Alcohol abstinence is the most important therapeutic goal for individuals with advanced liver disease (ALD), but commonly co-occurring alcohol use disorders (AUD) make it difficult to achieve. This challenge is perhaps best documented in the pre- and post-liver transplant period: around 30% of patients on a liver transplant list relapse with alcohol, and up to 50% can relapse in the first 10 years post-transplant. Tools to assist patients with ALD and AUD in initiating and maintaining abstinence have been limited: safe, tolerable, and effective pharmacotherapies for AUD are not widely used and treatment is often complicated by medical issues including malnourishment, physically debility, covert or overt hepatic encephalopathy, sleep and fatigue disorders, comorbid depression, and anxiety disorders.......