The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients with Alcohol Use Disorder

Alcohol use disorder (AUD) is a major public health problem in the United States (U.S.). The estimated 12-month and lifetime prevalence values for AUD are 13.9% and 29.1%, respectively, with approximately half of individuals with lifetime AUD having a severe disorder. AUD and its sequelae also account for significant excess mortality and cost the U.S. over $200 billion annually. Despite its high prevalence and numerous negative consequences, AUD remains undertreated. In fact, fewer than 1 in 10 individuals in the U.S. with a 12-month diagnosis of AUD receive any treatment. Nevertheless, effective and evidence-based interventions are available, and treatment is associated with reductions in the risk of relapse and AUD associated mortality.

The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients with Alcohol Use Disorder seeks to reduce these substantial psychosocial and public health consequences of AUD for millions of affected individuals. The guideline focuses specifically on evidence-based pharmacologic treatments for AUD, but also includes statements related to assessment and treatment planning that are an integral part of using pharmacotherapy to treat AUD. The guideline offers clear, concise, and actionable recommendation statements to help clinicians incorporate recommendations into clinical practice, with the goal of improving quality of care and treatment outcomes of AUD. Each recommendation is given a rating that reflects the level of confidence that potential benefits of an intervention outweigh potential harms. In addition to reviewing the available evidence on the use of AUD pharmacotherapy in outpatients, the guideline provides guidance to clinicians on implementing these recommendations to enhance patient care.