From the Guidelines
A comprehensive treatment plan for alcohol use disorder (AUD) should include medical detoxification, medications such as naltrexone, acamprosate, and disulfiram, and psychosocial interventions like cognitive-behavioral therapy and support groups, with a focus on addressing co-occurring mental health conditions and providing a strong support network. When creating an alcohol use disorder charting template, it is essential to consider the following key components:
- Medical detoxification to safely manage withdrawal symptoms, typically using benzodiazepines like diazepam (5-10mg every 4-6 hours as needed) or chlordiazepoxide (25-100mg every 6 hours as needed) for 3-7 days with tapering doses, as recommended by 1
- Medications specifically for AUD maintenance, including: + Naltrexone (50mg daily oral or 380mg monthly injection), which reduces cravings by blocking opioid receptors, as suggested by 2, 3 + Acamprosate (666mg three times daily), which helps restore brain chemistry, as recommended by 2, 3 + Disulfiram (250-500mg daily), which causes unpleasant reactions if alcohol is consumed, as mentioned in 3, 4
- Psychosocial interventions, including: + Cognitive-behavioral therapy to identify triggers and develop coping strategies + Motivational enhancement therapy to strengthen commitment to change + Support groups like Alcoholics Anonymous, as listed in 5
- Addressing co-occurring mental health conditions, such as depression and anxiety, which frequently accompany AUD, as noted in 5
- Regular monitoring through laboratory tests (liver function, complete blood count) to track physical health improvements, as recommended by 4
- A strong support network of family and friends, which significantly improves outcomes, as suggested by 5 This multimodal approach is necessary because AUD affects both brain chemistry and behavior, requiring biological, psychological, and social interventions for effective recovery, as emphasized by 2, 3, 4, 5, 1.
From the FDA Drug Label
To achieve the best possible treatment outcome, appropriate compliance-enhancing techniques should be implemented for all components of the treatment program, especially medication compliance. Factors associated with a good outcome in the clinical trials with naltrexone hydrochloride were the type, intensity, and duration of treatment; appropriate management of comorbid conditions; use of community-based support groups; and good medication compliance.
The key components of a treatment plan for patients with alcohol use disorder include:
- Type, intensity, and duration of treatment
- Appropriate management of comorbid conditions
- Use of community-based support groups
- Good medication compliance
- Compliance-enhancing techniques for all components of the treatment program, especially medication compliance 6.
From the Research
Key Components of a Treatment Plan for Patients with Alcohol Use Disorder
The key components of a treatment plan for patients with alcohol use disorder include:
- Assessment of alcohol use and withdrawal symptoms using tools such as the Clinical Institute Withdrawal Assessment for Alcohol Scale, Revised, and the Short Alcohol Withdrawal Scale 7
- Supportive care and pharmacotherapy as appropriate, with medications such as carbamazepine, gabapentin, and benzodiazepines for managing withdrawal symptoms 7
- Long-term treatment for alcohol use disorder, including pharmacotherapy with medications such as disulfiram, naltrexone, and acamprosate 8, 9, 10, 11
- Monitoring of patients with alcohol withdrawal syndrome daily for up to five days after their last drink to verify symptom improvement and to evaluate the need for additional treatment 7
Pharmacologic Interventions for Alcohol Use Disorder
Pharmacologic interventions for alcohol use disorder include:
- Disulfiram, an aversive agent that has been used for more than 40 years, although it has significant adverse effects and compliance difficulties 10
- Naltrexone, an anticraving agent that reduces relapse rates and cravings and increases abstinence rates 8, 9, 10, 11
- Acamprosate, which reduces relapse rates and increases abstinence rates 8, 9, 10, 11
- Off-label pharmacologic treatments such as gabapentin, baclofen, oxytocin, N-acetylcysteine, calcium carbonate, and psilocybin 9
- Topiramate, which is not approved for the treatment of AUD but is suggested as a therapeutic option by the American Psychiatric Association for patients who do not tolerate or respond to approved therapies 11
Assessment and Monitoring of Patients with Alcohol Use Disorder
Assessment and monitoring of patients with alcohol use disorder include:
- Using the three-question Alcohol Use Disorders Identification Test-Consumption and the Single Alcohol Screening Question instrument to assess unhealthy alcohol use in adults 18 years and older 7
- Monitoring patients with alcohol withdrawal syndrome daily for up to five days after their last drink to verify symptom improvement and to evaluate the need for additional treatment 7
- Regular follow-up appointments to assess the effectiveness of treatment and to make any necessary adjustments to the treatment plan 7, 8, 9, 10, 11