Treating Alcohol Use Disorder

Contributor: Aaron Lessen MD

Educational Pearls:

• Patients with alcohol use disorder are frequently discharged from the ED without further resources

• Pharmacological treatments to reduce cravings in AUD exist

• Naltrexone

• Effective at reducing alcohol cravings and heavy drinking

• Gabapentin

• Reduces the percentage of heavy drinking days in AUD

• Patients being discharged from the ED should be asked if they feel their alcohol use is a problem, which can further direct appropriate pharmacological interventions

References

1. Kranzler M.D. HR, Feinn Ph.D. R, Morris B.A. P, Hartwell Ph.D. EE. A Meta-analysis of the Efficacy of Gabapentin for Treating Alcohol Use Disorder Henry. Addiction. 2019;114(9):1547-1555. doi:10.1111/add.14655

2. Maisel NC, Blodgett JC, Wilbourne PL, Humphreys K, Finney JW. Meta-analysis of naltrexone and acamprosate for treating alcohol use disorders: When are these medications most helpful? Addiction. 2013;108(2):275-293. doi:10.1111/j.1360-0443.2012.04054.x

3. Mariani JJ, Pavlicova M, Basaraba C, et al. Pilot randomized placebo-controlled clinical trial of high-dose gabapentin for alcohol use disorder. Alcohol Clin Exp Res. 2021;45(8):1639-1652. doi:10.1111/acer.14648

Summarized & Edited by Jorge Chalit, OMSII