title: Management of alcohol misuse in patients with liver diseases.
abstract: Excessive alcohol use not only causes alcoholic liver disease (ALD) but also increases the risk of liver-related mortality in patients who already have other chronic liver diseases. Screening for alcohol misuse or alcohol use disorder (AUD) among patients with underlying liver disease is essential. This clinical review covers what is known about ALD, the impact of alcohol in patients with underlying liver diseases, current management of alcohol misuse and AUD, and the management of alcohol misuse and AUD specifically in patients with liver diseases. Several treatment options for alcohol misuse and AUD exist such as psychosocial intervention and behavioral and pharmacological therapies. The strategies used in the treatment of alcohol misuse and AUD are still applicable in those who consume alcohol and have underlying liver disease. However, certain medications still need to be carefully used due to potentially worsening already compromised liver function. Screening of ongoing alcohol use in subjects with liver disease is important, and prompt intervention is needed to prevent the associated morbidity and mortality from the detrimental effects of continued alcohol use on underlying liver disease. Considering alcoholism is a complex disease, probably a multidisciplinary approach combining psychotherapy and comprehensive medical care will be the most effective. Future research could focus on identifying additional treatment options for addressing the psychotherapy component since the self-determination and will to quit drinking alcohol can play such a crucial role in promoting abstinence.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University Medical Center, Indianapolis, Indiana, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Peng
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University Medical Center, Indianapolis, Indiana, USA.
authors.forename: Milan Prakash
authors.initials: MP
authors.lastname: Patel
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University Medical Center, Indianapolis, Indiana, USA.
authors.forename: Breann
authors.initials: B
authors.lastname: McGee
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University Medical Center, Indianapolis, Indiana, USA.
authors.forename: Tiebing
authors.initials: T
authors.lastname: Liang
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University Medical Center, Indianapolis, Indiana, USA.
authors.forename: Kristina
authors.initials: K
authors.lastname: Chandler
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University Medical Center, Indianapolis, Indiana, USA.|Southern Plains Tribal Health Board, Oklahoma Area Tribal Epidemiology Center, Oklahoma City, Oklahoma, USA.
authors.forename: Sucharat
authors.initials: S
authors.lastname: Tayarachakul
authors.affiliation: Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.|Roudebush Veterans Administration Medical Center, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Sean
authors.initials: S
authors.lastname: O'Connor
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University Medical Center, Indianapolis, Indiana, USA.|Roudebush Veterans Administration Medical Center, Indiana University School of Medicine, Indianapolis, Indiana, USA.|Depertment of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Suthat
authors.initials: S
authors.lastname: Liangpunsakul
mesh_terms: D000431:Ethanol / Q000009:adverse effects*; D005234:Fatty Liver / Q000150:complications; D006801:Humans; D008107:Liver Diseases / Q000150:complications*; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis; D008403:Mass Screening
chemical_list: D000431:Ethanol
keywords: Alcohol Drinking; Disease Management; Liver Diseases