Prevention, screening, and treatment for heavy drinking and alcohol use disorder

Abstract

Heavy drinking and alcohol use disorder (AUD) are major public health problems. Practitioners not specializing in alcohol treatment are often unaware of the guidelines for preventing, identifying, and treating heavy drinking and AUD. However, a consensus exists that clinically useful and valuable tools are available to address these issues. Here, we provide a critical review of existing information and recent developments in these areas. We also include information on heavy drinking and AUD among individuals with co-occurring psychiatric disorders, including drug use disorders. Areas covered include prevention; screening, brief intervention, and referral for treatment (SBIRT); evidence-based behavioral interventions; medication-assisted treatment; technology-based interventions (eHealth and mHealth); and population-level interventions. We also discuss the key issues that remain for future research.

Psychiatric comorbidities in alcohol use disorder

“…Alcohol use disorder treatments have greatly expanded in the past decade, with well documented evidence for efficacy across both pharmacological and non-pharmacological domains. 142,143 Interventions delivered through smartphone and other new technologies are feasible and acceptable among patients. 144 To that end, however, integrated treatments for simultaneously addressing alcohol use disorder and other externalising disorders (and internalising disorders) are limited in scope and number, in part because of the complexity of treating two or more concurrent disorders, but also because of our limited understanding of the underlying mechanisms linking alcohol use disorder to other psychiatric disorders.…”

Functional-Belief-Based Alcohol Use Questionnaire (FBAQ) as a Pre-Screening Tool for High-Risk Drinking Behaviors among Young Adults: A Northern Thai Cross-Sectional Survey Analysis

“…The primary outcome of interest was high-risk drinking behavior, which was determined from the 12-month AUDIT score [39]. According to previous literature, each participant can be categorized into four risk levels based on the total 12-month AUDIT score as follows: low-risk drinking (0-7), hazardous drinking (8)(9)(10)(11)(12)(13)(14)(15), dangerous or harmful drinking (16)(17)(18)(19), and almost certainly alcohol dependence (20 or more) [40,41]. In this study, we defined high-risk drinking behavior as participants who had a 12-month AUDIT score ≥8, which incorporates hazardous and harmful alcohol use and alcohol dependence.…”

“…Thus, preventive measures to reduce harmful drinking are crucial. One approach is early identification and intervention of people who are at an increased risk of adverse outcomes from alcohol consumption through the screening, brief intervention, and referral to treatment (SBIRT) paradigm [16].…”

A Cascade of Care for Alcohol Use Disorder: Using 2015-2018 National Survey on Drug Use and Health Data to Identify Gaps in Care

“…Importantly, effective treatments for AUD exist. Evidence-based psychotherapy interventions, including motivational interviewing, cognitive behavioral therapy, and contingency management improve outcomes in persons with AUD (Carvalho et al, 2019; Knox et al, 2019), as does Alcoholics Anonymous (Kelly et al, 2020). In addition, there are three Food and Drug Administration (FDA)-approved medications for treatment of AUD–naltrexone (available in oral and extended-release depot formulations), acamprosate, and disulfiram.…”