______________________________________________________________ Alcohol and Alcohol Use Disorder
however, benzodiazepines have allowed for safe detoxification for patients with alcohol use disorder since they were approved. While detoxification is not treatment, and detoxification problems have not been the most important problem area in successful treatment of the patient with alcohol use disorder, these are important findings. Recognizing that relapse prevention and harm-reducing medications are safe and effective in alcohol use disorders, fewer than 10% of these patients are given medication-assisted treatment. In a 2018 meeting of the American Psychiatric Association, experts suggested [374]: • Naltrexone or acamprosate should be offered to those patients with moderate-to-severe alcohol use disorder that have a goal of reducing consumption or achieving abstinence, prefer pharmacotherapy, or have not responded to nonpharmacologic therapies, and have no contraindications. • Disulfiram should be offered to patients with severe alcohol use disorder that seek to achieve abstinence, prefer the therapy, or have not responded (or are intolerant) to naltrexone or acamprosate, and have no contraindications. Additionally, patients must understand the risks associated with consuming alcohol while on disulfiram. • Topiramate or gabapentin should be offered to patients with moderate-to-severe alcohol use disorder when they aim to reduce or achieve abstinence, prefer them to other medications, or have not responded to naltrexone or acamprosate and have no contraindications. • Benzodiazepine use is discouraged except in patients with alcohol use disorder who require treatment for acute alcohol withdrawal. MANDATORY TREATMENT Even coerced or court-mandated treatment for alcohol use disorder can work. In a follow-up study (six months to one year) of Florida physicians with alcohol use disorder, 84% had positive outcomes, defined as positive counselor and physician assessment, negative alcohol testing, group attendance, and full return to work [375].
CONCLUSION In a society where alcohol use is ubiquitous, it is important for healthcare professionals to recognize the signs and symptoms of alcohol abuse and intervene before a state of dependence is reached. It is critical to stress upon patients the negative health effects of excessive alcohol consumption, especially the synergistic effects of alcohol and tobacco use, beginning at an early age. Owing to the several benefits provided by low to moderate drinking as discussed in this course, certain patients can be advised to drink more regularly, provided alcohol use is not contraindicated due to drug or herb interactions. RESOURCES Al-Anon Family Groups The mission of Al-Anon is to provide support for friends and families of problem drinkers. https://al-anon.org Alcoholics Anonymous https://www.aa.org American Society of Addiction Medicine (ASAM) The nation’s medical specialty society dedicated to educating physicians and improving the treatment of individuals suffering from alcoholism and other addictions. The mission of the ASAM is to: • Increase access to and improve the quality of addiction treatment • Educate physicians, medical and osteopathic students, other healthcare providers, and the public • Promote research and prevention • Promote the appropriate role of the physician in the care of patients with addiction • Establish addiction medicine as a specialty recognized by the American Board of Medical Specialties https://www.asam.org 301-656-3920 MedicAlert Foundation https://www.medicalert.org
WORKS CITED https://qr2.mobi/AlcoholDisorder
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