ programme 

The ‘Soberer and healthier Estonia’ programme is a set of different activities, the common goal of which is to help people who have problems with their health, relationships, and coping due to alcohol abuse. The activities of the programme are funded by the European Union Social Fund, the use of which in Estonia is organised by the National Institute for Health Development. A description of the conditions for granting support and information about other activities can be found on the website of the National Institute for Health Development

One of the activities of the ‘Soberer and healthier Estonia’ programme is the health services provided in general medical care (family physicians and family nurses) and in specialised medical care for the treatment of alcohol use disorder. The provision of health services and their financing takes place in accordance with the terms of the agreement concluded between the National Institute for Health Development and the health care provider. The agreement is valid until 31 December 2022.