{ "schema_version": "uw.editorial_geo.v1", "representation_profile": "lossless_source_sections", "local_stage_only": true, "catalog_id": "DEP-11-N05", "article_index": "DEP-11-N05", "language": "en", "headline": "Medicines for alcohol use disorder", "description": "Medicines for alcohol use disorder", "short_answer": "Medicine can be one part of care for a person with alcohol use disorder. Its purpose is to support changes chosen with a clinician and reduce the likelihood of a return to drinking or heavy-drinking episodes. A prescription does not replace attention to health, living circumstances, and available support. No single medicine suits everyone, and a lack of response to a first option does not mean that nothing will help. A person can discuss medicine without promising immediate abstinence or feeling ashamed that alcohol has served a function in their life.\n\nIf someone has been drinking heavily for a long time and plans to stop suddenly or substantially change their drinking, timely medical assessment of withdrawal risk comes first. Withdrawal can be dangerous for some people. Seizures, marked confusion, hallucinations, severe shaking, suspected poisoning, or immediate danger to oneself or others call for local urgent medical help; do not wait to answer the questions at the end of this article. Medicines for longer-term treatment and medical management of dangerous withdrawal address different problems. This article is not a basis for starting, stopping, or replacing either treatment with alcohol.", "short_answer_source": { "kind": "opening_after_h1", "role": "lead", "start_utf16": 38, "end_utf16": 1249, "sha256_utf8": "121331caf636d107b45a3dc106461749a0231a153ab6053bc4c90836f2ca10c3" }, "headline_source": { "role": "h1_heading", "start_utf16": 2, "end_utf16": 36, "sha256_utf8": "7c16816eff0308e32bf8c8eb14b0d2abee4a52d41355a5b74eb9bd21e729e4d5" }, "entities": [], "questions": [ { "q": "I. Discuss the goal before the medicine's name", "a": "A useful starting point is what the person wants to change and what has already been happening: a return to alcohol after intending not to drink, heavy episodes, health, sleep, work, relationships, responsibilities, and safety. A clinician can assess whether alcohol use disorder is present, its severity, other conditions and medicines, and the person's preferences. Neither drinking frequency nor a single difficult day lets a reader diagnose themselves or select a medicine. Periods of good work performance do not prove that risk is absent either.\n\nAbstinence is often recommended as a goal, especially where continued drinking is dangerous. The goal and sequence of care, however, are decided in discussion with a qualified professional, taking the person's circumstances and choices seriously. Discussing harm reduction does not promise a personally safe amount of alcohol or that a medicine will let someone keep drinking without consequences. In its [alcohol-treatment FAQ](https://alcoholtreatment.niaaa.nih.gov/FAQs-searching-alcohol-treatment), NIAAA distinguishes the general recommendation of abstinence from an individual goal set with a health professional.\n\nIt also helps to ask what benefit the person feels alcohol provides: relief from tension, loneliness, sleep difficulties, social discomfort, or pain, for example. That describes a need; it does not establish that alcohol treats it. Understanding the need can inform support beyond a prescription. A person may seek help even if they cannot yet put their goal into exact words or find a “right meaning” in life.", "source_spans": [ { "role": "h2_heading", "start_utf16": 1254, "end_utf16": 1300, "sha256_utf8": "d9b6993059e4aa79c814be853ca4bafb2b9042040c73aa82281f4df1634d3da1" }, { "role": "h2_answer", "start_utf16": 1302, "end_utf16": 2886, "sha256_utf8": "99429e69ca4e2fa3da6f594b902fa9ec162086384eed52e3b304fc2a57cc4b15" } ], "block_ids": [ "p0005", "p0006", "p0007" ], "source_segment_index": 1 }, { "q": "II. Alcohol withdrawal is a separate medical task", "a": "Stopping suddenly after prolonged heavy drinking can lead to dangerous withdrawal in some people. A clinician, rather than an article or home questionnaire, must assess the risk and suitable care setting. [NIAAA's professional resource](https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/alcohol-use-disorder-risk-diagnosis-recovery) separates medical withdrawal management from ongoing treatment of alcohol use disorder: getting through the acute period is not the same as receiving support to maintain change. The [NHS also warns](https://www.nhs.uk/live-well/alcohol-advice/alcohol-support/) that abruptly stopping when physically dependent can be harmful and that severe symptoms need urgent assessment.\n\nClinicians may use medicine to manage withdrawal in medical care according to the individual situation. This article gives no drugs, doses, timelines, or sequence for doing so: copying someone else's protocol at home is unsafe. If drinking has already changed suddenly and worrying symptoms appear, seek local medical help now rather than waiting for a planned appointment about longer-term treatment. If there is no immediate danger, discuss a change in drinking with a clinician in advance, particularly after a past severe withdrawal or when other illnesses or prescribed medicines are involved.", "source_spans": [ { "role": "h2_heading", "start_utf16": 2891, "end_utf16": 2940, "sha256_utf8": "2372fecae538d0d85b86134e078a5e0f57eaca25424126fcd838e064a3ad1d03" }, { "role": "h2_answer", "start_utf16": 2942, "end_utf16": 4282, "sha256_utf8": "d6ae469a837fb35a6e1e0be1af0ab3006cb32c3d33f12fb60102cd67fe4a1195" } ], "block_ids": [ "p0009", "p0010" ], "source_segment_index": 2 }, { "q": "III. Medicines that may be discussed for ongoing treatment", "a": "In the United States, naltrexone, acamprosate, and disulfiram are approved for alcohol use disorder. This is a statement about US approval, not a list of what is approved or available in every country. [NIAAA's patient guide](https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help) describes these as options to discuss with a health professional. A person can ask why a particular option is suggested, what outcome is expected, what would count as a lack of benefit, and how follow-up and changes to the plan would work.\n\nNaltrexone and acamprosate have been studied for reducing the risk of specific unfavorable drinking outcomes in groups of trial participants. Disulfiram works differently and calls for particularly clear voluntary consent, an understanding of its limitations, and medical supervision; it must not become a punishment or be given secretly to another adult. The names here support a better conversation with a clinician, not selection of a medicine from an online description. Availability, indications, and prescribing rules need to be checked in the relevant country and service.", "source_spans": [ { "role": "h2_heading", "start_utf16": 4287, "end_utf16": 4345, "sha256_utf8": "c6df490aa4fd6811f620172c5043d882443455c4c4c61e3818adf09f0e9b1d2a" }, { "role": "h2_answer", "start_utf16": 4347, "end_utf16": 5511, "sha256_utf8": "3ea7990fb6accf709aa7540b17ef4cbef553023d4fdb6d29604d61203e78a8b8" } ], "block_ids": [ "p0012", "p0013" ], "source_segment_index": 3 }, { "q": "IV. What the research actually found", "a": "A [2023 JAMA systematic review and meta-analysis by McPheeters and colleagues](https://pmc.ncbi.nlm.nih.gov/articles/PMC10630900/) combined 118 randomized trials involving 20,976 participants. It was not one trial of a “magic pill”: participants, accompanying psychosocial care, and measured outcomes differed. On average, acamprosate and oral naltrexone did better than placebo at reducing the risk of a return to any drinking; oral naltrexone also reduced the risk of a return to heavy drinking. The acamprosate result for a return to heavy drinking was not conclusive in this analysis. Placebo-comparison evidence for disulfiram was more limited. These are group findings, not a guarantee for an individual.