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Treatment of Alcoholism and Nicotine Dependence

Robert S. Zucker, MD, MPH
JAMA. 1996;276(10):783-784. doi:10.1001/jama.1996.03540100027021.
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To the Editor.  —In the introduction to their study of mortality following inpatient treatment for addictions, Dr Hurt and colleagues1 state that "a key outcome of alcoholism treatment is mortality." This questionable assumption, combined with the results of the study showing that the majority of alcoholics in their inpatient cohort died of tobacco-related causes, leads them to conclude that "nicotine dependence treatment is imperative in this group."While preventing premature death has been shown to be one of the benefits of a formal inpatient addictions treatment program,2 as compared with detoxification only, this is not truly a major treatment goal. The goal of rehabilitation programs for alcoholics, just as the goal for any rehabilitation program, should be to improve functional outcome. Some indicators of functional outcome are social stability and psychosocial adjustment.3 In fact, it has been suggested that only in publicly funded, inner-city programs, in which


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