W13 - Navigating the Treatment of Alcohol Use Disorder in Your Practice
Saturday, 24 October
11:15 – 12:45 (1.5 hrs)
Valerie Primeau*, MD, FRCPC; Andriy Samokhvalov, MD, PhD, FRCPC
Supported by the Addiction Psychiatry Section
At the end of this session, participants will be able to: 1) Describe the different medications used to treat alcohol use disorder; 2) Apply current principles for the management of alcohol withdrawal; and 3) Identify the importance of treating psychiatric comorbidities concurrently.
In any given year, one in five Canadians experiences a mental health or addiction problem. People with a mental illness are twice as likely to have a substance use disorder, compared to the general population. At least 20% of people with a mental illness have 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. More than 15% of people with a substance use disorder have a co-occurring mental illness. Alcohol use disorder (AUD) is the most prevalent addiction, with the lifetime prevalence of 18.1% in Canada. Unfortunately, despite the high prevalence of AUD in clinical practice, psychiatrists are not always familiar with the available evidence-based treatments for AUD, and there is significant variability in the treatments offered to patients. Some psychiatrists are not comfortable prescribing anti-craving medications. Some psychiatrists may feel it is best to wait for abstinence before treating the underlying mental illness. There is strong evidence that treating mental health and addictions together has the best outcome and leads to a decrease in relapse rates and health care use and costs. This course will review evidence-based guidelines and treatment strategies for the treatment of AUD and management of the concurrent mental illnesses. Clinical vignettes will be used to help clinicians think through real-life scenarios in treating AUD.
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.
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;18:189.