Alcohol use is a common contributor to medical disease and a leading cause of preventable death. Because brief interventions for unhealthy alcohol use are effective, and because risk factors for unhealthy alcohol use are not always immediately identifiable, universal screening is recommended for adults. For patients who screen positive, physicians should assess further to diagnose alcohol use disorder, determine risk of withdrawal symptoms, and recommend an appropriate level of treatment. Outcomes of alcohol use disorder management are improved with evidence-based psychosocial therapy, but there is no support for preferring one specific evidence-based therapy over another. Disulfiram, acamprosate, and naltrexone are medication-assisted treatment options approved by the Food and Drug Administration. Baclofen, topiramate, and gabapentin are off-label options that may be effective; they should be considered second-line treatment because of limited research.