PCSS-MAUD Webinar: Understanding and Addressing Youth Alcohol Use-Slides

Slides

Pdf Summary

The webinar "Treatment of Alcohol Use Disorder (AUD) in Rural Populations" by Dr. Greg Greenberg, MD, FASAM, addresses the unique challenges faced in managing AUD in rural settings. Funded by SAMHSA and presented under PCSS-MAUD, the session highlights barriers such as limited access to transportation, scarcity of specialty care providers, technology and communication restrictions, and privacy concerns in tight-knit communities.<br /><br />Dr. Greenberg, with extensive rural and addiction medicine experience, describes difficulties including recruitment of trained providers, limited funding often dependent on grants, and scarce support services like AA groups that may not offer anonymity. Treatment challenges are compounded by the lack of higher-level care facilities nearby, requiring providers to maximize available resources cautiously.<br /><br />Alcohol withdrawal management is emphasized, with recommendations to perform comprehensive histories, assess risk factors (e.g., previous severe withdrawal, comorbidities, age), and use appropriate tools like the CIWA-Ar scale to determine withdrawal severity. Mild to moderate cases can be managed with benzodiazepines and alternatives like gabapentin or carbamazepine in outpatient settings, while severe cases require monitored inpatient care—often unavailable in rural areas. Providers are urged to frequently reassess and consider community resources.<br /><br />AUD treatment options include FDA-approved medications (naltrexone, acamprosate, disulfiram) and off-label drugs like gabapentin and topiramate, complemented by counseling and social support, though the latter can be complicated due to rural privacy issues.<br /><br />Telemedicine is presented as a valuable tool to overcome transportation and stigma barriers, allowing flexibility and safer environments for patients. However, it comes with disadvantages such as technical limitations and reduced ability to perform urine drug screens. Guidelines for telemedicine etiquette, legal compliance, and hybrid care models (combining in-person and telehealth visits) are discussed.<br /><br />In summary, the webinar promotes adapting treatment strategies to rural realities through patient-centered, flexible approaches using available resources, frequent monitoring, and leveraging technology to improve access and outcomes in AUD care.

Keywords

Alcohol Use Disorder

AUD

Rural Populations

Treatment Challenges

Alcohol Withdrawal Management

CIWA-Ar Scale

FDA-approved Medications

Telemedicine

Addiction Medicine

Community Resources