"Evidence" and the treatment of alcohol use disorder

Alcohol use disorder is an important public health problem for which evidence-based treatments should be used. In the current article, two recent publications related to this topic (i.e., a featured article from The Atlantic and a brief guide from the Substance Abuse and Mental Health Services Administration [SAMHSA]) are critically evaluated. Both publications emphasize that evidence-based medications are underused for the treatment of alcohol use disorder. The featured article was critical of faith-based Alcoholics Anonymous(®) 12-step programs, but the critique was not based on a sound evaluation of research pertaining to their use. The brief guide prepared for SAMHSA was developed by a scientific consensus panel reviewing current evidence of the effectiveness of available medications, but focused only on those that have been approved by the U.S. Food and Drug Administration (FDA) for this indication, neglecting to describe potentially effective off-label use of other FDA-approved medications.