TIP 49: Treating Alcohol Use Disorders with Medication
People with alcohol use disorders (AUDs) now have more options in seeking help. A new resource from SAMHSA provides clinical guidelines for the proper use of medications in the treatment of AUDs.
Treatment Improvement Protocol (TIP) 49, Incorporating Alcohol Pharmacotherapies Into Medical Practice, provides the basic information, evidence- and consensus-based guidelines, tools, and resources necessary to help health care providers treat patients with AUDs.
TIP 49 is intended for use by physicians and other health care providers who can prescribe and administer medications for AUDs, in either specialty substance abuse treatment programs or primary care offices.
Because health care providers are in key positions to manage the care of large numbers of patients with AUDs, this TIP offers specific information about the different medications available for treatment.
A chapter is devoted to each of the following medications, which have been approved for use by the Food and Drug Administration:
- Acamprosate is thought to help modulate and normalize alcohol-related changes in brain activity, reducing symptoms of protracted withdrawal (e.g., disturbances in sleep and mood) that may trigger a relapse.
- Disulfiram causes an acutely toxic physical reaction when mixed with alcohol, which is thought to increase the patient’s motivation to remain abstinent.
- Oral naltrexone reduces both the rewarding effects of alcohol and the craving for it.
- Extended-release injectable naltrexone helps address patient nonadherence, which can limit the effectiveness of oral naltrexone.
These four medications have unique pharmacological actions and profiles of effects, and they produce different types of outcomes in individual patients, making it necessary for separate guidelines for their use. As more information becomes available, it will be added to the online bibliography and literature review that supplement this TIP on SAMHSA’s Knowledge Application Program Web site.
TIP 49 revises and expands TIP 28, Naltrexone and Alcoholism Treatment, and builds upon TIP 24, A Guide to Substance Abuse Services for Primary Care Physicians.
For print copies of TIP 49, call SAMHSA’s Health Information Network at 1-877-SAMHSA-7. Ask for publication number SMA09-4380. Download a PDF version of TIP 49. Download the online-only supplemental literature review.