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Alcohol use disorder — USMLE Step 3 MCQ

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ModeratePsychiatry (outpatient management)Alcohol use disorderUSMLE Step 3

A 48-year-old man drinks 6 to 8 beers nightly and has failed attempts to cut down. He has no current withdrawal symptoms, opioid use, severe liver disease, or acute psychiatric crisis. He wants medication to reduce heavy drinking. Which of the following is the most appropriate next step in management?

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Correct answer: D — Start naltrexone with counseling

Naltrexone is an evidence-based option for alcohol use disorder when there is no opioid use or major contraindication, alongside psychosocial treatment.

Reference: APA alcohol use disorder pharmacotherapy guideline: https://www.psychiatry.org/