Fast Five Quiz: Alcohol Use and Abuse

Stephen Soreff, MD


January 03, 2019

Among the many recommendations for the treatment of alcohol use disorder, the APA recommends the following:

  • The initial goals of treatment should include discussion of the patient's legal obligations (eg, abstinence from alcohol use, monitoring of abstinence). These should be documented in the medical record

  • Patients with alcohol use disorder should have a documented and individualized treatment plan that includes evidence-based nonpharmacologic and pharmacologic treatments

  • Antidepressant medications should not be used for the treatment of alcohol use disorder unless a comorbid disorder is present for which an antidepressant is an indicated treatment

  • Benzodiazepines should not be used unless treating acute alcohol withdrawal or a comorbid disorder is present for which a benzodiazepine is an indicated treatment

  • Naltrexone or acamprosate should be offered to patients with moderate-to-severe alcohol use disorder; disulfiram, topiramate, or gabapentin is recommended for patients who prefer these medications or those who have not responded to treatment with naltrexone and acamprosate; acamprosate should not be used by patients who have severe renal impairment and should not be used as a first-line treatment in those with mild-to-moderate renal impairment

  • Naltrexone is recommended in patients with alcohol use disorder and comorbid opioid use disorder, if patients wish to abstain from opioid use and either abstain from or reduce alcohol use and are able to abstain from opioid use for a clinically appropriate time prior to naltrexone initiation

For more on the treatment of alcohol use disorder, read here.


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