How do you manage patients with alcohol use disorder who express interest in moderation rather than full abstinence?

In the past, I would try to engage these patients in complete recovery—AA, etc. Today, having read the literature on harm reduction and perhaps being more experienced and tolerant with age, I engage the patient in healthcare activities like exercise, sleep, and diet, and discuss recovery from alcoho...

With humility. I don't have a crystal ball, and I can't say how any one particular patient will do with an attempt to reduce their use. I have crossed paths with people who do moderate their use, and their life improves (fewer symptoms of AUD).

That said, I think it's also my responsibility to share...

Great question.

In my shared clinical experience with colleagues, the vast majority of patients with alcohol use disorder are not seeking full abstinence but prefer to become more 'sensible drinkers'. The WHO published guidelines some years ago that showed if treatment for AUD can help a person drop...

Present evidence shows we can help someone become a controlled drinker with the help of naltrexone. The difference is that, in contrast with social drinking, the controlled drinker still obsesses about the "drink." Still much better, less harmful, and more acceptable. Naltrexone is obligatory.