{
  "schema_version": 1,
  "kind": "condition",
  "id": "chronic-alcohol-problem",
  "name": "Chronic Alcohol Problem",
  "category": "chronic",
  "sources": "Alcohol Use Disorder: Screening, Evaluation, and Management (Nursing) - StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK568739/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class PS12 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · DailyMed - NALTREXONE HYDROCHLORIDE tablet, film coated (oral tablets), Dosage and Administration, Treatment of Alcoholism",
  "review_status": "reviewed",
  "verified_against": "No dose - referral pathway, no medicine given in primary care · Chronic Alcohol Problem - disease-level clinical article (chronic-alcohol-problem-clinical.txt)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 422,
      "generic": "Referral & safety-netting (no drug therapy)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": "Harmful or dependent alcohol use causing health, psychological, or social damage; alcohol use is uncommon but not absent in Egypt, and the GP's role is screening, brief intervention, thiamine to prevent Wernicke's encephalopathy, and referral to addiction services for dependence, with diazepam used only for supervised withdrawal.",
      "adult_duration": "Refer, with advice",
      "dose_source": "No dose - referral pathway, no medicine given in primary care",
      "rationale": "Harmful or dependent alcohol use causing health, psychological, or social damage; alcohol use is uncommon but not absent in Egypt, and the GP's role is screening, brief intervention, thiamine to prevent Wernicke's encephalopathy, and referral to addiction services for dependence, with diazepam used only for supervised withdrawal.",
      "cautions": [
        "Rare in Egyptian primary care.",
        "Referral is the pathway; the medicines listed alongside are what primary care can give before or while it happens.",
        "RED FLAG - Patients with alcohol-related cirrhosis require screening for complications such as hepatocellular carcinoma and esophageal varices.",
        "RED FLAG - Signs of withdrawal such as tremor, agitation, hallucinations or seizures need urgent medical supervision; confusion, unsteady gait or abnormal eye movements suggest Wernicke's encephalopathy, in which thiamine is given before glucose; evidence of liver disease or gastrointestinal bleeding also needs urgent assessment."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Children follow the same pathway: recognise and refer. No primary-care medicine is implied.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "chronic-alcohol-problem"
    },
    {
      "id": 423,
      "generic": "Naltrexone",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": 50.0,
      "adult_dose": "50 mg once daily",
      "adult_duration": "12 weeks in the trials that showed benefit; review and continue on clinical grounds",
      "dose_source": "DailyMed - NALTREXONE HYDROCHLORIDE tablet, film coated (oral tablets), Dosage and Administration, Treatment of Alcoholism - verbatim: \"A dose of 50 mg once daily is recommended for most patients.\"",
      "rationale": "A licensed once-daily tablet exists that reduces relapse and drinking days, is prescribable in general practice and is stocked in Egypt. It works alongside counselling, not instead of it.",
      "cautions": [
        "The patient must be off all opioids, tramadol included, for at least 7 to 10 days before the first dose, or you will precipitate a severe withdrawal.",
        "It blocks opioid pain relief, so plan analgesia in advance and make sure the patient carries something stating they take it.",
        "Liver injury and raised transaminases have been reported; check liver function before and during treatment, and take extra care in decompensated cirrhosis.",
        "Watch for new or worsening depression and suicidal thinking, and ask the family to report it."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "No paediatric dose in the sources opened - this is an adult medicine.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "MORFBLOCK 50 MG 10 F.C.TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "COPAD EGYPT",
          "price_egp": 180.0,
          "pack_count": 10,
          "unit_price": 18.0,
          "strength_mg": 50.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "MORFBLOCK 50 MG 20 F.C.TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "COPAD EGYPT",
          "price_egp": 360.0,
          "pack_count": 20,
          "unit_price": 18.0,
          "strength_mg": 50.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ANARCOL 50 MG 30 F.C.TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MULTI-APEX",
          "price_egp": 777.0,
          "pack_count": 30,
          "unit_price": 25.9,
          "strength_mg": 50.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "chronic-alcohol-problem"
    }
  ]
}