With the growth of non-alcoholic beverages (e.g., NA beer, liquor, etc), how do you approach a patient's consumption of these products in the setting of alcohol related liver disease?

This is definitely a challenging conundrum to deal with. Historically, even the NA beverages would have 0.5% alcohol, so they weren't truly NA. With time, that has seemingly changed. Regardless, my approach is the same. I strongly advise against the idea that NA beverages are allowed. Mostly because this can lead down a "slippery slope" where NA becomes A fairly quickly and is unable to be managed properly. Certainly, if a patient insists, then the conversation shifts towards counseling, understanding motives, understanding the social situations, and identifying strategies to avoid any potential relapses, and what the triggers might be. PETH testing for sure.

Perhaps, in a patient whom I have been taking care of for a long time and the trus...

No alcoholic drinks and cocktails are good alternative to alcohol, alcoholic drinks and cocktails. However, the problem is that many of these drinks are very tasty. If you’re having them in the company of others or some good food or some good music, the drinks become associated with good times. It’s not that much of a jump to go from delicious tasting margarita mix to a full-blown margarita, it can be a slippery slope lying back too tasty alcoholic drinks.

I’ve seen this work in real life. It’s similar to the phrase. The first drink is one of the next thousand. As alcoholics, they have documented cravings for alcohol. If not, perhaps bothalcohol and drugs. If you let them get the taste of a delicious cocktail, it may be very hard to stop dr...