Primary Care for People With Alcohol Use Disorder

Alcohol use disorder is one of the most common chronic conditions encountered in primary care. In the United States, 1 in 10 people 12 years and older had alcohol use disorder in 2024. Patients with alcohol use disorder have increased risk for complications and comorbidities in gastrointestinal, cardiovascular, and neurologic systems, as well as anxiety and mood disorders, trauma-related stress disorders, suicide, and unintentional injuries. The US Preventive Services Task Force recommends screening adults with the abbreviated Alcohol Use Disorders Identification Test-Consumption or similar tool. Routine evaluation of patients with alcohol use disorder can include focused physical examination, blood tests, imaging studies to evaluate liver function and fibrosis, and assessment for the likelihood of developing alcohol withdrawal syndrome. Treatment in the primary care setting is effective, and all patients with alcohol use disorder should receive a brief behavioral counseling intervention and treatment or referral for treatment, if indicated. Treatment of co-occurring mental health conditions increases the likelihood of recovery from both conditions. Patients should receive routinely recommended vaccines, including the pneumococcal vaccine in those 19 years or older.