Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder

Alex Haga — Thu, 06 Feb 2025 19:07:47 +0000

Date Added:

February 6, 2025

Journal/Publication:

Canadian Medical Association Journal

Publication Date:

October 16, 2023

Issue:

Volume:

195

Pages:

E1364-E1379

URL:

Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.230715

Keywords

alcohol drinking

alcoholism

drinking

PMID (1):

37844924

MeSH

Alcohol Drinking / therapy

Alcoholism* / diagnosis

Canadian guideline for management of patients with alcohol use disorders. James W. Mold, MD, MPH

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Background: In Canada, low awareness of evidence-based interventions for the clinical management of alcohol use disorder exists among health care providers and people who could benefit from care. To address this gap, the Canadian Research Initiative in Substance Misuse convened a national committee to develop a guideline for the clinical management of high-risk drinking and alcohol use disorder.

Methods: Development of this guideline followed the ADAPTE process, building upon the 2019 British Columbia provincial guideline for alcohol use disorder. A national guideline committee (consisting of 36 members with diverse expertise, including academics, clinicians, people with lived and living experiences of alcohol use, and people who self-identified as Indigenous or Métis) selected priority topics, reviewed evidence and reached consensus on the recommendations. We used the Appraisal of Guidelines for Research and Evaluation Instrument (AGREE II) and the Guidelines International Network's Principles for Disclosure of Interests and Management of Conflicts to ensure the guideline met international standards for transparency, high quality and methodological rigour. We rated the final recommendations using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool; the recommendations underwent external review by 13 national and international experts and stakeholders.

Recommendations: The guideline includes 15 recommendations that cover screening, diagnosis, withdrawal management and ongoing treatment, including psychosocial treatment interventions, pharmacotherapies and community-based programs. The guideline committee identified a need to emphasize both underused interventions that may be beneficial and common prescribing and other practice patterns that are not evidence based and that may potentially worsen alcohol use outcomes.

Interpretation: The guideline is intended to be a resource for physicians, policymakers and other clinical and nonclinical personnel, as well as individuals, families and communities affected by alcohol use. The recommendations seek to provide a framework for addressing a large burden of unmet treatment and care needs for alcohol use disorder within Canada in an evidence-based manner.

Author/s:

Evan Wood, Jessica Bright, Katrina Hsu, Nirupa Goel

Planning and Implementing Screening and Brief Intervention for Risky Alcohol Use

Jeffrey Wilson — Thu, 27 Dec 2018 16:53:24 +0000

Date Added:

December 27, 2018

Publisher:

National Center on Birth Defects and Developmental Disabilities

Publication Date:

January 1, 2014

Type:

Meta-analyses, Reviews, and Guidelines, Practice Management Research Results

Format:

Slides

Keywords

MeSH

referral and consultation

This is a comprehensive set of recommendations from the CDC on how to establish a system for screening for and management of patients with unhealthy alcohol use.

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Like hypertension or tobacco screening, alcohol screening and brief intervention (alcohol SBI) is a clinical preventative service. It identifies and helps patients who may be drinking too much. It involves:

A validated set of screening questions to identify patients' drinking patterns,
A short conversation who are drinking to omuch, and for patients with severe risk, a referral to specialized treatment as warranted.

The entire service takes only a few minutes, is inexpensive, and may be reimbursable. Thirty years of resesarch has shown that alcohol SBI is effective at reducing the amount of alcohol consumed by those who are drinking too much. Based on this evidence the U.S. Preventative Services Task Force and many other organizations have recommended that alcohol SBI be implemented for all adults in primary health care settings.

Author/s:

Higgins-Biddle, John C., Hungerford, Daniel W., Baker, Susan D., Reynolds, Megan R., Cheal, Nancy E., Weber, Mary Kate, Dang, Elizabeth P.