Episode five: Alcohol Use Disorder Part Two: Treatment and Withdrawal

Dr. Randal Mason is a family physician and addiction medicine specialist serving as Regional Medical Director for Addiction Medicine and Substance Use at Island Health. Born and raised on Vancouver Island, he completed his UBC Family Medicine residency at the Indigenous Training Site in Ladysmith/Nanaimo, and later established innovative primary care models, including high school-based wellness centers and First Nations health clinics. He has served as Medical Director of AVI Health's Westshore clinic and advocates for expanded safer-supply drug programs to address BC's overdose crisis. Dr. Mason focuses on reducing health-care barriers for underserved populations through team-based care models— integrating primary care and addiction services.

In this second episode of a two-part series on Alcohol Use Disorder (AUD) in British Columbia, addiction medicine physician Dr. Randal Mason returns to dive deeper into the practical realities of treatment. He challenges the traditional "all-or-nothing" view of recovery and explains how harm reduction and patient-defined goals are reshaping clinical approaches.  

Dr. Mason walks through evidence-based pharmacological options: naltrexone, acamprosate, gabapentin and topiramate, He makes the case that these medications are safe and effective enough to be managed in primary-care settings. The conversation covers the complexities of alcohol withdrawal, how to use the CIWA score to determine the appropriate level of care and when outpatient withdrawal management is reasonable. Dr. Mason emphasizes the importance of combining pharmacotherapy with motivational interviewing, patient goal-setting, and realistic hope — even in the most challenging cases. 

Credits

Season one of CPD In Practice is accredited by the College of Family Physicians of Canada (CFPC). To claim your credits, you must enroll in the CPD In Practice+ learning activity.