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Alcohol Pharmacotherapy

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Alcohol Pharmacotherapy

0.5 hr CE

Goal: To prescribe drugs for alcohol use disorders that will affect patient outcomes and how to select them to meet patient needs.

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Activity Steps

1. Activity Content
2. Post-Assessments
3. Earn Certificate

Funding: Initial development of this activity was supported by funding from the National Institute on Alcohol Abuse and Alcoholism (Grant #1 R43 AA026474-01).

This activity is designed to change: Competence, Performance, Patient Outcome. 0.5 hr

Overview

Needs and Training Gaps

Educational Objectives:

After completing this activity, participants will be able to:

  • Explain to patients how different pharmacotherapies are used to halt negative alcohol use.
  • Prescribe the appropriate pharmacotherapy for treatment of alcohol use disorder based on the individual patient needs.
  • Describe the potential of emerging pharmacotherapies for treating alcohol use disorders.

Training Activity References

Audience and Accreditation

Audience: Health professionals

TypeEst. TimeReleasedExpires
DCBN0.5 hr(s)4/9/214/8/23
FBN CNA0.5 hr(s)4/9/214/8/23

Accreditation Statement: Clinical Tools, Inc. is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

DCBN Credit Statement: Clinical Tools, Inc. designates this enduring material for a maximum of 0.5 hour(s) of DCBN credit. Clinical Tools, Inc. is an approved provider by the District of Columbia Board of Nursing and is registered with CE Broker, Provider #50-1942.

FBN CNA Credit Statement: Clinical Tools, Inc. designates this enduring material for a maximum of 0.5 hour(s) of Florida Board of Nursing – Certified Nursing Assistants credit. Providers and other health professionals should claim only the credit commensurate with the extent of their participation in the activity.

Arkansas State Board of Nursing Accreditation Statement: Clinical Tools, Inc. is recognized by the Arkansas State Board of Nursing as an accredited provider of continuing medical education for nurses.

Georgia Board of Nursing Accreditation Statement: Clinical Tools, Inc. is recognized by the Georgia Board of Nursing as an accredited provider of continuing medical education for nurses.

New Mexico State Board of Nursing Accreditation Statement: Clinical Tools, Inc. is recognized by the New Mexico State Board of Nursing as an accredited provider of continuing medical education for nurses.

South Carolina Board of Nursing Accreditation Statement: Clinical Tools, Inc. is recognized by the South Carolina Board of Nursing as an accredited provider of continuing medical education for nurses.

A letter of completion for 0.5 hours is available.

A score of 70% on the post-test is required to complete the activity.

Participation Requirements

Authors

Clinical Tools, Inc. requires everyone who is in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest to the provider, which are defined as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. Any conflicts of interest are resolved prior to the delivery of the educational activity to the learner. CTI does not permit individuals with financial conflicts of interest to participate in any stage of activity development.

T Bradley Tanner, MD (President, Clinical Tools, Inc.)
Disclosure: Has disclosed no relevant financial relationships. Dr. Tanner is the owner of Clinical Tools.

Read Bio
T. Bradley Tanner, MD is president of Clinical Tools and responsible for the vision of the company. He has received funding via grants and contracts from NIDA, NIAAA, NIMH, NCI, AHRQ, CDC, the Dept of Defense, and NASA to develop medical and health education projects. Dr. Tanner served as principal investigator on 2 NIDA grants to develop the DATA-2000 qualifying buprenorphine training program and clinical practice tools on BupPractice.com. He also has a strong background in technology and oversees the development and delivery of all Clinical Tools websites. Dr. Tanner is also a board-certified psychiatrist with experience in inpatient, outpatient, and emergency health settings. He currently treats patients and educates medical students and residents via his role as a Clinical Associate Professor of Psychiatry at the University of North Carolina at Chapel Hill.

Karen Rossie, DDS, PhD (Research Scientist, Clinical Tools, Inc. )
Disclosure: Has disclosed no relevant financial relationships.

Read Bio
Karen Rossie, DDS, PhD, directs projects at Clinical Tools. She majored in biology at Cleveland State University and studied dentistry at Case Western Reserve University followed by completing a Masters in pathology at Ohio State University, and later, a PhD in Psychology from the Institute of Transpersonal Psychology. She taught and practiced oral pathology and oral medicine for 15 years at the Ohio State University and the University of Pittsburgh, doing research in autoimmune disease, viral effects in bone marrow transplantation, oral cancer, salivary gland disease, candidiasis, and diabetes. She has used this diverse background to lead or contribute to CTI projects related to tobacco cessation, opioid abuse treatment, anxiety, dementia care, alcohol use disorder, screening and brief interventions for substance abuse, obesity, and pain and addiction.

