Friday, Oct. 20
15:45 – 16:45 (1 hr)
Meeting Room: Port McNeill (4th floor – North Tower)
Valerie Primeau*, MD, FRCPC; Valerie Primeau, MD FRCPC; Andriy V. Samokhvalov, MD PhD FRCPC
Supported by the Addiction Psychiatry Section

CanMEDS Roles:

1. Medical Expert
2. Collaborator
3. Health Advocate

At the end of this session, participants will be able to: 1) Describe the evidence-based medications used to treat alcohol use disorder (AUD), from acute withdrawal to community maintenance treatment; 2) Discuss the 2023 Canada’s Guidance on Alcohol and Health: Final Report, which recommends fewer than two standard drinks a week to avoid harm; and 3) Identify the importance of concurrent integrated treatment and recognize the impact of the COVID-19 pandemic on the prevalence and treatment of AUD.

In any given year, one in five Canadians experiences a mental health or addiction problem. People with mental illness are twice as likely to have a substance use disorder, with at least 20% of people with mental illness having a co-occurring substance use disorder. For people with schizophrenia, the number may be as high as 50%. Similarly, people with substance use disorders are up to three times more likely to have a mental illness, with more than 15% of people with substance use disorders having a co-occurring mental illness. Alcohol use disorder (AUD) is the most prevalent substance use disorder. Since the COVID-19 pandemic, frequency of drinking, days of heavy drinking, and alcohol-related consequences have all increased, especially in women. This is troubling given the recent release of the 2023 Canada’s Guidance on Alcohol and Health: Final Report, which recommends a maximum of two standard drinks a week to avoid alcohol-related consequences. Despite the high prevalence of AUD, psychiatrists are not always familiar with the available evidence-based treatments, and there is significant variability in what is offered to patients. Some psychiatrists are not comfortable prescribing anticraving medications. Some may feel it is best to wait for abstinence before treating underlying mental illness. There is strong evidence that treating mental health and addictions concurrently has the best outcome, leading to a decrease in relapse rates and health care costs. This course will review evidence-based guidelines and clinical strategies for the treatment of AUD and concurrent mental illness in an interactive format.

References:

1. Reus VI, Fochtmann LJ, Bukstein O, et al. The American Psychiatric Association practice guideline for the pharmacological treatment of patients with alcohol use disorder. Am J Psychiatry 2018;175(1):86–90.
2. Samokhvalov AV, Probst C, Awan S, et al. Outcomes of an integrated care pathway for concurrent major depressive and alcohol use disorders: a multisite prospective cohort study. BMC Psychiatry 2018;18(1):189.