PCSS-MAUD Webinar: Treatment of Alcohol Use Disorder in Rural Populations-Slides

Slides

Pdf Summary

The webinar "Treatment of Alcohol Use Disorder in Rural Populations," presented by Dr. Greg Greenberg, focuses on the unique challenges and treatment strategies for Alcohol Use Disorder (AUD) in rural settings. Funded by SAMHSA and hosted by PCSS-MAUD, the session emphasizes that rural populations face barriers like limited transportation, scarce specialty care, recruitment difficulties for trained providers, privacy concerns in tight-knit communities, and limited technology and communication resources.<br /><br />Treatment of alcohol withdrawal in resource-limited rural environments requires careful assessment, including a thorough history and mental health evaluation. Risk factors for severe withdrawal—such as previous withdrawal seizures, older age, heavy long-term alcohol use, and comorbid conditions—warrant treatment in monitored settings, which are often distant or unavailable in rural areas. Providers need to be vigilant about withdrawal severity assessed via CIWA-Ar scores. Mild to moderate withdrawals may be treated outpatient with medications like benzodiazepines, gabapentin, carbamazepine, and phenobarbital (by experienced providers), while severe cases require higher levels of care, often difficult to access for rural patients.<br /><br />AUD treatment options include FDA-approved medications (naltrexone, acamprosate, disulfiram) and off-label agents (gabapentin, topiramate, baclofen). Counseling and social support groups are important but complicated by anonymity issues in rural communities.<br /><br />Telemedicine is highlighted as a valuable tool to overcome transportation and access barriers, providing convenience, safety, and flexibility. However, technological limitations, confidentiality concerns, and legal considerations must be addressed. Hybrid models combining initial in-person visits with telemedicine follow-ups can optimize care.<br /><br />Overall, a patient-centered, flexible approach using shared decision-making, understanding local resources, frequent re-evaluation, and leveraging technology can improve AUD treatment in rural populations despite systemic limitations. The webinar provides additional online resources and modules for providers seeking comprehensive AUD management strategies tailored to rural settings.

Keywords

Alcohol Use Disorder

AUD treatment

rural populations

withdrawal management

telemedicine in AUD

SAMHSA funding

FDA-approved medications

resource-limited settings

patient-centered care

confidentiality challenges