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[4] [5] Appropriate clinical management for patients with comorbid metabolic conditions and problematic alcohol use should include: Comprehensive assessment of alcohol consumption patterns using validated screening tools (AUDIT, AUDIT-C) Referral to addiction medicine specialists or behavioral health providers for evidence-based AUD treatment, especially with red flags such as history of severe withdrawal, seizures, delirium tremens, pregnancy, severe liver disease, or suicidality Consideration of FDA-approved pharmacotherapies for alcohol use disorder (naltrexone, acamprosate, disulfiram) with attention to their specific contraindications [9] [11] If GLP-1 therapy is indicated for diabetes or obesity, close monitoring for changes in alcohol consumption and related behaviors Patient education emphasizing that any effects on alcohol cravings are not established therapeutic benefits Regular follow-up to assess medication adherence, adverse effects, and overall treatment response Patients should never discontinue evidence-based treatments for alcohol use disorder in favor of unproven approaches

10.1371/journal.pcbi.1000155 274 HubbardS

Wang H, Wang Z, Wang D, Nie K, Wu W, Gao Y, et al

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[8] [9] This means that higher oral doses may be required in certain circumstances to achieve therapeutic effects