Treating high-risk drinking, alcohol use disorder: new Canadian guideline
published on October 16, 2023
The first-ever Canadian guideline for treating high-risk drinking and alcohol use disorder (AUD) has been published today in the CMAJ (Canadian Medical Association Journal).
Developed in partnership between the Canadian Research Initiative on Substance Misuse (CRISM) and BC Centre on Substance Use (BCCSU), the guideline provides 15 evidence-based recommendations to reduce harms associated with high-risk drinking and to support people’s treatment and recovery from AUD.
In addition to the new clinical guidelines, a website has been developed, called helpwithdrinking.ca, to raise awareness of resources and treatments available to Canadians. These resources do not make recommendations for reducing health risks associated with alcohol, but provide Canadians with information about what treatments are available for high risk drinking and how they can be accessed.
The message: help is available.
High-risk drinking common, but often goes untreated
High-risk drinking, alcohol use disorder (AUD), and alcohol-related harms are common in Canada. Nearly 18% of people aged 15 years or older in Canada will meet the clinical criteria for an AUD in their lifetime, and over 50% of people in Canada aged 15 or older currently drink more than the amount recommended in Canada’s Guidance on Alcohol and Health.
Despite the high prevalence of high-risk drinking and AUD, these conditions frequently go unrecognized and untreated in the health care system. Even if recognized, AUD does not receive evidence-based interventions. It’s estimated that less than 2% of eligible patients receive evidence-based alcohol treatment in the form of evidence-based pharmacotherapies, likely due to low awareness. Conversely, according to the guideline, many Canadian patients receive medications that may be ineffective and potentially harmful.
To address this health issue, Health Canada funded CRISM and BCCSU to develop the Canadian Guideline for the Clinical Management of High-Risk Drinking and Alcohol Use Disorder.
The guideline provides recommendations for the clinical management of high-risk drinking and AUD to support primary healthcare providers to implement evidence-based screening and treatment interventions.
Developed by a 36-member committee, the guideline is based on the latest evidence, expert consensus, lived/living experience as well as clinical experience from across Canada. It makes recommendations for care providers about how to ask about alcohol, diagnose alcohol use disorder, manage alcohol withdrawal, and create treatment plans based on the individual’s goals. It also highlights the possible negative effects of selective serotonin reuptake inhibitor (SSRI) therapy, which can worsen the disease in some patients with AUD, or AUD and concurrent anxiety or depression.
Treatment plans can include medications, counselling, harm reduction, or a combination.
Read more:
- Guideline: Canadian Guideline for the Clinical Management of High-Risk Drinking and Alcohol Use Disorder
- Article: Canadian Medical Association Journal (CMAJ) – “Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder”
- Website: helpwithdrinking.ca
Quotes:
“High risk drinking and alcohol use disorder frequently go unrecognized and untreated in our health care system, leaving individuals without access to effective treatments that can improve their health and wellbeing. These guidelines give primary care providers the tools to support early detection and treatment, and connecting patients and families with specialized care services and recovery-oriented supports in their communities.”
Dr. Jürgen Rehm, co-chair of the guideline writing committee and senior scientist in the Institute for Mental Health Policy Research at the Centre for Addiction and Mental Health (CAMH)
“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.”
Dr. Evan Wood, co-chair of the guideline writing committee and an addiction medicine specialist at UBC and BCCSU
Media contact:
Kevin Hollett
Communications, BC Centre on Substance Use
[email protected]