\n\nThe review included adult trials lasting at least twelve weeks; many participants also received psychosocial support. Moderate or severe disorder was more common in the studied populations, and some age and clinical groups were represented less well. Adverse effects and contraindications matter to the choice too. The review does not show that a prescription will preserve cognitive performance, make drinking safe, or replace follow-up. Its average effect cannot be transferred to everyone who drinks, including someone without a diagnosed disorder.\n\nDifferences between studies are informative. In the [COMBINE trial published in 2006](https://pubmed.ncbi.nlm.nih.gov/16670409/), 1,383 recently abstinent volunteers with what was then diagnosed as alcohol dependence took part in a sixteen-week study at eleven US academic sites. Naltrexone or a specialist behavioral intervention improved some drinking outcomes within that design; acamprosate did not outperform placebo in those specific conditions. Some between-group differences were no longer present at later follow-up. This neither overturns all other studies nor supports switching medicines on one's own: the population, accompanying care, outcomes, and follow-up period affect the conclusion.", "source_spans": [ { "role": "h2_heading", "start_utf16": 5516, "end_utf16": 5552, "sha256_utf8": "dbbd4e394b61acd2d8cd359b692be288a9bfe5dc4b52a909b54be7b09a641cec" }, { "role": "h2_answer", "start_utf16": 5554, "end_utf16": 7521, "sha256_utf8": "91845301e296386fcc6317f5bbe487c74682ca4d55adef083024e70b13875b94" } ], "block_ids": [ "p0015", "p0016", "p0017" ], "source_segment_index": 4 }, { "q": "V. Does an option fit this person?", "a": "The desired effect is only one part of the decision. A clinician considers medical conditions, liver and kidney function, other medicines, and whether follow-up is feasible. For example, opioid pain medicines or an anticipated need for them are important when discussing naltrexone; serious liver disease can also change the choice. Kidney function matters for acamprosate. [NIAAA's FAQ](https://alcoholtreatment.niaaa.nih.gov/FAQs-searching-alcohol-treatment) notes that the same option does not help everyone and that concurrent medicines and illness affect decisions. This article is no reason to stop prescribed pain relief, psychiatric care, or another treatment.\n\nDiscussing contraindications need not become a self-administered medical checklist. A person can tell the prescriber which medicines they already take, what conditions they know about, and which adverse effects or concerns matter to them. Anxiety, depression, other substance use, or memory difficulties may need their own assessment; a medicine for alcohol use disorder does not replace that care. If an unwanted effect occurs, contacting the prescriber about the next step is safer than secretly stopping or changing a regimen.", "source_spans": [ { "role": "h2_heading", "start_utf16": 7526, "end_utf16": 7560, "sha256_utf8": "2da60cc21305823dbd1187a62923018f803de95acd6102a6fd66ccad87a3dc3f" }, { "role": "h2_answer", "start_utf16": 7562, "end_utf16": 8761, "sha256_utf8": "8b781d52f35080c34c97229abfea4df448da32f030200eda78012d92c8aca1cc" } ], "block_ids": [ "p0019", "p0020" ], "source_segment_index": 5 }, { "q": "VI. Medicinal treatment does not itself mean a “new addiction”", "a": "Having a prescription, needing long-term care, or experiencing an adverse effect does not itself mean a new substance use disorder. Physical adaptation, unpleasant symptoms after a medicine is changed, therapeutic benefit, and a use disorder are different questions; the word “hooked” cannot answer them all. [NIAAA](https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help) states that the three medicines described as US-approved for alcohol use disorder are non-addictive in this sense. That does not make any medicine harmless, remove contraindications, or mean that every psychiatric medicine is the same.