Most Recent Reviews

CTI Content Review: Mon, 8/10/2020
CTI Editorial Review: Tues, 8/11/2020


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Funding Information Development of this website was funded by grant #2R44AA026474 from the National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health. The website contents are solely the responsibility of the authors and do not necessarily represent the official views of NIH. No commercial support is received.
Clinical Tools is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

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A member of The Clinical Encounters Training Group: SBIRT Training | BupPractice | PainTx Challenge | CE:Vaping | CE:Alcohol | CE:Obesity | OpioidCME

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Unless otherwise noted, individuals pictured are models and are used for illustrative purposes only.
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Training Activity References

Accord Healthcare, Inc.. Naltrexone Hydrochloride – drug label information. Dailymed. 2014. Available at: http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=49aa3d6d-2270-4615-aafa-b440859ab870 Accessed on: 2015-06-11.

AHRQ. Clinician Summary – Pharmacotherapy for Adults With Alcohol Use Disorder (AUD) in Outpatient Settings. AHRQ.gov. 2016. Available at: https://www.effectivehealthcare.ahrq.gov/ehc/products/477/2161/alcohol-misuse-drug-therapy-clinician-160211.pdf Accessed on: 2016-02-25.

Alkermes, Inc.. Vivitrol – drug label information. Dailymed. 2013. Available at: http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=cd11c435-b0f0-4bb9-ae78-60f101f3703f#section-2.4 Accessed on: 2015-06-11.

Gastfriend D. Intramuscular extended-release naltrexone: current evidence. Annals of the New York Academy of Sciences. 2011; 1216: 144-166. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21272018 Accessed on: 2015-06-11.

Heilig M, Goldman D, Berrettini W, O’Brien CP. Pharmacogenetic approaches to the treatment of alcohol addiction. Nature Reviews Neuroscience. 2011; 12: 670-684. Available at: http://www.nature.com/nrn/journal/v12/n11/full/nrn3110.html Accessed on: 2015-05-29.

Iheanacho T, Issa M, Marienfeld C, et al. Use of naltrexone for alcohol use disorders in the Veterans’ Health Administration: A national study. Drug and Alcohol Dependence. 2013; 132: 122-123. Available at: http://www.ncbi.nlm.nih.gov/pubmed/23434041 Accessed on: 2015-06-10.

Kalra G, De Sousa A, Shrivastava A. Disulfiram in the management of alcohol dependence: A comprehensive clinical review. OJPsych. 2014; 4: . Available at: http://www.scirp.org/journal/PaperInformation.aspx?PaperID=41667#.VWXQE8_BzRY Accessed on: 2015-05-27.

Lee J, Kresina TF, Campopiano M, et al.. Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care. Biomed Research International. 2015. Available at: http://www.ncbi.nlm.nih.gov/pubmed/25629034 Accessed on: 2015-06-09.

Mason BJ, Lehert P. Acamprosate for Alcohol Dependence: A Sex-Specific Meta-Analysis Based on Individual Patient Data. Alcoholism: Clinical and Experimental Research. 2012; 36(3): 497-508. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21895717 Accessed on: 2015-06-09.

Mylan Pharmaceuticals Inc.. Acamprosate Calcium tablet, delayed release Drug Label Information. Dailymed. 2014. Available at: http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=75ddfd10-55b2-426e-bc74-3413cd0d7c94 Accessed on: 2015-06-09.

NIAAA. Treatment for alcohol problems: Finding and getting help. NIH. 2014. Available at: http://pubs.niaaa.nih.gov/publications/Treatment/treatment.htm Accessed on: 2015-05-20.

Physicians Total Care Inc. Antabuse – Disulfiram tablet. DailyMed. 2012. Available at: http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=12850de3-c97c-42c1-b8d3-55dc6fd05750 Accessed on: 2015-06-10.

Reus VI, Fochtmann LJ, Buckstein O, et al.. The American Psychiatric Association practice guideline for the pharmacological treatment of patients With Alcohol Use Disorder. The American Journal of Psychiatry. 2018; 175(1): 86-90. Available at: https://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2017.1750101?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed& Accessed on: 2018-01-13.

SAMHSA. Screening, Brief Intervention, and Referral to Treatment (SBIRT). SAMHSA. 2014. Available at: http://www.samhsa.gov/sbirt Accessed on: 2015-03-20.

