Areas that will be covered by the guideline:

• Definitions of alcohol dependence and harmful alcohol use according to the main diagnostic classification systems (ICD-10 and DSM-IV).
• Early identification of alcohol dependence or harmful alcohol use in people in at-risk populations, in particular treatment-seeking populations, and identification of factors that should lead to investigation into the possibility of alcohol dependence or harmful alcohol use (please refer also to the prevention and clinical management guidance currently under development).
• Identifying people with alcohol dependence and harmful alcohol use in clinical practice, including the sensitivity and specificity of different methods, and thresholds.
• Assessment, including identification and management of risk, and assessment of severity of alcohol-related problems, dependence and alcohol withdrawal.
• Development of appropriate care pathways that support the integration of other NICE guidance on the management, treatment and aftercare of alcohol misuse.
• The range of care routinely available in the NHS.
• Pharmacological interventions, for example, initiation and duration of treatment, management of side effects and discontinuation. Specific pharmacological treatments considered will include:

• opioid antagonists (naltrexone and nalmefene)
• acamprosate
• disulfiram
• topiramate
• baclofen
• chlordiazepoxide
• serotogenic agents (selective serotonin reuptake inhibitors and serotonin-3 receptor antagonist, ondansetron).

• Note that guideline recommendations will normally fall within licensed indications; exceptionally, and only if clearly supported by evidence, use outside a licensed indication may be recommended. The guideline will assume that prescribers will use a drug's summary of product characteristics to inform their decisions for individual patients.
• Common psychological and psychosocial interventions currently provided, for example, 12-step programmes, cognitive behavioural therapy, motivational enhancement therapy, relapse prevention, contingency management and community reinforcement approach.
• Low intensity psychological interventions, for example, referral to Alcoholics Anonymous and guided self-help.
• Combined pharmacological and psychological/psychosocial treatments.
• Management of alcohol withdrawal in community and residential settings.
• Management of common mental health problems and drug misuse in the context of alcohol dependence, if this differs from their management alone.
• Prevention and management of neuropsychiatric complications of alcohol dependence or harmful alcohol use including:

• alcohol related brain damage
• Wernicke–Korsakoff syndrome.

• Sensitivity to different beliefs and attitudes of people of different genders, races and cultures, and issues of social exclusion.
• The role of family and carers in the treatment and support of people with alcohol dependence and harmful alcohol use (with consideration of choice, consent and help), and support that may be needed by family and carers (such as conjoint marital therapy and family therapy).
• The Guideline Development Group will consider making recommendations on complementary interventions or approaches to care relevant to alcohol dependence and harmful alcohol use.
• The Guideline Development Group will take reasonable steps to identify ineffective interventions and approaches to care. If robust and credible recommendations for re-positioning the intervention for optimal use, or changing the approach to care to make more efficient use of resources, can be made, they will be clearly stated. If the resources released are substantial, consideration will be given to listing such recommendations in the ‘Key priorities for implementation’ section of the guideline.

Areas that will not be covered by the guideline:

• Treatments not normally made available by the NHS.
• The separate management of comorbid conditions.
• The management of acute alcohol withdrawal in the emergency department and general medical and surgical settings. This will be covered in 'Alcohol-use disorders in adults and young people: clinical management' (publication expected May 2010).
• The prevention and management of Wernicke's encephalopathy. This will be covered in 'Alcohol-use disorders in adults and young people: clinical management' (publication expected May 2010).