\n\nA person may ask why long-term treatment is suggested, what is known about its benefits and harms for them, how results will be assessed, and what alternatives exist. Skepticism can be discussed without automatically casting the clinician as a seller or the patient as “weak.” Sometimes another contact, a revised plan, and additional support are needed. One option not working is not a personal failure.", "source_spans": [ { "role": "h2_heading", "start_utf16": 8766, "end_utf16": 8828, "sha256_utf8": "81b15728b17d55970620a06061c8796df0b209d793c6fea288b6f4d02b739123" }, { "role": "h2_answer", "start_utf16": 8830, "end_utf16": 9906, "sha256_utf8": "d605b41dc617b1d13e9b2632a3de04e77dbb556e54b1705c4d1284a03111037a" } ], "block_ids": [ "p0022", "p0023" ], "source_segment_index": 6 }, { "q": "VII. Bringing care into real life", "a": "Medicine may complement psychological, social, and medical support. [NIAAA's patient material](https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help) describes medicines, counseling, and mutual-help groups; their combination and sequence depend on the circumstances. A feasible first step is to contact a clinician or local alcohol service and describe what is concerning now: withdrawal risk, a return to heavy episodes, adverse effects, health, or difficulty sustaining a desired change. Ask who assesses the need for medicine and who will be responsible for follow-up.\n\nBefore booking, check whether the service sees people of the relevant age, the language of the conversation, consultation and medicine costs, waiting time, what information is retained, and who can access it. A booking is not care already received. If the appointment is distant while the risk is changing, ask about earlier local medical assessment. A person need not have ideal support, a settled life purpose, or the ability to tell their entire story at once before seeking an initial conversation.", "source_spans": [ { "role": "h2_heading", "start_utf16": 9911, "end_utf16": 9944, "sha256_utf8": "7d50b2ebe289f22c8a65923c053712861935b7f5690a4b77adb19fdaf87bc298" }, { "role": "h2_answer", "start_utf16": 9946, "end_utf16": 11084, "sha256_utf8": "9fedae0b9d5ae9d7cc37f287f9d371fd07cc91f75c93daf866187bd60b3aada0" } ], "block_ids": [ "p0025", "p0026" ], "source_segment_index": 7 }, { "q": "VIII. What relatives and friends can and cannot do", "a": "Someone close can offer help finding a service, getting there, or talking about acceptable support. An adult patient takes part in deciding about treatment and who may receive their medical information. Relatives should not secretly administer a medicine, demand passwords, take control of another adult's money, or turn children into monitors of medicines or drinking. They may protect their own finances, time, sleep, and safety, and seek support for themselves even if the person with an alcohol problem is not yet ready for treatment.\n\nIf there is violence, threats, or coercion, the safety of the person affected and of children requires separate planning and local help. It must not wait for a joint conversation or a prescription. Immediate danger calls for a local emergency service. Care, meaning, work, and relationships can support change, but they are neither entry requirements for medical help nor guarantees that a medicine will work.", "source_spans": [ { "role": "h2_heading", "start_utf16": 11089, "end_utf16": 11139, "sha256_utf8": "177a326aca21e06440d80d8370745bac95a3773656fb27088e3a99a7fbb2848a" }, { "role": "h2_answer", "start_utf16": 11141, "end_utf16": 12090, "sha256_utf8": "c0e6331f7c8612074044cf2ec2eafc9df1d1143715f4fd18e2be3cfd73d1aac0" } ], "block_ids": [ "p0028", "p0029" ], "source_segment_index": 8 }, { "q": "Appendix: five optional starting points for a clinical conversation", "a": "These questions refer only to experience a person already has. Do not drink deliberately, stop suddenly, discontinue medicine, or test a bodily reaction in order to answer them. For dangerous withdrawal symptoms, poisoning, or immediate danger, seek local urgent help before making notes or filling in questions.