Liver and Alcohol Health
Liver and Alcohol Health bridges hepatology and addiction care so patients with risky drinking, AUD, or alcohol-related liver disease receive timely, effective treatment. This page translates joint guidelines into steps clinicians can run tomorrow: universal alcohol screening in primary care, ED, and specialty clinics; brief interventions that fit a 10-minute slot; and fast paths to medications for alcohol use disorder (naltrexone, acamprosate; cautious disulfiram) aligned with liver status. We show how to stage liver disease (labs, noninvasive fibrosis scores, ultrasound) while avoiding stigma and fatalism, and how to coordinate nutrition, vaccines, and infection prevention. If you’re evaluating tracks at an alcohol and liver disease conference (/program/scientific-topics/liver-and-alcohol-health), you’ll find protocols for inpatient withdrawal with hepatic impairment, ambulatory taper plans, and linkage from GI/hepatology clinics to addiction services without extra waits. Because sleep, pain, anxiety, and social stressors feed relapse, we embed circadian repair, non-sedating pain strategies, and benefits/housing navigation into the care plan.
Implementation demands shared ownership. Hepatology starts meds for AUD during clinic or admission; addiction teams monitor cravings and adherence; primary care manages comorbid hypertension, diabetes, and sleep apnea; pharmacy monitors interactions and hepatic dosing; dietitians build protein-adequate plans that patients can afford. We outline transplant evaluation pathways that focus on engagement and recovery supports rather than punitive abstinence clocks, and we include wound-care and infection-risk advice for patients with decompensation. Equity runs through every step: interpreters, low-literacy materials, transport vouchers, and tele/phone follow-ups keep care reachable. Dashboards track alcohol-free days, liver function trends, admissions, and quality of life; case reviews adjust the plan when progress stalls. For withdrawal specifics, see Detox and Withdrawal Management; for tobacco synergy that improves liver and cancer outcomes, pair with Cessation in Mental Illness.
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Universal screening + BI
- AUDIT-C with brief motivational conversations in all clinics.
- Warm handoffs to same-day addiction starts.
AUD medications with liver care
- Naltrexone or acamprosate aligned to hepatic function.
- Cautious disulfiram; monitor labs and interactions.
Withdrawal with impairment
- Symptom-triggered protocols adapted for liver disease.
- Thiamine and electrolyte care embedded early.
Sleep, pain, and stress
- Circadian anchors and non-sedating analgesia reduce relapse.
- Benefits/housing supports stabilize recovery context.
Teams, Equity, and Outcomes
Co-management
Hepatology, addiction, primary care, pharmacy, and dietetics.
Transplant pathways
Engagement and supports outweigh punitive clocks.
Nutrition and vaccines
Protein targets, alcohol-free calories, HAV/HBV updates.
Infection prevention
Wound care, SBP education, and safer-use supplies.
Equity features
Language access, low-literacy materials, and transport help.
Family roles
Caregiver coaching for medications and appointments.
Dashboards
Alcohol-free days, LFT trends, admissions, QoL.
Learning loops
Case huddles refine protocols based on outcomes.
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