NIAAA Sessions to Focus on New Clinical Tools, Treatment Disparities

The 2023 Annual Meeting will feature a track of sessions sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Laura Kwako, Ph.D., a program officer in the Division of Treatment, Health Services, and Recovery Branch (THSRB) at NIAAA, said the topics will encompass two primary areas: presentations highlighting some of the clinical tools and resources that NIAAA has released in the past year and talks addressing health disparities and underserved populations in alcohol use disorder (AUD) care.

As Kwako explained to Psychiatric News, almost everyone with alcohol use problems might be considered underserved. “The data suggest that almost 90% of individuals with alcohol misuse or alcohol use disorder don’t receive evidence-based care,” she said. “And only 3% receive comprehensive care that includes an FDA-approved medication for alcohol use disorder.”

To help inform better clinical practice, NIAAA published “The Healthcare Professional’s Core Resource on Alcohol” (HPCR) in 2022; this comprehensive manual tackles topics such foundational information on standard drink sizes and the neuroscience of addiction. Kwako will present an overview of the manual at the meeting, with a focus toward the areas that may be most relevant to practicing psychiatrists, including incorporating the Alcohol Symptom Checklist assessment into routine screening.

Another important project conducted by NIAAA last year was establishing a formal definition of recovery in relation to AUD that factors in DSM-5 diagnostic criteria (“NIAAA Definition of Recovery Provides Measurable Endpoints for AUD Researchers”). Individuals are considered recovered when they achieve remission of AUD symptoms as defined by DSM-5 and cease all heavy drinking (abstinence is not required). Kwako said a definition may seem minor, but having an operational description of a key clinical endpoint can help physicians set treatment goals for patients and improve research by creating a standardized outcome measure for clinical trials. Brett Hagman, Ph.D., program director for the THSRB, will chair a symposium discussing the new definition in more detail as well as exploring multiple pathways by which individuals can reach recovery.

Other NIAAA-sponsored sessions will cover topics including the barriers facing women of color in seeking treatment for AUD, the potential of using psychiatric electronic consults to increase access to AUD medications, and the important role of psychiatrists in assisting with patients dealing with alcohol-induced organ damage.

“That last session is a prime example of an important patient population that falls through the treatment gap—the large group of people who may never develop alcohol use disorder but will experience problems from years and years of regular drinking,” said Kwako, who has worked with such patients in her role as a clinical psychologist for NIH’s inpatient research hospital. “There is definitely a role for mental health professionals even in the absence of addiction.”

Kwako told Psychiatric News that she and all the speakers are excited to come back to an in-person Annual Meeting; NIAAA was APA’s planned partner in 2020 before COVID-19 led to cancellation of the meeting, so the institute has not been a featured guest for years.

The issue of problematic drinking has become more salient than ever, Kwako noted, as alcohol consumption and alcohol-related health issues have risen significantly since 2020.

“Alcohol has especially caused problems for the people who psychiatrists were already seeing in practice, such as the person dealing with depression or the AUD patient who just reached a place of stability before the pandemic shutdown closed off their social supports,” she said. ■