\n\n1. What have I already noticed about my drinking and attempts to change it, without a new experiment?\n2. Which goal matters to me now: safety, health, heavy episodes, relationships, responsibilities, or something else?\n3. Which conditions, prescribed medicines, and past treatment reactions do I already know about and need to mention to a clinician?\n4. What kind of conversation and follow-up is realistically accessible in my location, at the available time and cost, in my language and with suitable privacy?\n5. Which adults could support me with my consent, and what boundaries do relatives and children need?\n\nNot having answers is no reason to delay help.", "source_spans": [ { "role": "h2_heading", "start_utf16": 12095, "end_utf16": 12162, "sha256_utf8": "8ba9e4442525ec02285208faf93caf3c7dc86a894e49b025885d5374a8bcba21" }, { "role": "h2_answer", "start_utf16": 12164, "end_utf16": 13139, "sha256_utf8": "eb9b2c4110a730890020bf2dc34e87816df3fcf30617b5a3808f11a3660bd166" } ], "block_ids": [ "p0031", "p0032", "p0033" ], "source_segment_index": 9 }, { "q": "Sources and limits of application", "a": "- [NIAAA, “Treatment for Alcohol Problems: Finding and Getting Help”](https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help) — official US patient overview, no page date stated; types of care and three US-approved medicines, not prescribing guidance for another country.\n- [NIAAA, “FAQs: Searching for Alcohol Treatment”](https://alcoholtreatment.niaaa.nih.gov/FAQs-searching-alcohol-treatment) — official US FAQ, no page date stated; treatment goals and individual restrictions, not an assessment of a particular patient.\n- [NIAAA, “Alcohol Use Disorder: From Risk to Diagnosis to Recovery”](https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/alcohol-use-disorder-risk-diagnosis-recovery) — US professional overview, no page date stated; distinction between withdrawal and ongoing care, not a home protocol.\n- [McPheeters and colleagues, JAMA, 2023, systematic review and meta-analysis](https://pmc.ncbi.nlm.nih.gov/articles/PMC10630900/) — adult randomized medicine trials; average outcomes and population limits do not predict an individual's response.\n- [Anton and colleagues, JAMA, 2006, COMBINE trial — author abstract in PubMed](https://pubmed.ncbi.nlm.nih.gov/16670409/) — volunteers at US sites, sixteen weeks; the design and outcome statements here are limited to the abstract's data.\n- [NHS, “Alcohol support”](https://www.nhs.uk/live-well/alcohol-advice/alcohol-support/) — official UK guidance, no page date stated; warning about dangerous withdrawal, not a local contact number outside the UK.", "source_spans": [ { "role": "h2_heading", "start_utf16": 13144, "end_utf16": 13177, "sha256_utf8": "5eb1909264375549557460b1ab6bea7d0384a644a05cd035c8fc6bb8f7ce6425" }, { "role": "h2_answer", "start_utf16": 13179, "end_utf16": 14782, "sha256_utf8": "b79c169cba80ace02d3749e57db0ae33f42796ae1acbaa662ba95b3d10aba73a" } ], "block_ids": [ "p0035" ], "source_segment_index": 10 }, { "q": "Topics", "a": "alcohol use disorder, alcohol treatment, medicines, naltrexone, acamprosate, disulfiram, alcohol withdrawal, medical care, treatment choice, adverse effects, family support, harm reduction", "source_spans": [ { "role": "h2_heading", "start_utf16": 14787, "end_utf16": 14793, "sha256_utf8": "e22820fcf5cd90e3fdd99a7569e0ee2f30eb7ebadfb2fe4d159b30c166ff81b7" }, { "role": "h2_answer", "start_utf16": 14795, "end_utf16": 14983, "sha256_utf8": "23b2c263a36922901095b7a71acaa0d63f9d7c96934b10723b7d879c6cf5aab6" } ], "block_ids": [ "p0037" ], "source_segment_index": 11 }, { "q": "Authors", "a": "Andrey Zarinsh — author and founder of United Wisdom. He explores inner transformation, the unity of traditions, intercultural dialogue, and contemporary spiritual discipline. Instagram: @andrey.zarinsh.