Using Alcohol Biomarkers to Guide Pharmacotherapy for Alcohol Use Disorder (1.5 CME)
(1.5 CME) In this conference recording from the 2018 Annual Conference, you will learn that clinicians can use several biochemical measurements to objectively assess patients’ current or past alcohol use. However, none of these currently available biomarkers, including measures of various liver enzymes and blood volume, are ideal. Several more experimental markers hold promise for measuring acute alcohol consumption and relapse. These include certain alcohol byproducts, such as phosphatidylethanol, acetaldehyde, ethyl glucuronide (EtG), and fatty acid ethyl esters (FAEE), as well as two measures of sialic acid, a carbohydrate that appears to be altered in alcoholics.
This symposium will provide an update on the use of alcohol biomarkers in general clinical practice, with special emphasis on:
- the use of alcohol biomarkers as a guide to the diagnosis and treatment of AUD in primary care settings;
- the use of phosphatidylethanol (PEth) testing as a guide to treatment in patients with co-occurring HIV/AIDS and AUD; and
- the use of alcohol biosensors to monitor response to treatment in both specialty and non-specialty treatment settings.
Deidra Y. Roach
Dr. Roach has more than 30 years of experience in the field of addiction treatment. She currently serves as a Program Director for the National Institute on Alcohol Abuse and Alcoholism where, among other responsibilities, she manages research portfolios addressing the treatment of co-occurring mental health and alcohol use disorders and alcohol-related HIV/AIDS among women. She also serves on the Interagency Coordinating Committee on Fetal Alcohol Spectrum Disorders (ICCFASD) and the NIH Coordinating Committee for Research on Women’s Health. Dr. Roach chairs the Women Drinking, and Pregnancy Work Group of the ICCFASD.
Scott H. Stewart
Scott H. Stewart, MD, MS, Associate Professor, Division of General Internal Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo.
Dr. Stewart is a general internist and adult primary care physician, currently teaching and practicing at the Erie County Medical Center, an academic urban safety-net hospital in Buffalo, NY. After graduating medical school at Temple University in 1993 and completing Internal Medicine training at the University of Pittsburgh in 1996,Dr. Stewart worked for three years in private practice in the beautiful state of Maine, then returned to academia and completed a health services research fellowship at MUSC in Charleston, SC. He has been on the faculty of MUSC and the University at Buffalo since 2001. Working with experienced mentors at the Charleston Alcohol Research Center at MUSC and Research Institute on Addictions in Buffalo early in his research career helped in melding his long-standing interest in alcohol-related problems with scholarly efforts, leading to NIAAA support.
Dr. Stewart believes that objective testing and monitoring is needed to optimize AUD treatment in primary care, similar to other chronic conditions such as diabetes and dyslipidemia. While traditional alcohol consumption biomarkers suffer from limited sensitivity or specificity, and self-report screens are subject to error, relatively newer biomarkers have great potential to guide AUD treatment. Accordingly, a point of my foci has been on the use of carbohydrate-deficient transferrin and newer biomarkers (e.g., blood phosphatidylethanol, ethyl glucuronide) in various patient populations and during alcoholism treatment trials. Dr. Stewart believes biomarker development is a complicated and slow process, but these and other laboratory tests will continue to alter how AUD is detected and monitored in medical settings in the coming years.
Judy Hahn, PhD is an Associate Professor in the HIV, ID, and Global Medicine Division in the Department of Medicine at UCSF. She is an epidemiologist with extensive experience studying the behavioral and biological intersections of substance use and infectious diseases. She is a pioneer in the use of biological markers as objective measures for alcohol use. She has received numerous grant awards from the NIH and has published over 100 manuscripts.
She is currently leading studies to examine the safety and cost-benefit ratios of using isoniazid to prevent active TB among HIV/TB co-infected drinkers in Uganda, interventions to improve the safety of INH delivered to this population, as well as using mobile phones and tablets to reduce the harm associated with heavy alcohol use. Judy is also a long-time investigator on the UFO Study of HCV in young persons who inject drugs in San Francisco.
M. Katherine Jung
M. Katherine Jung, PhD, is the Director of the Division of Metabolism and Health Effects (DMHE) in the National Institute on Alcohol Abuse and Alcoholism (NIAAA). DMHE oversees a portfolio on the role of alcohol on organ damage, and the mechanisms of alcohol’s effect on physiology and pathology. Dr. Jung’s training and research experience are in biochemistry, cell biology, and molecular biology. Her peer-reviewed publications span the the areas of alcohol-induced organ damage, cell biology, cancer biology, and drug discovery. She has a longstanding interest in biomarkers of alcohol consumption and of alcohol-associated organ damage. Dr. Jung co-leads the Wearable Alcohol Biosensor initiative for NIAAA.
ACCME Accreditation Statement
The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
AMA Credit Designation Statement
The American Society of Addiction Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ABPM Maintenance of Certification (MOC)
The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 1.5 LLSA credits towards ABPM MOC Part II requirements.
ABAM Transitional Maintenance of Certification (tMOC)
This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of 1.5 AMA PRA Category 1 Credit(s)™ for completing this course.