Treatment of Alcohol Use Disorder with Dr. Marlene Martin MD, The Curbsiders #194

Source: Martin M, Chan, C, Williams PN, Brigham SK, Watto MF. “194 Treatment of Alcohol Use Disorder”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. February 10, 2020.

Dismantle alcohol use disorder with some evidence based tools for your toolbelt! We cover everything from ways to screen patients for risky drinking, to all the different treatment options with our guest expert Dr. Marlene Martin, @MarleneMartinMD, Director of the Addiction Care Team and Assistant Professor of Clinical Medicine at the UCSF. We learn how to initiate medications such as naltrexone and acamprosate for the treatment of alcohol use disorder, how to define treatment success, if psychosocial interventions such as Alcoholics Anonymous are effective, and what’s the deal with baclofen and gabapentin? After listening to this episode, listeners will feel ready to start prescribing medications such naltrexone to treat alcohol use disorder. Your patients need you!

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Credits Written and Produced by: Carolyn Chan, MD Cover Art and Infographic: Carolyn Chan, MD Hosts: Carolyn Chan, MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio) Guest: Marlene Martin, MD Sponsor ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order!

Time Stamps 00:00 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders 00:45 Intro, guest bio 01:30 Guest one-liner, book recommendation, favorite failure, career advice Picks of the week*: Project Runway (TV show); The Quiet Place (film); Tattoos on the Heart: The Power of Boundless Compassion (book) by: Gregory Boyle; Cats (film) 08:20 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders 09:05 Case of Mr Hops; Defining unhealthy alcohol use 13:37 Screening and diagnosis; assessing for tolerance; stratifying severity of AUD 16:56 Spiel and first steps after diagnosing a patient with unhealthy alcohol use; Motivational interviewing; Exploring motivation to change 22:12 Pharmacologic treatment options: Naltrexone, acamprosate, disulfiram 26:40 How effective are medications for alcohol use disorder; Defining success 29:41 Naltrexone prescribing, dose titration 34:25 Acamprosate prescribing; Naltrexone in advanced liver disease 38:05 Off label use of baclofen, gabapentin and topiramate 43:39 Risk stratifying for inpatient versus outpatient treatment; Non-pharmacologic interventions 49:26 Deciding duration of therapy 52:24 Take home points; Plug for AMERSA conference 53:57 Outro *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Disclosures Dr Marlene Martin reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.