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To begin, you refer him to substance use counselling, and suggest: acamprosate for AUD (NNT~11 for abstinence over 12-52 weeks) 51 nicotine replacement and varenicline (NNT~13 over 6-12 months for smoking cessation) 44 If he develops troublesome withdrawal or struggles with ongoing substance use despite your assistance, you could refer him for support through an addiction medicine clinic or obtain additional support from telemedicine resources including British Columbias 24/7 Addiction Medicine Clinician Support Line: www.bccsu.ca/24-7

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