Alcohol and drug use disorders

Abstract

Alcohol and other drug use increase the risk for a wide array of health consequences, including substance use disorders (SUDs). Fully 10% of deaths among working adults are due to alcohol, a leading cause of preventable death. SUDs can be short-lived and resolve on their own, or they can be more severe, chronic diseases. Substance use disorders can be identified in clinical care settings by brief questionnaires as brief as single items, and longer questionnaires and interview can provide assessments of levels of risk and severity useful for determining appropriate management. Effective SUD treatments include pharmacotherapy, behavioral modalities, and recovery supports. Treatment should be adapted to severity and response, and medications should not be withheld from those not receiving psychosocial interventions. Other medical and mental health comorbidities must be addressed, as should social ills. Promising models exist for integrating the management of SUDs into general health settings.