A recent article published in Psychology Today and authored by Dr. Mark Gold focused on the treatment of alcohol use disorder and the role of early intervention. According to the U.S. National Institute of Alcohol Abuse and Alcoholism (NIAAA), health practitioners should screen patients for alcohol consumption and initiate interventions with the purpose of harm reduction. “Experts now recognize a pre-addiction stage of alcohol use disorder (AUD). If a person is identified with pre-addiction before alcohol issues become entrenched and then receives treatment, major emotional and physical pain could be averted,” said Dr. Gold.
During the pre-addiction phase, there is an increased risk of developing a substance use disorder, potentially leading to AUD. “A diagnosis of pre-addiction could similarly serve as an alert to the individual about a behavioural pattern with potentially major—but also very preventable—health and life consequences down the road. It could create a different inflection point, one that recruits the patient more actively as an agent in their own health and wellness,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA).
Data released by the Centre for Addiction and Mental Health (CAMH) shows that 18% of people aged 15 years and older in Canada will meet the clinical criteria for an AUD in their lifetime, while over 50% of people in Canada aged 15 years and older currently drink more than the amount recommended in Canada’s Guidance on Alcohol and Health. What’s more, pre-addiction and AUD often remain unrecognized and untreated in the health care system.
In 2023, the BC Centre on Substance Use (BCCSU) published the first Canadian guideline for treating high-risk drinking and AUD, providing evidence-based recommendations to reduce harms associated with high-risk drinking to support treatment and recovery from AUD.
“Despite the burden of illness, there remains a tremendous gap between what we know is effective treatment and the care Canadians are actually receiving. Unfortunately, in the absence of effective care, people are being routinely prescribed potentially harmful medications that can, unknown to most prescribers, actually increase alcohol use in some patients. These guidelines seek to close that gap and ensure Canadians are accessing the safest and most effective treatments that meet their needs,” said Dr. Evan Wood, co-chair of the guideline writing committee and an addiction medicine specialist at UBC and BCCSU in a released statement.
In recent years, new studies have examined the effectiveness of compounds such as psilocybin, ketamine, and other psychedelics in reducing alcohol consumption. Furthermore, it has also been shown that GLP-1 receptor agonists may be effective in the treatment for AUD in individuals treated for obesity. “Current AUD medications are the same MATs we’ve had for decades. AUD treatment failures are more likely when we do not treat comorbidities. Further research on neuromodulation (TMS), ketamine, psychedelics, and GLP-1 receptor agonists may increase patient and physician interest in AUD treatment,” concluded Dr. Gold.