Outpatient managed withdrawal is best for patients who are medically healthy, have no history of seizures, have good psychosocial supports, are reliable (answer phone calls, follow instructions exactly, and return for appointments), and have no major or unstable mental illness. From Treating Alcohol Use Disorder: A Fact Book (2023).

Biomarkers of alcohol use are sometimes helpful when we are not sure whether our patients are reliable in reporting their level of use. Here are two common situations where we might order a test: ⦁ Screening for ongoing alcohol use in a patient who is requesting controlled substance medications for a psychiatric issue ⦁ Monitoring for relapse in a patient who has been abstinent and who is in a mandated treatment program (such as part of probation or an employer-mandated program) From Treating Alcohol Use Disorder: A Fact Book (2023).

There are many approaches to treating alcohol use disorder (AUD), and the initial approach for any given patient will vary depending on the severity of their use, their experience with treatment, the existence of concurrent illness, etc. This fact sheet gives you a framework for choosing an initial treatment strategy based on how many of the 11 DSM-5 criteria for AUD the patient meets. From Treating Alcohol Use Disorder: A Fact Book (2023).

The goal of motivational interviewing is to enhance your patient’s motivation to decrease their alcohol intake. The technique focuses on working with the patient wherever they are in the process of change. Rather than telling them to change, you are always listening for signs of their own internal motivation. From Treating Alcohol Use Disorder: A Fact Book (2023).

Blood alcohol level (BAL, sometimes called BAC for blood alcohol concentration) is often used in emergency rooms to give insight into the severity of a patient’s alcohol use and to help guide predictions about when they will be sober enough for a psychiatric evaluation and when they may start to experience withdrawal. From Treating Alcohol Use Disorder: A Fact Book (2023).

Alcohol withdrawal symptom onset: Usually within six to eight hours of last drink, though in some very heavy drinkers, withdrawal may not begin until 24 hours after last drink. From Treating Alcohol Use Disorder: A Fact Book (2023).

There are many benzodiazepines to choose from. Generally they are all effective for alcohol withdrawal, and the key thing is to pick one that you are comfortable with and get familiar with its use. Nonetheless, some benzos have become favorites of addiction specialists, and in this sheet we provide some guidelines for how to decide on benzos for specific patients. From Treating Alcohol Use Disorder: A Fact Book (2023).

Predicting the severity of withdrawal is important for deciding on the right treatment setting. Will your patient need inpatient treatment, or will outpatient treatment be sufficient? And if inpatient is needed, will they need to be treated in the ICU, or will a psychiatric unit suffice? In this fact sheet, we help you predict the severity of withdrawal in a given patient. From Treating Alcohol Use Disorder: A Fact Book (2023).

When family members need support from others who are also struggling with a loved one’s substance use issues, referring them to Al-Alon or Alateen is a great option. From Treating Alcohol Use Disorder: A Fact Book (2023).

Naltrexone blocks opioid receptors in the brain, which can decrease cravings for and rewarding effects of alcohol or opioids. Especially when combined with other types of therapy or support, it can help people to stop using alcohol or opioids and prevent relapse. From Treating Alcohol Use Disorder: A Fact Book (2023).