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Alcohol use disorder pharmacotherapy — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareAlcohol use disorder pharmacotherapyUSMLE Step 3

A 52-year-old man returns after completing outpatient counseling for alcohol use disorder. He has reduced drinking but still binges on weekends. He has no opioid use, cirrhosis, or renal impairment. AST and ALT are mildly elevated at less than twice the upper limit of normal. He wants medication to reduce relapse. Which of the following is the most appropriate next step in management?

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Correct answer: D — Start oral naltrexone

Naltrexone reduces heavy drinking and relapse in alcohol use disorder and is appropriate when the patient is not using opioids and has no severe acute hepatitis or liver failure.

Reference: APA Alcohol Use Disorder Pharmacotherapy Guideline