Pharmacologic interventions

Pharmacologic interventions to treat alcohol use in patients with liver disease target symptoms of alcohol withdrawal or are aimed at reducing or eliminating alcohol consumption. Benzodiazepines remain the accepted pharmacologic treatment for alcohol withdrawal, although anticonvulsants may be used for mild-moderate alcohol withdrawal. Disulfiram, naltrexone, and acamprosate are the most widely utilized pharmacologic treatments for alcohol consumption although quite a few other medications have been studied and are prescribed. Use of all of these medications in the face of liver disease requires careful choice to avoid hepatotoxicity. In all cases, patients should receive a thorough evaluation. Risks versus benefits must be considered in each individual patient and concurrent psychosocial treatment is highly recommended.