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Implementing Evidence-Based Care for Alcohol Use Disorder
Scott E Hadland1,2, Brittany B Dennis3,4, Evan Wood3,4
1Division of Adolescent and Young Adult Medicine, Mass General Brigham for Children, Boston, MA, USA.
NEJM Evidence
|July 28, 2026
Summary
Most people with problematic alcohol use don't get evidence-based care. Recent findings show harms at lower drinking levels, highlighting a need for better screening and treatment for alcohol use disorders.
Area of Science:
- Public Health
- Clinical Medicine
- Addiction Research
Background:
- Alcohol use significantly contributes to global morbidity and mortality.
- Current guidelines for safe alcohol consumption are evolving, with new research indicating harms at lower levels than previously recognized.
- Most individuals with problematic alcohol use lack access to evidence-based care and accurate information.
Purpose of the Study:
- To highlight the gap between current evidence and clinical practice in addressing alcohol use.
- To emphasize the need for improved identification and management of alcohol use disorders.
- To advocate for the adoption of updated guidelines and effective treatments.
Main Methods:
- Review of recent research on alcohol consumption guidelines and harms.
- Analysis of the current utilization of screening tools for alcohol use.
- Examination of evidence-based treatment protocols for alcohol withdrawal and alcohol use disorders.
- Assessment of the efficacy of commonly prescribed psychotropic medications for alcohol use disorders.
Main Results:
- Health and social harms are associated with alcohol consumption levels below traditional guidelines.
- Screening tools for alcohol use are underutilized in clinical settings.
- Existing alcohol withdrawal management protocols may not reflect the latest evidence on benzodiazepine-sparing approaches.
- Evidence-based psychosocial treatments and pharmacotherapies for alcohol use disorders are underprescribed.
- Routine use of antidepressants and other psychotropic medications may lack benefit and carry potential harm for individuals with alcohol use disorders.
Conclusions:
- There is a critical need for healthcare systems and clinicians to improve the identification and management of alcohol use.
- Adoption of updated guidelines and evidence-based treatments is essential for reducing alcohol-related morbidity and mortality.
- Enhanced screening and treatment strategies are required to address the gap in care for problematic alcohol use.
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