SAMHSA. The facts about naltrexone. HHS Publication No. (SMA) 12-4444. 2012. Available at: http://store.samhsa.gov/product/The-Facts-about-Naltrexone-for-Treatment-of-Opioid-Addiction/SMA15-4444 Accessed on: 2015-06-11.

Skinner MD, Lahmek P, Pham H, Aubin HJ. Disulfiram efficacy in the treatment of alcohol dependence: A meta-analysis. PLoS One. 2014; 9: . Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3919718/ Accessed on: 2015-05-28.

Specka M, Heilmann M, Lieb B, Scherbaum N. Use of disulfiram for alcohol relapse prevention in patients in opioid maintenance treatment. Clin Neuropharmacol. 2014; 37: 161-165. Available at: http://www.ncbi.nlm.nih.gov/pubmed/25384073 Accessed on: 2015-05-28.

Swift RM, Aston ER. Pharmacotherapy for alcohol use disorder: Current and emerging therapies. Harv Rev Psychiatry. 2015; 23: 122-133. Available at: http://www.ncbi.nlm.nih.gov/pubmed/25747925 Accessed on: 2015-05-29.

VA/DoD. VA/DoD Clinical Practice Guideline for the Management of Substance Use Disorders. . 2015. Available at: http://www.healthquality.va.gov/guidelines/MH/sud/ Accessed on: 2016-11-15.

Yahn SL, Watterson LR, Olive MF. Safety and efficacy of acamprosate for the treatment of alcohol dependence. Subst Abuse. 2013; 6: 1-12. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3565569/ Accessed on: 2015-05-28.

Primary care physicians (PCPs) and other health care providers can have an overall positive effect on the patients they treat. Since about 70% of the population visits a PCP at least every other year, this puts the health care provider in a unique position to help (CASA 2000). Alcohol use continues to be a widespread public and social health problem. The health care provider needs to be able to screen for drinking in patients and assess, provide brief interventions, and/or make appropriate referrals when screening results are positive. Routine screening of all adults and adolescents for the continuum of alcohol use problems is currently recommended (NIAAA 2007) but does not always occur. The reality is that few physicians or other health care providers are routinely providing screening or intervention with their patients (D’Amico et al., 2005). Routine screening of all adults and adolescents for the continuum of alcohol use problems is currently recommended (NIAAA 2007).

At-risk drinkers can be effectively treated solely in primary care by using brief interventions (SAMHSA, 2014). Motivational interviewing skills can be used as a part of brief interventions for alcohol use problems. No two patients with alcohol use disorders will respond to treatment in the same manner. Alcohol abuse can affect anyone, regardless of age, gender, race, or specific lifestyle situations. As a health professional, it will be important for you to tailor your patient interviews about alcohol use to the patient’s age, gender, and race.

Alcohol addiction is a complex disease, and continued research provides insight into the biological basis of this disease. Patient education is key to increasing compliance and thus improving the success of treatment.

Training Gap References

CASA. National Survey of Primary Care Physicians and Patients on Substance Abuse. The National Center on Addiction and Substance Abuse at Columbia University. 2000.

D’Amico EJ, Paddock SM, Burnam A, Kung FY. Identification of and guidance for problem drinking by general medical providers: results from a national survey. Medical Care. 2005; 43(3): 229-236.

National Survey of Primary Care Physicians and Patients on Substance Abuse. The National Center on Addiction and Substance Abuse at Columbia University. 2000.

NIH. Alcohol-Related Traffic Deaths Fact Sheet. NIH. 2010. Available at: http://report.nih.gov/NIHfactsheets/Pdfs/AlcoholRelatedTrafficDeaths(NIAAA).pdf Accessed on: 2015-05-07.

SAMHSA. Screening, Brief Intervention, and Referral to Treatment (SBIRT). SAMHSA. 2014. Available at: http://www.samhsa.gov/sbirt Accessed on: 2015-03-20.

Participation Requirements

Activity Credit: Obtaining credit for participation in this activity requires that you complete the pre-assessments, work through the modules (including all in-module interactive activities), complete the post-assessments with a 70% score on the post-test, and then request credit. At the end of the activity, you will be instructed on how to print out a certificate for your records.

Time Requirement: Keep track of the amount of time it takes you to complete this activity. You will be required to spend a set amount of time in order to claim credit. You should claim credit only for the time actually spent in the activity.

Technical Requirement: To participate in this activity, you will need a computer, an Internet connection, and a Web browser. This activity requires Chrome, Firefox, and IE7 or higher.