An AUDacious Proposal: How to Improve Gastroenterology Fellow Training for Alcohol Use Disorder and Alcohol-Associated Liver Disease

Alcohol use disorder (AUD), an increasingly prevalent and treatable cause for alcohol-associated liver disease (ALD), is the most common reason for liver transplantation and liver-related deaths in the United States. Despite overwhelming evidence that ALD-related mortality and healthcare costs are rising, patients with ALD are generally undertreated for AUD. Though multidisciplinary care models integrating addiction medicine, hepatology, and social workers, with established training for health professionals on ALD-related stigma can address this treatment gap, numerous barriers exist, which include a lack of addiction providers, insufficient training in addiction amongst primary care and non-addiction medicine providers, limited knowledge and negative beliefs regarding AUD pharmacotherapy, and negative attitudes of clinicians towards patients with AUD. In this issue of Digestive Disease and Sciences, Jagdish et al. implemented a one-hour educational intervention for gastroenterology fellows at a tertiary academic care center consisting of a formal lecture presentation created in collaboration with an addiction medicine specialist. By sharing their work in increasing confidence in addiction medicine-guided training for gastroenterology fellows and highlighting perceived attitudes of providers charged with caring for this vulnerable patient population, progress can be made for health professional trainees in screening, diagnosis, and initial management of AUD to improve access to multidisciplinary, life-saving care for patients with ALD.