This TIP, Incorporating Alcohol Pharmacotherapies Into Medical Practice, revises and expands on TIP 28, Naltrexone and Alcoholism Treatment, and includes discussion of the other medications currently approved for treating alcohol use disorders (AUDs). It provides the basic information, evidence- and consensus-based guidelines, tools, and resources necessary to help healthcare practitioners treat patients with AUDs.

Contents

• Consensus Panel
• Expert Advisory Board
• What Is a TIP?
• Foreword
• Chapter 1—Introduction
  • Alcohol Use Disorders in Medical Settings
  • Audience for TIP 49
  • Recognition of Alcohol Dependence as a Chronic Illness
  • Purpose of TIP 49
  • What TIP 49 Does Not Cover
  • Specialty Treatment Versus Screening and Brief Intervention
  • Why Use Medications To Treat Alcohol Dependence?
  • Format, Approach, and Organization of TIP 49
• Chapter 2—Acamprosate
  • What Is Acamprosate?
  • Why Use Acamprosate?
  • How Is Acamprosate Used?
  • Who Is Appropriate for Treatment With Acamprosate?
  • Treatment Duration and Discontinuing Acamprosate
  • Final Clinical Thoughts
• Chapter 3—Disulfiram
  • What Is Disulfiram?
  • Why Use Disulfiram?
  • How Is Disulfiram Used?
  • Who Is Appropriate for Treatment With Disulfiram?
  • Treatment Duration and Discontinuing Disulfiram
  • Final Clinical Thoughts
• Chapter 4—Oral Naltrexone
  • What Is Oral Naltrexone?
  • Why Use Oral Naltrexone?
  • How Is Oral Naltrexone Used?
  • Who Is Appropriate for Treatment With Oral Naltrexone?
  • Treatment Duration and Discontinuing Oral Naltrexone
  • Final Clinical Thoughts
• Chapter 5—Extended-Release Injectable Naltrexone
  • What Is Extended-Release Injectable Naltrexone?
  • Why Use Extended-Release Injectable Naltrexone?
  • How Is Extended-Release Injectable Naltrexone Used?
  • Who Is Appropriate for Treatment With Extended-Release Injectable Naltrexone?
  • Treatment Duration and Discontinuing Extended-Release Injectable Naltrexone
  • Final Clinical Thoughts
• Chapter 6—Patient Management
  • Integrating Medication for Alcohol Dependence Into Clinical Practice Settings
  • Initial Assessment
  • Choosing a Medication
  • Combination Therapy
  • Choosing a Psychosocial Intervention
  • Developing a Treatment Plan
  • Patient Awareness
  • Monitoring Patient Progress
  • Modifying the Treatment Strategy
  • Discontinuing Pharmacotherapy
  • Final Clinical Thoughts
• Appendix A—Bibliography
• Appendix B—NIAAA's A Pocket Guide for Alcohol Screening and Brief Intervention
• Appendix C—Excerpts From Quick Guide for Clinicians Based on TIP 45, Detoxification and Substance Abuse Treatment
• Appendix D—Excerpts From Quick Guide for Clinicians Based on TIP 24, A Guide to Substance Abuse Services for Primary Care Clinicians
• Appendix E—Resource Panel
• Appendix F—Field Reviewers
• Appendix G—Acknowledgments

This publication was produced under the Knowledge Application Program, contract number 270-04-7049, a Joint Venture of The CDM Group, Inc., and JBS International, Inc., for the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). Christina Currier served as the CSAT Government Project Officer.

Suggested citation:

Center for Substance Abuse Treatment. Incorporating Alcohol Pharmacotherapies Into Medical Practice. Treatment Improvement Protocol (TIP) Series 49. HHS Publication No. (SMA) 09-4380. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2009.

The views, opinions, and content expressed herein are those of the expert panel and do not necessarily reflect the views, opinions, or policies of CSAT, SAMHSA, or HHS. No official support of or endorsement by CSAT, SAMHSA, or HHS for these opinions or for particular instruments, software, or resources is intended or should be inferred.