FROM THE ALCOHOL USE DISORDERS CLINICAL KNOWLEDGE CENTER
December is National Drunk and Drugged Driving Prevention Month

by Anne Lambert, MS

Every President of the United States since 1981 has designated December as National Drunk and Drugged Driving (3-D) Prevention Month. The National Highway Traffic Safety Administration (NHTSA) reports that an alcohol-related motor vehicle crash kills someone every 31 minutes and nonfatally injures someone every two minutes.(1) In 2005, 39% of all traffic-related deaths were attributed to drunk driving.(1) To help municipalities across the nation reduce highway fatalities during the holiday season, NHTSA has created a 3-D Holiday Planner that provides public marketing materials to spread the word about not driving while impaired.(2)

The National Center for Injury Prevention and Control also offers a list of strategies that are proven to reduce the number of alcohol-related fatal crashes including sobriety checkpoints, reducing the legal limit for blood alcohol concentration (BAC) to 0.08%, raising the minimum legal drinking age to 21, and implementing "zero tolerance" laws for young drivers.(3)

Helping your patients with alcohol dependence negotiate this holiday season without relapsing can be key to their recovery process. It's important to have recent, evidence-based materials and commentary from informed clinicians at your fingertips for ready reference.

In our October 23 Clinical Compass™ article on holiday drinking we asked our readers two questions. The first, "How confident are you incorporating pharmacotherapy in the management plan of your patients with alcohol dependence?" revealed some interesting data.



Sixty-two percent of participants do not feel "very confident" incorporating pharmacotherapy into treatment for their patients with alcohol dependence. However, the FDA-approved medications for alcohol dependence have proven efficacy and can help your patients who are having trouble establishing or maintaining abstinence. The NIAAA, in Helping Patients Who Drink Too Much, states, "All approved drugs have been shown to be effective adjuncts to the treatment of alcohol dependence. Thus, consider adding medication whenever you're treating someone with active alcohol dependence or someone who has stopped drinking in the past few months but is experiencing problems such as craving or slips. Patients who have previously failed to respond to psychosocial approaches alone are particularly strong candidates.(4) Find out more about this topic by listening to Expert Discussions on Alcohol Dependence, a podcast series of four interviews with key opinion leaders. Or, watch an archived video broadcast that features evidence-based options for incorporating pharmacotherapy into treatment plans for patients with alcohol dependence.

In question 2, we asked "Does Alcoholics Anonymous (AA) support the use of medications in the management of patients with alcohol dependence?" A majority of respondents (62%) said that AA does not support the use of medications or that they did not know if AA supported the use of medications. However, AA states, "Certainly, the decision to take medication should be made primarily between a doctor who is informed about alcoholism and a patient who is informed about the medication."(5) Learn more about the proven efficacy of AA and its effect on improved medication adherence in patients with alcohol dependence(6) in our Clinical Navigator series, Practical Management Options for Alcohol Dependence. In this CME/CE-certified series, our authors offer strategies for helping patients who participate in AA to stay on their medication. Choosing a different AA group can sometimes be all it takes to help a patient with alcohol dependence feel comfortable with taking his medication and attending AA.

Recently, CME Outfitters, launched a national series of live meetings on Improving the Continuum of Care in Alcohol Dependence: Latest Evidence for Counselors and Clinicians. These NAADAC-approved presentations focus on the essential work that counselors do with each patient by providing an overview of the neurobiology of addiction, different management strategies that have proven useful, the use of psychosocial interventions in combination with pharmacotherapy, and how the various members of the multidisciplinary team can work together to provide optimal care. For remaining dates and availability please visit www.neurosciencecme.com/cmea.asp?ID=267. If you miss these remaining opportunities, please log on to our website in early 2008 to see a web archive of one of the meetings featuring Kyle Kampman, MD, and Gail Kaempf, MSN, CRNP, from the Treatment Research Center at the University of Pennsylvania. We will follow up on the meetings with three monthly newsletters that will report back on what counselors really wanted to know during the live sessions and provide evidence-based answers, treatment options, and long-term management strategies.

The New Year will also bring three interactive patient cases to neuroscienceCME.com. A clinician will interview simulated patients to demonstrate effective counseling techniques for patients with alcohol dependence. The cases will focus on recognition and diagnosis, adherence, and integrating pharmacotherapy into treatment for patients with alcohol dependence.

Look for more information in upcoming issues of Clinical Compass™ and at neuroscienceCME.com. We hope you find all these resources useful in your practice and we hope you are able to incorporate these evidence-based strategies into your management of patients.

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