Mr Bond's management raises several issues.1 In the rapid responses on bmj.com, Mark Willenbring succinctly summarises the most practical approach to the management of Mr Bond's alcohol dependence.2 Regular follow-up with feedback on progress and continuing encouragement to reduce alcohol use can be surprisingly effective. It is also a straightforward management plan that can be offered by the patient's current medical team. Cirrhotic patients can safely be offered treatment to control their alcohol use with acamprosate, naltrexone, or disulfiram, singly or in combination.3 These drugs are simpler to prescribe and monitor than many used in routine clinical practice and …