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Management of alcohol use disorder in patients with chronic liver disease
Open accessAbstract
Alcohol use disorder (AUD) rates have risen dramatically in the United States, resulting in increasing rates of alcohol-associated liver disease (ALD), but many patients struggle to access alcohol use treatment. AUD treatment improves outcomes, including mortality, and represents the most urgent means by which care can be improved for those with liver disease (including ALD and others) and AUD. AUD care for those with liver disease involves 3 steps: detecting alcohol use, diagnosing AUD, and directing patients to alcohol treatment. Detecting alcohol use can involve questioning during the clinical interview, the use of standardized alcohol use surveys, and alcohol biomarkers. Identifying and diagnosing AUD are interview-based processes that should ideally be performed by a trained addiction professional, but nonaddiction clinicians can use surveys to determine the severity of hazardous drinking. Referral to formal AUD treatment should be made, especially where more severe AUD is suspected or identified. Therapeutic modalities are numerous and include different forms of one-on-one psychotherapy, such as motivational enhancement therapy or cognitive behavior therapy, group therapy, community mutual aid societies (such as Alcoholics Anonymous), inpatient addiction treatment, and relapse prevention medications. Finally, integrated care approaches that build strong relationships between addiction professionals and hepatologists or medical providers caring for those with liver disease are crucial to improving care for this population.
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“There is evidence of the effectiveness of MAGs for patients with addiction disorders such as alcohol use (Dale et al., 2019; Mellinger et al., 2023)”
From Analysis of the Efficacy of Mindfulness Meditation in a Mutual Aid Group for Bipolar Disorder (2024) · cites this paper as Mellinger et al., 2023
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Metadata
- Authors
- Mellinger, J. L., Fernandez, A. C., & Winder, G. S.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Mellinger, Jessica L.
- Venue
- Hepatology Communications
- Published
- 2023-06-14
- Volume
- 7
- Issue
- 7
- ISSN
- 2471-254X (ISSN-L)
- PMC
- PMC10270526
- OpenAlex
- W4380576976
- Cited by
- 52
- References
- 101
- Citations by year
- 2026: 14 · 2025: 16 · 2024: 17 · 2023: 4
- FWCI
- 10.18
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Hepatology Communications (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Clinical Neurology › Alcoholism and Thiamine Deficiency
- Keywords
- alcoholism, chronic liver disease, alcoholic liver disease, alcohol use detection, alcohol biomarkers, motivational enhancement therapy, cognitive behavioral therapy, group therapy, Alcoholics Anonymous, integrated care, addiction professionals, hepatologists
- MeSH terms
- Gastroenterologists, Alcohol Drinking, Ethanol, Alcoholism, Humans, Liver Diseases, Alcoholic
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