\n\nMaria Evilkut — co-author of United Wisdom. Alongside her research, she seeks to test these ideas in practice and observe how principles of unity and mutual understanding work in real life between people and cultures. Instagram: @ilkutki.\n\nContent review date: 14 October 2026. Language version: EN.", "source_spans": [ { "role": "h2_heading", "start_utf16": 14988, "end_utf16": 14995, "sha256_utf8": "2c00c9aaa72c717ad6d901a09c4d698a68b2e9740be3769e0af7d6bd85d72d5d" }, { "role": "h2_answer", "start_utf16": 14997, "end_utf16": 15501, "sha256_utf8": "e65a3749695eca12bf4d066ae2a089f2fbc27630c9536f018986bc8e9967dd36" } ], "block_ids": [ "p0039", "p0040", "p0041" ], "source_segment_index": 12 } ], "claims": [], "claims_policy": "no_reclassified_claims", "sources": [ { "id": "src_9784114de383676a", "title": "NIAAA, “FAQs: Searching for Alcohol Treatment”", "url": "https://alcoholtreatment.niaaa.nih.gov/FAQs-searching-alcohol-treatment", "source_spans": [ { "role": "markdown_link", "start_utf16": 2260, "end_utf16": 2356, "sha256_utf8": "5a5bbbed282324f1d21474bdb8095403b4822457ff91cc047b8e7594f99ecd97" }, { "role": "markdown_link", "start_utf16": 7936, "end_utf16": 8022, "sha256_utf8": "e4e1efffbf319bdaba5c7b1bdd9a31e4497ea3c5ee290b3d301de8562b464732" }, { "role": "markdown_link", "start_utf16": 13515, "end_utf16": 13636, "sha256_utf8": "d2e704538f49ff01115ae6b4f14f632ed8d9e449b0f5e67073a622a35ee9659f" } ], "read_scope": "- [NIAAA, “FAQs: Searching for Alcohol Treatment”](https://alcoholtreatment.niaaa.nih.gov/FAQs-searching-alcohol-treatment) — official US FAQ, no page date stated; treatment goals and individual restrictions, not an assessment of a particular patient.", "read_scope_kind": "verbatim_bibliography_entry", "read_scope_span": { "role": "bibliography_entry", "start_utf16": 13513, "end_utf16": 13764, "sha256_utf8": "4c8c576f454a28c0e33045c9cd135ad75c9aa3ce906eff80a672182d1dbca358" }, "shared_entry_urls": [] }, { "id": "src_9e893bf5475317e6", "title": "NIAAA, “Alcohol Use Disorder: From Risk to Diagnosis to Recovery”", "url": "https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/alcohol-use-disorder-risk-diagnosis-recovery", "source_spans": [ { "role": "markdown_link", "start_utf16": 3147, "end_utf16": 3308, "sha256_utf8": "34b93811a4ac5142942388a7aa9d98aab0f84025674c35520da0d98c244b2090" }, { "role": "markdown_link", "start_utf16": 13767, "end_utf16": 13964, "sha256_utf8": "ee04cc938b6ca5aae70939d23eef13381ab2445fad0e981a581c25fff745f8f4" } ], "read_scope": "- [NIAAA, “Alcohol Use Disorder: From Risk to Diagnosis to Recovery”](https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/alcohol-use-disorder-risk-diagnosis-recovery) — US professional overview, no page date stated; distinction between withdrawal and ongoing care, not a home protocol.", "read_scope_kind": "verbatim_bibliography_entry", "read_scope_span": { "role": "bibliography_entry", "start_utf16": 13765, "end_utf16": 14083, "sha256_utf8": "bb778761e259a675ad845419da6a8a74ce718067276d4eaa8361cb081748abb3" }, "shared_entry_urls": [] }, { "id": "src_97d03b280cd2501c", "title": "NHS, “Alcohol support”", "url": "https://www.nhs.uk/live-well/alcohol-advice/alcohol-support/", "source_spans": [ { "role": "markdown_link", "start_utf16": 3491, "end_utf16": 3569, "sha256_utf8": "9c3a2edc7888eb089f8d75004a99cc12f40dd336007c36c6a7848bcde763ac1a" }, { "role": "markdown_link", "start_utf16": 14572, "end_utf16": 14658, "sha256_utf8": "b8b77fd9a86d8afc81dca14fefaeda02a2cd01c276d5f9a8942a94cb1e206129" } ], "read_scope": "- [NHS, “Alcohol