Treatment of Alcohol Use Disorder Treatment options for AUD include psychosocial treatment and medications. Individualize based on patient preference and goals. Goals: abstinence or reduction in heavy drinking days. Psychosocial Treatment • Individualize per patient preference • CBT, mutual support groups (AA), therapy, harm reduction groups • Can be effective alone and in combination with medications Naltrexone • First line therapy for most patients • Start at 2Smg or 50mg a day • Reassess response in 4-6 weeks • Counsel on GI side effects • Contraindicated: severe liver disease or using opioids Acamprosate Recommended as next option if unable to use naltrexone. • Start at 666 mg TID (6 pills/day) • Dose adjust in renal dz • Can be used in liver dz • Contraindicated: CrCl< 30 Disulfiram • Not commonly used due to unpleasant reactions if return to drinking • Consider in patients who have not tolerated prior meds listed • Consider in highly motivated pts • Consider in settings where meds are administered Other Options • Gapabentin, Topiramate, Baclofen • None are FDA approved for AUD Data exists to support there may be some positive drinking outcomes • Not recommended as first line medication therapy by Dr. Carolyn Chan @CarolynAChan #Alcohol #UseDisorder #Addiction #PrimaryCare #Treatment #Management #AUD
