drinking

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

Alex Haga — Mon, 05 May 2025 15:32:40 +0000

Date Added:

May 5, 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

alcoholism

drinking

PMID (1):

37844924

MeSH

Alcohol Drinking / therapy

Alcoholism* / diagnosis

Alcoholism* / drug therapy

British Columbia

Humans

A Canadian guideline for management of alcohol use disorders. James W. Mold, MD, MPHG

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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, Josey W G Ross

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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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.

Author/s:

Evan Wood, Jessica Bright, Katrina Hsu, Nirupa Goel

About Moderate Alcohol Use

Alex Haga — Thu, 30 May 2024 22:17:25 +0000

Date Added:

May 30, 2024

Journal/Publication:

CDC

Publication Date:

May 15, 2024

URL:

About Moderate Alcohol Use

Type:

Patient Education Materials

Format:

Article

Keywords

MeSH

Information for patients regarding moderate alcohol use and health. James W. Mold, MPH

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KEY POINTS
Drinking excessively increases your risk of getting sick, injured, or dying sooner.
You can choose not to drink alcohol, drink less, or drink in moderation to lower these risks, compared to drinking excessively.
However, even moderate drinking may increase your risk of death and other alcohol-related harms, compared to not drinking.

FRAMES: The Essentials of a Brief Intervention for Problem Drinking Pocket Cards

Tracy Ashby — Wed, 28 Nov 2018 06:00:00 +0000

Date Added:

December 11, 2018

Type:

Clinical Decision Aids

Format:

Article

Keywords

MeSH

This is a pocket card reminder of the components of the FRAMES brief intervention for unhealthy alcohol use.

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Pocket cards of FRAMES: brief intervention for problem drinkers.

Effect of Increased Daily Water Intake in Premenopausal Women With Recurrent Urinary Tract Infections: A Randomized Clinical Trial

Tracy Ashby — Tue, 23 Oct 2018 05:00:00 +0000

Date Added:

October 23, 2018

Journal/Publication:

JAMA Internal Medicine

Publisher:

American Medical Association

Publication Date:

October 1, 2018

URL:

Effect of Increased Daily Water Intake in Premenopausal Women With Recurrent Urinary Tract Infections: A Randomized Clinical Trial

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1001/jamainternmed.2018.4204

Keywords

women

water

drinking

PMID (1):

30285042

MeSH

female

drinking

water

This RCT found that increasing water intake by 1500cc/day dramatically reduced the incidence of UTIs in premenopausal women with a history of recurrent cystitis and daily fluid (pretreatment) fluid intake less than 1500cc.

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IMPORTANCE:

Increased hydration is often recommended as a preventive measure for womenwith recurrent cystitis, but supportive data are sparse.

OBJECTIVE:

To assess the efficacy of increased daily water intake on the frequency of recurrent cystitis in premenopausal women.

DESIGN, SETTING, AND PARTICIPANTS:

Randomized, open-label, controlled, 12-month trial at a clinical research center (years 2013-2016). Among 163 healthy women with recurrent cystitis (≥3 episodes in past year) drinking less than 1.5 L of fluid daily assessed for eligibility, 23 were excluded and 140 assigned to water or control group. Assessments of daily fluid intake, urinaryhydration, and cystitis symptoms were performed at baseline, 6- and 12-month visits, and monthly telephone calls.

INTERVENTIONS:

Participants were randomly assigned to drink, in addition to their usual fluid intake, 1.5 L of water daily (water group) or no additional fluids (control group) for 12 months.

MAIN OUTCOMES AND MEASURES:

Primary outcome measure was frequency of recurrentcystitis over 12 months. Secondary outcomes were number of antimicrobial regimens used, mean time interval between cystitis episodes, and 24-hour urinary hydration measurements.

RESULTS:

The mean (SD) age of the 140 participants was 35.7 (8.4) years, and the mean (SD) number of cystitis episodes in the previous year was 3.3 (0.6). During the 12-month study period, the mean (SD) number of cystitis episodes was 1.7 (95% CI, 1.5-1.8) in the water group compared with 3.2 (95% CI, 3.0-3.4) in the control group, with a difference in means of 1.5 (95% CI, 1.2-1.8; P < .001). Overall, there were 327 cystitis episodes, 111 in the water group and 216 in the control group. The mean number of antimicrobial regimens used to treat cystitis episodes was 1.9 (95% CI, 1.7-2.2) and 3.6 (95% CI, 3.3-4.0), respectively, with a difference in means of 1.7 (95% CI, 1.3-2.1; P < .001). The mean time interval between cystitis episodes was 142.8 (95% CI, 127.4-160.1) and 84.4 (95% CI, 75.4-94.5) days, respectively, with a difference in means of 58.4 (95% CI, 39.4-77.4; P < .001). Between baseline and 12 months, participants in the water group, compared with those in the control group, had increased mean (SD) urine volume (1.4 [0.04] vs 0.1 [0.04] L; P < .001) and voids (2.4 [0.2] vs -0.1 [0.2]; P < .001) and decreased urine osmolality (-402.8 [19.6] vs -24.0 [19.5] mOsm/kg; P < .001).

CONCLUSIONS AND RELEVANCE:

Increased water intake is an effective antimicrobial-sparing strategy to prevent recurrent cystitis in premenopausal women at high risk for recurrence who drink low volumes of fluid daily.

TRIAL REGISTRATION:

ClinicalTrials.gov identifier: NCT02444975.

Author/s:

Hooton, Thomas M., Vecchio, Mariacristina, Iroz, Alison, Tack, Ivan, Dornic, Quentin, Seksek, Isabelle, Lotan, Yair