support”](https://www.nhs.uk/live-well/alcohol-advice/alcohol-support/) — official UK guidance, no page date stated; warning about dangerous withdrawal, not a local contact number outside the UK.", "read_scope_kind": "verbatim_bibliography_entry", "read_scope_span": { "role": "bibliography_entry", "start_utf16": 14570, "end_utf16": 14782, "sha256_utf8": "f9337b8086dff616851311c41ed161e5154426223d9aedb55f41dfae15de50f4" }, "shared_entry_urls": [] }, { "id": "src_6dc3b3a2dfcc6f51", "title": "NIAAA, “Treatment for Alcohol Problems: Finding and Getting Help”", "url": "https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help", "source_spans": [ { "role": "markdown_link", "start_utf16": 4549, "end_utf16": 4690, "sha256_utf8": "79f4ca9a458c04a0471aa1c195ab70f34f759aba9d0054d79c7359422e296110" }, { "role": "markdown_link", "start_utf16": 9139, "end_utf16": 9264, "sha256_utf8": "251ee85c0de32d3da60f584cdd9592dbad2db63389d07c4837afdc72e9385496" }, { "role": "markdown_link", "start_utf16": 10014, "end_utf16": 10158, "sha256_utf8": "6a407324e43d13de512dbcc496ea3249db21d7cafe39367d1b22faccc88bec6b" }, { "role": "markdown_link", "start_utf16": 13181, "end_utf16": 13366, "sha256_utf8": "d4085e703dfeccdccdca96506ec726745ff277ffa0e6eae31dd527fb0b03eb5d" } ], "read_scope": "- [NIAAA, “Treatment for Alcohol Problems: Finding and Getting Help”](https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help) — official US patient overview, no page date stated; types of care and three US-approved medicines, not prescribing guidance for another country.", "read_scope_kind": "verbatim_bibliography_entry", "read_scope_span": { "role": "bibliography_entry", "start_utf16": 13179, "end_utf16": 13512, "sha256_utf8": "86d5657fe01187fd47d8718db46db6a1a54d2516ed3e1cb6a486c04a1157c080" }, "shared_entry_urls": [] }, { "id": "src_87acfd154b69ddad", "title": "McPheeters and colleagues, JAMA, 2023, systematic review and meta-analysis", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10630900/", "source_spans": [ { "role": "markdown_link", "start_utf16": 5556, "end_utf16": 5684, "sha256_utf8": "c23c0e62b683a598da9fded90acda931916ce4756849304f64c185634748101b" }, { "role": "markdown_link", "start_utf16": 14086, "end_utf16": 14214, "sha256_utf8": "c393eb232a057db380a27ea5716f49764defdf8e13d84f2087983c25f32c0456" } ], "read_scope": "- [McPheeters and colleagues, JAMA, 2023, systematic review and meta-analysis](https://pmc.ncbi.nlm.nih.gov/articles/PMC10630900/) — adult randomized medicine trials; average outcomes and population limits do not predict an individual's response.", "read_scope_kind": "verbatim_bibliography_entry", "read_scope_span": { "role": "bibliography_entry", "start_utf16": 14084, "end_utf16": 14330, "sha256_utf8": "775369227f4669d849c33e714076a7a39528a28515a41f5a92b8acddbf33bee8" }, "shared_entry_urls": [] }, { "id": "src_53dca8917ff83474", "title": "Anton and colleagues, JAMA, 2006, COMBINE trial — author abstract in PubMed", "url": "https://pubmed.ncbi.nlm.nih.gov/16670409/", "source_spans": [ { "role": "markdown_link", "start_utf16": 6871, "end_utf16": 6947, "sha256_utf8": "19f5e11e06eac43b7c36f11e2bdbca52b48b2b201329c7be3824d7bad46a41a8" }, { "role": "markdown_link", "start_utf16": 14333, "end_utf16": 14453, "sha256_utf8": "c9b0dcea76cdcf303658cd64283ec379a074ea30756317205147ec5ba40bc795" } ], "read_scope": "- [Anton and colleagues, JAMA, 2006, COMBINE trial — author abstract in PubMed](https://pubmed.ncbi.nlm.nih.gov/16670409/) — volunteers at US sites, sixteen weeks; the design and outcome statements here are limited to the abstract's data.", "read_scope_kind": "verbatim_bibliography_entry", "read_scope_span": { "role": "bibliography_entry", "start_utf16": 14331, "end_utf16": 14569, "sha256_utf8": "eaeea6810cc4d9012236e93531ab0a47b9a80aec246530381265b1fbc56beb61" }, "shared_entry_urls": [] } ], "retrieval_limits": [ "This