Medication-Assisted Withdrawal and Alcohol Use Disorder Treatment in the Ambulatory Setting

Alcohol use disorder (AUD) represents a significant burden of disease in central Vermont, but receives little attention and resources compared to other drivers of morbidity and mortality. As part of a community health improvement project, primary care providers in central Vermont were surveyed regarding current practices and perceived barriers related to the effective treatment of AUD. 69% of respondents reported treating alcohol withdrawal syndrome (AWS) and 83% reported treating AUD. Respondents indicated concern about the safety and efficacy of the medications they currently prescribe and expressed interest in learning about other evidence-based treatments for AWS and AUD. The most frequently cited barriers to the treatment of AUD were lack of time and resources for adequate follow-up; patient’s unwillingness to decrease use; and provider lack of knowledge and comfort in treating AWS and AUD. The authors make several recommendations to improve care for patients struggling with AUD, including incorporating peer recovery coaches into primary care settings; providing CME opportunities for clinician training in evidence-based treatments for AWS and AUD; and implementing a decision-making protocol to determine the appropriate setting for patients experiencing AWS.https://scholarworks.uvm.edu/fmclerk/1805/thumbnail.jp