Perspective from Frances Levin, MD
January 05, 2018
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New APA guidelines aim to improve treatment outcomes for alcohol use disorder

Perspective from Frances Levin, MD
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Anita Everett, MD
Anita Everett

The American Psychiatric Association has released new practice guidelines for the treatment of alcohol use disorder that focus on improving treatment outcomes and quality of care for patients, according to a press release issued by the organization.

The new guidelines offer clinicians recommendations on evidence-based pharmacological treatments for alcohol use disorder and on the assessment and treatment planning necessary to treat patients using pharmacotherapy.

“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,” Anita Everett, MD, APA president, said in the press release.

Alcohol use disorder remains undertreated, with fewer than one in 10 people in the U.S. with a 12-month diagnosis of alcohol use disorder receiving treatment and an estimated lifetime prevalence rate of 29%, according to the release. An expert panel led by Victor I. Reus, MD, chair of the APA Practice Guideline Writing Group, created these guidelines to help patients with alcohol use disorder receive the best treatment.

The guidelines recommend:

  • naltrexone and acamprosate to treat patients with moderate-to-severe alcohol use disorder when nonpharmacological approaches have no effect or when patients prefer them;
  • topiramate and gabapentin for patients with moderate-to-severe alcohol use disorder, but usually after trying naltrexone and acamprosate first; and
  • disulfiram, but not generally as a first-line treatment.

The guidelines also include evidence-based psychotherapeutic treatments for alcohol use disorder, such as cognitive-behavioral therapy, 12-step facilitation and motivational enhancement therapy, according to the release. In addition, they suggest that community-based peer support groups, including Alcoholics Anonymous, can help patients. – by Savannah Demko

References:

Reus VI, et al. Amer J Psychiatry. 2018;doi:10.1176/appi.ajp.2017.1750101.

Disclosures: Everett is APA president. Reus is chair of the APA Practice Guideline Writing Group.