local GEO representation applies only to the specified source article version and its SHA-256.", "Qualifications, sources and attributions remain in the full sections and byte-identical Markdown copy.", "No new source research was conducted in this GEO stage." ], "master_sha256": "9ff4707b36e0b1733a941a8551dc3cdbeeb6a2b72c8a9850881913bc57796a71", "provenance": { "raw_reader_sha256": "9ff4707b36e0b1733a941a8551dc3cdbeeb6a2b72c8a9850881913bc57796a71", "ru_master_sha256": "c172fe1bb4688ad0f5d9de267541523bb655941da908fbb9847adebbd20ac7b1", "reader_path": "outputs/uw-addictions-corpus-20261013/articles/DEP-11-N05/ARTICLE_EN.md", "review_pointer": "outputs/uw-addictions-corpus-20261013/articles/DEP-11-N05/INDEPENDENT_REVIEW.json", "review_sha256": "b676f7755ca2340faaa5122caf5520df14973b66301a844c5d2b2792b1dfb989", "clean_md_relative_filename": "GEO.en.md", "body_length_utf16": 15502, "source_segments": [ { "kind": "opening", "index": 0, "heading": null, "start_utf16": 0, "end_utf16": 1251, "sha256_utf8_raw_slice": "b19c9e4e9fe9b01a9001cee2256c79a9ac029cfc242daeb7a820106d3b2d069c" }, { "kind": "h2_section", "index": 1, "heading": "I. Discuss the goal before the medicine's name", "start_utf16": 1251, "end_utf16": 2888, "sha256_utf8_raw_slice": "afacf05e0601800dc96611694b88eedcd26ab8c24c5c28b5928fff2d17b3e979" }, { "kind": "h2_section", "index": 2, "heading": "II. Alcohol withdrawal is a separate medical task", "start_utf16": 2888, "end_utf16": 4284, "sha256_utf8_raw_slice": "9c36955a9b40cb9709f1ee337cb613b5c93302192e8a3a60b6ecdf4e9027f63d" }, { "kind": "h2_section", "index": 3, "heading": "III. Medicines that may be discussed for ongoing treatment", "start_utf16": 4284, "end_utf16": 5513, "sha256_utf8_raw_slice": "12652dac8a49921b33f7bf78e4c34b2e015266e9f342b774fd52d46b796effb0" }, { "kind": "h2_section", "index": 4, "heading": "IV. What the research actually found", "start_utf16": 5513, "end_utf16": 7523, "sha256_utf8_raw_slice": "fe1216b53085b6130523cceaa682b42a29d4431bd17ee1a23202e1c52e565aeb" }, { "kind": "h2_section", "index": 5, "heading": "V. Does an option fit this person?", "start_utf16": 7523, "end_utf16": 8763, "sha256_utf8_raw_slice": "5dd5493bbc44fe35e667cb3715200879f8f14fcc2e2de0dfd2848a86124d5976" }, { "kind": "h2_section", "index": 6, "heading": "VI. Medicinal treatment does not itself mean a “new addiction”", "start_utf16": 8763, "end_utf16": 9908, "sha256_utf8_raw_slice": "6e9dd9cd5b7f7b185911e3823457658ac3dee4bd034b724ac7cd39a1a715cd1c" }, { "kind": "h2_section", "index": 7, "heading": "VII. Bringing care into real life", "start_utf16": 9908, "end_utf16": 11086, "sha256_utf8_raw_slice": "920738236992a45f75e6e1103f784ac8def1f31230fdbd3584672eddb137041d" }, { "kind": "h2_section", "index": 8, "heading": "VIII. What relatives and friends can and cannot do", "start_utf16": 11086, "end_utf16": 12092, "sha256_utf8_raw_slice": "93f347012c9a375c474912843d275440f0e0e4ef6d016d2350c755f6478e2388" }, { "kind": "h2_section", "index": 9, "heading": "Appendix: five optional starting points for a clinical conversation", "start_utf16": 12092, "end_utf16": 13141, "sha256_utf8_raw_slice": "d16760bf89331670701523456a9fcdae72224b5079127d9cdebdf631da5ee7b8" }, { "kind": "h2_section", "index": 10, "heading": "Sources and limits of application", "start_utf16": 13141, "end_utf16": 14784, "sha256_utf8_raw_slice": "62ed1ddc5974345c3ed7004f4c8e5759d333495cc0fe29ddc23b8fc456930a17" }, { "kind": "h2_section", "index": 11, "heading": "Topics", "start_utf16": 14784, "end_utf16": 14985, "sha256_utf8_raw_slice": "4fb8d44e0386fa4cbb660332704ece029c96cadc2b93b2db10d25e3c64224f16" }, { "kind": "h2_section", "index": 12, "heading": "Authors", "start_utf16": 14985, "end_utf16": 15502, "sha256_utf8_raw_slice": "7bb01d7b72de2e0bc963025d16c99f9b1a8825df1954087277a6553f50b93071" } ], "common_blocks_module_sha256": "6cf638661a819f960c39d08058bf6d0d0696e8b816f677d95b389f5f1d11e4d2" } }