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Alcohol use disorder — USMLE Step 3 MCQ

Instant feedback + full explanation. One question, done properly.

ModerateAmbulatory Medicine / Primary CareAlcohol use disorderUSMLE Step 3

A 46-year-old man drinks 6 beers nightly and has cravings despite counselling. Liver enzymes are mildly elevated, bilirubin is normal, and he has no opioid use. He wants medication to reduce relapse risk. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Start naltrexone

Naltrexone reduces heavy drinking and craving in alcohol use disorder and is appropriate when opioid use is absent and liver disease is not severe.

Reference: ASAM and APA alcohol use disorder pharmacotherapy guidance