The New(er) Drugs for Alcoholism

Topics: Alcoholism

Reviewing the new medications for alcoholism brings us into a pharmacologic netherworld. Nothing is very clear, and when you think you've finally come to a conclusion, a new study comes along to cast a fresh fog over everything. We'll start with naltrexone (brand name ReVia), currently the only medication other than Antabuse (disulfiram) to be FDA-ap

Alcoholics Anonymous: A Primer

Topics: Alcoholism

By now, it is clear that the most effective treatment for alcoholism is consistent attendance at AA (Alcoholics Anonymous) meetings. Not only have outcome studies shown that AA attendance promotes abstinence, but in addition, therapy aimed specifically at encouraging AA attendance has been shown to robustly increase the chances that patients will actual

Dr. Stuart Gitlow on using Benzodiazepines in Alcoholism

Topics: Alcoholism

TCR: Dr. Gitlow, let's get right into the issue of benzodiazepines. A typical scenario for many of us in office practice is that we will see a patient recently out of detox who will say, "Well doctor, I have always had terrible anxiety whether I have been drinking or not, I have tried this and I have tried that, and if I can't take something that will h

Exposure Therapy Efficacious for PTSD Co-Occurring With Alcohol Use Disorder

Topics: Addiction | Addiction Treatment | Alcohol | Alcohol Use | Alcohol use disorder | Alcoholism | Co-occurring disorders | Dual diagnosis | Prolonged exposure | Psychotherapy | PTSD | Research | Research Update | Substance Use | Substance use disorders

Review of: Norman SB et al, Efficacy 2019;76(8):791–799 Patients with co-occurring posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) have worse outcomes compared to patients with either diagnosis alone. Integrated approaches, in which both diagnoses are simultaneously addressed, are viewed as best practice. Providers, however, are

The COMBINE Study: A Core Paper in the Treatment of AUD

Topics: Acamprosate | Addiction | Addiction Treatment | Alcohol | Alcohol Use | Alcohol use disorder | Alcoholism | Medication | Naltrexone | Pharmacology | Psychotherapy | Research | Research Update | Substance Use | Substance use disorders | Therapy during medication appointment | Therapy with Med Management

Review of: Anton RF et al, JAMA 2006;295(17):2003–2017 Conducted from 2001 to 2004 and published in 2006, the COMBINE study was the largest pharmacotherapy study that assessed the treatment of alcohol use disorder (AUD). Although there were significant data on the use of naltrexone and acamprosate (both had been FDA approved), widespread use had no

Treating Alcohol Use Disorder

Topics: Addiction Treatment | Alcohol | Alcohol use disorder | Alcoholism | Medication | Naltrexone | Substance Use Disorder | Therapy with Med Management

CATR: Can you tell us about the role of medications for alcohol use disorder (AUD)? Dr. Arias: Medications are a very important part of AUD treatment. They can and should be used as a first-line treatment in any reasonable medical setting—primary care or psychiatry, or a specialty addiction setting. Unfortunately, very few patients ever receive them.

Biomarkers of Alcohol Use

Topics: Addiction | Addiction Treatment | Alcohol | Alcohol use disorder | Alcoholism | Laboratory Testing in Psychiatry | Substance Use Disorder

We all want to know how much alcohol our patients are drinking. Asking patients directly about their drinking often generates useful information and helps build rapport, but this tactic is not always reliable. Denial and shame as well as issues related to secondary gain can sometimes contaminate self-report. Thankfully, there are many measures that can

Gabapentin Enacarbil XR Efficacy Less Than Expected for AUD

Topics: Addiction | Addiction Treatment | Alcohol | Alcohol use disorder | Alcoholism | Clinical practice | extended-release | Medication | Novel Medications | Pharmacology | Psychopharmacology | Research Update

Review of: Falk DE et al, Alcohol Clin Exp Res 2019;43(1):158–169 Gabapentin enacarbil extended-release (GE-XR) (Horizant) is an extended-release version of gabapentin. GE-XR is a prodrug, meaning that once ingested it is metabolized into gabapentin. It is currently approved for treatment of postherpetic neuralgia and restless legs syndrome. It di

Disulfiram: An Underused Strategy for Alcohol Use Disorders

Topics: Abstinence | Addiction | Addiction Treatment | Alcohol | Alcohol Use | Alcohol use disorder | Alcoholism | Disulfiram | Free Articles | Psychopharm Myths

Alcohol ranks third among preventable causes of death in the US, but it is by far the most undertreated. Fewer than 8% of people with alcohol use disorders (AUDs) receive treatment for their disease, and only a minority of them receive FDA-approved medications. Those medications are acamprosate (Campral), naltrexone (Vivitrol, ReVia), and disulfiram (An