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Am Fam Physician. 2022;106(4):466-469

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Key Points for Practice

• Screening tools can identify unhealthy alcohol use, which can be treated effectively with brief interventions.

• Benzodiazepines are the primary therapy for alcohol withdrawal; gabapentin, carbamazepine, and valproic acid appear to be effective for less severe withdrawal symptoms.

• Naltrexone and topiramate are effective for preventing relapse in alcohol use disorder.

• Psychological therapies are a primary treatment for cannabis and stimulant use disorders and are effective for alcohol use disorder, but they are not beneficial in opioid use disorder.

From the AFP Editors

More than 20 million people in the United States meet the criteria for substance use disorder, leading to $600 billion in health care expenditures annually. Despite this growing problem, only one in eight people with substance use disorder receives targeted care. The U.S. Department of Veterans Affairs and the U.S. Department of Defense (VA/DoD) published updated clinical practice guidelines for managing substance use disorders, based on a systematic review.

Screening for Unhealthy Substance Use

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Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Michael J. Arnold, MD, Assistant Medical Editor.

A collection of Practice Guidelines published in AFP is available at

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