Alcohol Use Disorder

Alcohol use disorder (AUD) is prevalent worldwide, with an estimated lifetime prevalence of 20% in the United States. AUD poses a personal and public health strain on the population and is of a great concern in the aging population. AUD is associated with an increase in years of life lost to premature mortality, disability-adjusted life years, and years lived with disability. Untreated AUD may lead to physiological, social, and economic consequences for the affected individuals. The burden is high for the elderly population as they are more susceptible to physiologic consequences of alcohol use, notably neurological complications, and functional decline. As a chronic and relapsing disease, both pharmacologic and non-pharmacologic treatments are utilized to address the disorder. There are three Food and Drug Administration (FDA) approved medications for AUD (naltrexone, acamprosate, and disulfiram), and additional medications used off-label to assist in reducing alcohol cravings, decrease consumption, and prevent relapse. In this chapter, we review the epidemiology, risk factors, assessment, and evidence-based treatment for AUD with a focus on options and considerations for the geriatric population.