Guidelines On The Medical Treatment Of Alcohol Use Disorder From The APA With An Additional Resource

Posted on April 16, 2019 by Tom Wade MD

In addition to the Guidelines listed next in this post, please see Medication for the Treatment of Alcohol Use Disorder: A Brief Guide [Link is to the PDF download] 2015 from U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration.

Here are excerpts from  the Jan 05, 2018 press release from the American Psychiatric Association (APA) on the New Practice Guideline on Treatment of Alcohol Use Disorder:

“This new guideline is an important step in bringing effective, evidence-based treatments for alcohol use disorder to many more people and in helping address the public health burden of alcohol use,” said APA President Anita Everett, M.D.

The Practice Guideline for the Pharmacological Treatment of Patients with Alcohol Use Disorder focuses specifically on evidence-based pharmacological treatments for alcohol use disorder.

Guideline recommendations

  • Naltrexone and acamprosate are recommended to treat patients with moderate to severe alcohol use disorder in specific circumstances (e.g., when nonpharmacological approaches have not produced an effect or when patients prefer to use one of these medications).
  • Disulfiram produces physical reactions (e.g., flushing) if alcohol is taken within 12-24 hours of the medication use and is not generally used as a first-line treatment.
  • Topiramate and gabapentin are also suggested as medications for patients with moderate to severe alcohol use disorder, but typically after trying naltrexone and acamprosate first.

 

The guideline also includes statements related to assessment and treatment planning. Evidence-based psychotherapeutic treatments for alcohol use disorder, including cognitive-behavioral therapy, 12-step facilitation, and motivational enhancement therapy, also play a major role in treatment. In addition, community-based peer support groups such as Alcoholics Anonymous (AA) and other programs are helpful for many patients. However, specific recommendations related to these treatments are outside the scope of this guideline.

 

Pharmacological Treatment of Patients with Alcohol Use Disorder

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