Alcohol use disorder (AUD) is a mosaic of symptoms. Alcoholic liver disease (ALD) in its acute and chronic forms is a common clinical consequence of longstanding AUD. Alcohol consumption is a preventable cause of many disorders. It is ranked in the front of statistics on risk factors for preventable diseases and premature death. There is no safe dose determined of consumed alcohol for the liver. Alcohol is the most common cause of liver damage and liver diseases. Mortality associated with liver cirrhosis is an indicator of alcohol-related mortality. Alcoholic liver disease in its acute and chronic form is the direct consequence of harmful alcohol use. Alcoholic cirrhosis, as well as another cause of advanced chronic liver disease, is the major risk factor for the development of liver-related complications. This is a consequence of portal hypertension, expressed in terms of decompensation, liver failure or hepatocellular carcinoma. Drinking relapses increase the risk of recurrent severe hepatitis, with monthly mortality of about 50 %. Achieving abstinence is the key to improving survival in patients with ALD. Alarmingly, the appropriate treatment of patients may be delayed for a variety of reasons. One of them is an advanced liver disease with hepatic dysfunction. Suboptimal use of pharmacological adjuvant therapy is often reported. Pharmacological treatment with naltrexone has been shown to be an effective and safe strategy to treat AUD. Patients affected by ALD can be treated as long as liver function is closely monitored. Contraindication to naltrexone treatment is acute hepatitis or other serious acute liver damage.

Key words: alcohol – alcohol use disorder – alcoholic liver disease – alcoholic liver cirrhosis – naltrexone