Evidence-Based Pharmacotherapy for Alcohol Use Disorders

2020 ◽  
pp. 307-326
Author(s):  
Donald McNally ◽  
Albert J. Arias

Pharmacotherapy is a vital component of alcohol use disorder (AUD) treatment. From a biopsychosocial perspective, the use of pharmacotherapy alone and in combination with various therapeutic and psychosocial modalities to reduce harmful drinking behaviors is supported by a strong evidence base. This chapter presents an overview of the use of both US Food and Drug Administration (FDA)-approved and off-label treatments for AUD, and it provides practical information and evidence for the use of pharmacotherapy. Comprehensive reviews of medications are undertaken with an emphasis on evidence-based practice and clinical utility to aid in the treatment of AUD and harmful drinking behaviors.

2004 ◽  
Vol 65 (4) ◽  
pp. 521-529 ◽  
Author(s):  
Justine Corry ◽  
Kristy Sanderson ◽  
Cathy Issakidis ◽  
Gavin Andrews ◽  
Helen Lapsley

2020 ◽  
pp. 154041532097157
Author(s):  
Victor Garcia ◽  
Emily Lambert ◽  
Alex Heckert ◽  
Nahomy Hidalgo Pinchi

Introduction: This brief report recommends how the effectiveness of the juramento, a practice found in Mexican Catholicism, can be enhanced by combining it with Screening, Brief Intervention, and Referral to Treatment. The juramento is a grassroots intervention around a sacred pledge made to Our Lady of Guadalupe to abstain from alcohol from 6 months to 1 year. Method: The recommendations are made possible from an ongoing qualitative study on the use of the juramento among Mexican immigrant farmworkers in southeastern Pennsylvania. The subsample for this report is 15 Mexican immigrant farmworkers who made a juramento and two priests who administer the intervention. Results: Adding the Alcohol Use Disorders Identification Test and a referral to treatment in the counseling session of the juramento keeps its religious and cultural appeal. The core of the intervention—the ritualized pledge to Our Lady of Guadalupe—remains intact. Conclusion: Approaching the juramento with an evidence-based brief intervention lens will expand the availability of culturally based interventions to include a grassroots intervention in the Mexican immigrant community. The juramento is organic, rooted in culture and religion, making it more likely that it will help in reducing alcohol use disorders, especially those with strong religiosity.


2021 ◽  
Author(s):  
Kinsey Pebley ◽  
Indika Mallawaarachchi ◽  
G Wayne Talcott ◽  
Melissa A Little

ABSTRACT Introduction Alcohol use is prevalent among military personnel, with many engaging in binge drinking behaviors. Military trainees are unique, in that they experience an enforced alcohol ban for 8 weeks while in Basic Military Training. However, they are also typically young adults, who consume alcohol at higher rates than any other age group. The current study aimed to describe alcohol consumption among trainees, determine when, where, and with whom Airmen drank for the first time during Technical Training, and if these patterns were significantly different based on descriptive norms (i.e., beliefs about how many other individuals engage in a certain behavior) related to alcohol use, given that most military members consume alcohol. Last, we aimed to determine if alcohol consumption or potential alcohol use disorders were significantly different based on descriptive norms. Materials and Methods Airmen (n = 599) were recruited at Joint Base San Antonio—Fort Sam Houston during their last week of Technical Training to complete a survey. Study procedures were approved by the 59th Medical Wing Institutional Review Board. Participants were asked about their beliefs related to how many other Airmen drink alcohol (i.e., less than 50%, 50%, or greater), their own experiences with alcohol (e.g., how much they drink compared with consumption before military service, blackouts after drinking during Technical Training), and when, where, and with whom they consumed alcohol for the first time after beginning military training. Results Over half of the Airmen reported not engaging in drinking behaviors during Technical Training. Among those who reported drinking one or more drinks during Technical Training, most reported drinking the same amount or less than they did prior to Basic Military Training. The majority of Airmen reported that they had “maybe” experienced blackouts from drinking since Technical Training. Most Airmen drank for the first time with another someone who was not an Airman, at a restaurant, home, or other place off base, and while they were on leave. Results indicated no significant differences between groups related to beliefs about how many Airmen drink during Technical Training and where, when, and with whom Airmen drank for the first time since joining the Air Force. There were also no differences in Alcohol Use Disorders Identification Test scores or drinks per week between these normative belief groups. Conclusions Almost half of Airmen resume drinking after alcohol restrictions are lifted during Technical Training but maintain low numbers of drinks consumed per week and low risk for alcohol use disorders, which may indicate that this is an opportune time for intervention to prevent alcohol consumption from escalating over time. Airmen reported drinking for the first time with another Airman off base during leave. Focusing on how Airmen navigate alcohol-related decision-making while their responsibilities are reduced, or how other Airmen influence their decisions to engage in risky drinking, may help prevent alcohol use rates from increasing post-enforced ban.


2015 ◽  
Vol 5 (6) ◽  
pp. 248-252
Author(s):  
Taylor A. Nichols

Abstract Despite multiple studies evaluating various therapeutic agents, few have emerged as superior agents for the management of alcohol use disorders. As a result, off-label agents, including gabapentin, are being utilized more frequently in clinical practice. Gabapentin has gained popularity as one of the more commonly studied off-label agents. Gabapentin's relatively low abuse potential, side effect profile, and limited hepatic metabolism make it an attractive option compared with benzodiazepines and other anticonvulsants. Several randomized, placebo- and active-controlled trials have evaluated off-label use of gabapentin for the treatment of alcohol detoxification and dependence. Study results and interpretation from the more robust available data are summarized within this article.


2016 ◽  
Vol 102 (1) ◽  
pp. 56-60 ◽  
Author(s):  
Pauline De Bruyne ◽  
Thierry Christiaens ◽  
Koen Boussery ◽  
Els Mehuys ◽  
Myriam Van Winckel

Background and aimsDuring the last decades, much attention has been paid to off-label and unlicensed prescriptions in paediatrics. However, on-label prescribing can also cause health issues. In this paper, the case of first-generation H1-antihistamines is investigated, notably the range of indications for which products are licensed in different European countries and the evidence base (or lack thereof) for each indication, as well as reported adverse drug reactions.MethodsReview of the Summary of Product Characteristics of first-generation H1-antihistamines with a focus on paediatric use. This is plotted against the evidence available in the literature.ResultsThis investigation shows a large variability in labelled indications and licensing ages when compared in five different European countries. Moreover, most of the indications are not based on clinical trials evaluating efficacy and safety of these drugs in children.ConclusionsMany of the licensed indications of first-generation antihistamines do not appear to be evidence based.


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