Alcohol use disorder is the most common cause of advanced liver disease in the Western world. Diagnosis of alcohol use disorder can be difficult because patients with liver disease tend to deny alcohol intake for the fear of being excluded from treatment and because available biomarkers of alcohol intake have poor specificity in these patients. Alcohol abstinence is the cornerstone of the therapy in these patients. However, pharmacological treatments for alcohol use disorders have not been formally tested in patients with advanced liver disease, except for baclofen. Psychosocial intervention became crucial in these patients considering the limited pharmacological choice. However, psychosocial approach and an appropriate team to manage these patients are not still well defined. In this review, we critically discuss the diagnosis and the management of alcohol use disorder in patients with liver disease.

中文翻译：

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肝病患者酒精使用障碍的诊断和管理：光与影。

酒精使用障碍是西方世界晚期肝病的最常见原因。酒精使用障碍的诊断可能很困难，因为肝病患者由于害怕被排除在治疗之外而倾向于拒绝饮酒，并且因为可用的酒精摄入生物标志物在这些患者中的特异性较差。戒酒是这些患者治疗的基石。然而，酒精使用障碍的药物治疗尚未在晚期肝病患者中进行正式测试，但巴氯芬除外。考虑到有限的药物选择，心理社会干预对这些患者至关重要。然而，管理这些患者的心理社会方法和适当的团队仍未明确定义。在本次审查中，