AUD Management Walkthrough

Alcohol Use Disorder · Clinical Walkthrough

A practical way to approach alcohol use in clinic

Work through the first decisions: whether to raise concern, how to respond to ambivalence, when safety changes the plan, and what comes next.

Clinical scenario
You’re seeing a patient whose drinking is starting to matter.

Maybe it came up in labs. Maybe they mentioned drinking more than usual. Maybe sleep, mood, blood pressure, or relationships are starting to point in the same direction.

You’re deciding whether to push on it, how to approach it, and what to actually do next.

Takes about 2–3 minutes
Step 1 of 6
Do you actually need to act on this?
Step 1

Do you actually need to act on this?

Not every patient who drinks heavily needs intervention. But some do—and missing that moment is where things drift.

Quick orientation: you are not diagnosing perfectly here. You are deciding whether alcohol has become clinically relevant enough to move toward.
  • There is some loss of control or escalation.
  • There are meaningful consequences: medical, functional, or relational.
  • Alcohol is serving a role: sleep, anxiety, coping, social ease, or escape.
The trap: jumping straight to “they should stop” without understanding what role alcohol is actually playing.

You do not need full clarity. But if you ignore this moment, you may keep circling it later.

Step 2

How are they responding to this?

Two patients can have the same drinking pattern—and need very different approaches depending on how they respond in the moment.

General direction: you can move more directly into assessment and next steps—but alignment still matters.
General direction: pushing harder usually backfires. The goal shifts to understanding what alcohol is doing for them, not convincing them to change.
The trap: trying to “win” the conversation instead of understanding it.
Step 3

Where are they on the spectrum of change?

This is where things often drift. Not everyone is trying to stop.

General direction: even with abstinence as the goal, safety and feasibility still need to be worked through.
General direction: this is still active treatment territory. But what that looks like is less straightforward.
General direction: you are not “waiting.” You are working, but in a different way.
The trap: treating abstinence as the only real goal and losing alignment with where the patient actually is.
Step 4

Is it safe for them to change right now?

Before encouraging change, you need to know whether stopping—or even cutting back—could be unsafe.

Clinical anchor: withdrawal is the part of AUD management that can become dangerous quickly.
  • History of withdrawal seizures or delirium tremens.
  • Very heavy use.
  • Medical instability or significant active symptoms.
If stopping is not safe, the problem changes—from motivation to level of care.
The trap: encouraging change without first understanding whether it is safe.
Step 5

What do you actually do next?

This is where most clinicians get stuck.

You have identified the concern. You have gauged readiness. You have thought about safety. But choosing the next step is not as straightforward as it seems.

The right intervention depends on multiple things at once, not just the diagnosis.
  • The patient’s goal: stop, cut back, or not ready yet.
  • What happens when they try to reduce or stop.
  • Whether medication fits the situation, and how to explain it.
  • What they are actually willing to try right now.

Sometimes the next step includes medication. But knowing when to offer it, which one to choose, and how to explain it depends on the full picture.

The trap: either doing nothing because it feels unclear, or defaulting to a generic plan that does not actually fit the situation.
Managing AUD PDF Download

Clinical decision tool

Want a one-page framework for alcohol-related visits?

Get a quick reference for deciding how to raise concern, assess readiness, check safety, and choose a next step.

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Step 6

What happens after the first decision?

Even when you choose a reasonable next step, that is not the end of the problem.

  • Patients change goals.
  • They may keep drinking even with treatment.
  • Medications partially work, or do not.
  • Engagement fluctuates.
Now you have to decide what to adjust without losing the patient in the process.
Complexity checkpoint

At this point, you are juggling readiness, goals, safety, medication decisions, and follow-up strategy. Those variables do not always point in the same direction.

The trap: assuming that a reasonable first step means the plan is clear from there.
Next step

Continue with the full framework

You have seen the major decision points. The course is where those questions get worked through in full.

How do I bring this up without increasing shame?
What do I do when they are ambivalent?
When is medication the right next step?
How do I know if withdrawal changes the plan?
Managing AUD: A Practical Clinical Framework is a 1.5-hour audio course designed for outpatient clinicians who want a clearer way to handle alcohol-related visits without turning every conversation into a lecture.
What the course helps you do
  • Talk about alcohol use in a way that lowers defensiveness and keeps the patient engaged.
  • Use motivational interviewing and harm-reduction principles in brief clinical visits.
  • Decide when to offer medication and how to choose between naltrexone and other options.
  • Assess withdrawal risk before recommending reduction or abstinence.
  • Follow up when patients keep drinking, change goals, or only partially respond.
Listen through the private podcast feed on the go, then use the clinical workspace when you are back in clinic.
Built for point-of-care use

The workspace is organized around real questions: what to say, which tool to open, which medication to consider, when withdrawal matters, and what to adjust next. You can jump to a note, open a PDF or patient handout, or return to the exact course section when you want to hear the reasoning again.

$149
discounted from $179
Walkthrough-completion discount code: AUDGUIDE30
You can use that code even if you view the full course page first and purchase afterward.
Preview the course Get the course for $149

If you want a more structured, practical way to handle alcohol-related visits—and not feel like you are improvising each time—this is built for that.