PUBLIC HEALTH STRATEGIES AND CLINICAL INTERVENTIONS IN THE TREATMENT OF ALCOHOL USE DISORDER

Abstract

Alcohol Use Disorder (AUD) is a major global public health problem, associated with high morbidity and mortality, high socioeconomic costs, and existing therapeutic limitations. Despite the progressive development of pharmacological and psychotherapeutic interventions, a large proportion of affected individuals remain without adequate treatment due to underdiagnosis, low spontaneous seeking of treatment, stigma related to alcoholism, low adherence, limited access to specialized services, and low professional training. In this context, the present study aimed to evaluate the main public health strategies and clinical interventions used in the treatment of AUD, with emphasis on behavioral therapies, traditional pharmacotherapy, new therapeutic approaches, and pharmacological innovations. This is a narrative literature review based on recent scientific articles selected from the PubMed database. The studies analyzed demonstrated that integrated interventions involving Cognitive Behavioral Therapy (CBT), Motivational Interviewing, and pharmacotherapy show better clinical outcomes, especially in reducing heavy drinking and preventing relapses. Among pharmacological treatments, naltrexone, acamprosate, and disulfiram stand out, in addition to repositioned agents such as topiramate, gabapentin, and baclofen, which show potential benefit in specific patient profiles, particularly those with alcohol withdrawal symptoms, heavy drinking patterns, or advanced liver disease. Furthermore, in recent years, GLP-1 receptor agonists, such as semaglutide and liraglutide, have emerged as potential therapeutic alternatives, demonstrating a reduction in craving, alcohol consumption, and alcohol-related hospitalizations in clinical and observational studies. It is concluded that the management of alcohol-related substance use disorder (AUD) requires a multidisciplinary, individualized approach centered on the integration of mental health, primary care, and pharmacological interventions. Advances in the development of new therapies may expand therapeutic possibilities and contribute to better clinical and social outcomes related to the disorder.