Implementing Evidence-Based Care for Alcohol Use Disorder.

AbstractAlcohol use is a major contributor to morbidity and mortality, but most individuals with problematic alcohol use do not receive evidence-based care or accurate information about drinking. Recommendations on safe levels of alcohol consumption are rapidly evolving, with recent research finding health and social harms at levels well below traditional lower-risk drinking guidelines. Screening tools to identify alcohol use are widely available but infrequently used. Alcohol withdrawal management protocols have not kept pace with recent evidence highlighting the safety and benefits of benzodiazepine-sparing approaches. Similarly, despite clear evidence on the efficacy of psychosocial treatments and evidence-based pharmacotherapies (e.g., naltrexone) to treat alcohol use disorders, most individuals do not receive such treatment. Research also shows a lack of benefit and potential harm of routine use of antidepressants and other psychotropic medications commonly prescribed to individuals with alcohol use disorders. There is a critical opportunity for clinicians across specialties and healthcare systems to better identify and address alcohol use.