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NLM Director’s Comments Transcript
Improving Care for Alcohol Abuse: 07/07/2014

Picture of Dr. Lindberg
illustration of no drinking allowed when driving
Photo: Courtesy of
the National Library of Medicine.

Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D. senior staff U.S. National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

Here is what's new this week in MedlinePlus.listen

A systematic review that reports effective medications which prevent a return to drinking are infrequently prescribed suggests a broader need for more patient centered care for adults who abuse alcohol, finds an accompanying commentary recently published in the Journal of the American Medical Association.

The systematic review of about 23,000 participants in 122 clinical trials (and one other study) suggests four medications, including acamprosate and oral naltrexone, are associated with a reduction in a return to heavy drinking among adults who abuse alcohol.

The systematic review adds if 12 persons are treated with acamprosate, it prevents one person from returning to drinking. The systematic review adds if 20 persons are treated with oral naltexone, it prevents one person from returning to drinking. While both of these number-needed-to-treat statistics are seen as clinically efficacious, the review’s authors note these and other effective medications are rarely prescribed.

The review’s lead author told the New York Times (and we quote): ‘These drugs are really underused quite a bit, and our findings show that they can help thousands and thousands of people’ (end of quote). MedlinePlus.gov’s alcoholism health topic page reports about 18 million Americans are alcoholics or have alcohol-related health challenges.

The authors of an accompanying commentary note the review’s findings suggest a broader need for more patient centered care for persons who abuse alcohol. The commentary’s authors write (and we quote): ‘Current medical management of alcohol abuse disorders is usually in stark contract to concepts of patient-centered care’ (end of quote).

To remedy, the commentary’s authors note the review’s findings should encourage clinicians and patients to discuss treatments for alcoholism. Optimally, the commentary’s authors emphasize the findings should revitalize efforts to: a) help patients better understand their condition and treatment options, b) provide information about the benefits and risks of various treatments, c) support patients when they clarify their treatment preferences, and d) assist patients as they go through the difficult steps to stop excessive drinking.

The commentary’s authors explain the clinical trials assessed in the systematic review were derived from patients who abused alcohol but abstained from drinking. The commentary’s authors note future research is needed regarding patients who wish to reduce alcohol consumption without giving up drinking. In addition, the commentary’s authors explain the clinical trials assessed in the systematic review were based on combining drug treatments with frequent behavioral interventions. The commentary’s authors continue more research is needed on the efficacy of medications without frequent behavioral interventions.
Nevertheless, the commentary’s authors conclude (and we quote): ‘Patients with alcohol abuse disorders should be offered options, including medications, evidence-based behavioral treatments, and mutual support for recovery. Moreover, patients should expect shared decision making about the best options for them’ (end of quote).

Meanwhile, a helpful overview of alcohol abuse and alcoholism - in a patient page provided by Journal of the American Medical Association - can be found in the ‘start here’ section of MedlinePlus.gov’s alcoholism health topic page. The link to an interesting website called ‘Rethinking drinking’ (from the National Institute on Alcohol Abuse and Alcoholism) also is available in the ‘start here’ section of MedlinePlus.gov’s alcoholism health topic page.

The American Academy of Family Physicians provides a website about alcohol abuse treatment with naltrexone in the ‘treatment’ section of MedlinePlus.gov’s alcoholism health topic page. The American Academy of Family Physicians also provides a website about the safety of medicines to curb drinking within the ‘rehabilitation/recovery’ section of MedlinePlus.gov’s alcoholism health topic page.

MedlinePlus.gov’s alcoholism health topic page additionally provides links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. You can sign up to receive updates about alcohol abuse as they become available on MedlinePlus.gov.

To find MedlinePlus.gov’s alcoholism health topic page type ‘alcoholism’ in the search box on MedlinePlus.gov’s home page, then, click on ‘alcoholism (National Library of Medicine).’ MedlinePlus.gov also has comprehensive health topic pages on alcohol as well as underage drinking.

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Please email Dr. Lindberg anytime at: NLMDirector@nlm.nih.gov

That's NLMDirector (one word) @nlm.nih.gov

A written transcript of recent podcasts is available by typing 'Director's comments' in the search box on MedlinePlus.gov's home page.

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A disclaimer — the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.

It was nice to be with you. I look forward to meeting you here next week.