What are the APA treatment guidelines for alcoholism?

Updated: Nov 27, 2018
  • Author: Warren Thompson, MD, FACP; Chief Editor: Glen L Xiong, MD  more...
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Answer

The American Psychiatric Association (APA) released the following guidelines in 2018:

  • Naltrexone and acamprosate are recommended to treat patients with moderate to severe alcohol use disorder in specific circumstances (e.g., when nonpharmacological approaches have not produced an effect or when patients prefer to use one of these medications).
  • Disulfiram produces physical reactions (e.g., flushing) if alcohol is taken within 12–24 hours of the medication use and is not generally used as a first-line treatment.
  • Topiramate and gabapentin are also suggested as medications for patients with moderate to severe alcohol use disorder, but typically after trying naltrexone and acamprosate first.

The guideline also includes statements related to assessment and treatment planning. Evidence-based psychotherapeutic treatments for alcohol use disorder, including cognitive-behavioral therapy (CBT), 12-step facilitation, and motivational enhancement therapy, also play a major role in treatment. In addition, community-based peer support groups such as Alcoholics Anonymous (AA) and other programs are helpful for many patients. [48]


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