Treatment of Alcohol Use Disorder (AUD)

Usually treatment via CADS, christchurch


Anti-Craving Medications


Naltrexone - Opiod receptor Antagonist - **Funded in NZ via special authority, through CADS**

  • NNT = 20
  • Does undergo hepatic metabolism, and no studies in AUD in liver disease, however generally considered safe in Cirrhotics up to CP-B
  • Dose: 25-50mg daily
  • Do Not use in patients on opiates - as this will result in opiate withdrawal


Acamprosate. (Not available in NZ)

  • NNT = 12
  • Dose: 333mg TDS
  • No Hepatic metabolism
  • Do Not use in patients with eGFR < 30


Baclofen 

  • GABAb agonist
  • The only drug studied in Cirrhotics
  • Can be used in compensated and decompensated Cirrhotics
  • Dose: Start at 10mg TDS - can be up-titrated, usually not more than 90mg daily








Refernce: https://liverfellow.org/post/how-do-i-manage-alcohol-use-disorder-in-hepatology-clinic
Core IM
https://journals.lww.com/hep/Fulltext/2020/01000/Diagnosis_and_Treatment_of_Alcohol_Associated.25.aspx

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