Medication for the Treatment of Alcohol Use Disorder: A Brief Guide
Alcohol problems are alarmingly common in the general population. Between 10 and 20 percent of patients seen in primary care or hospital settings have a diagnosable alcohol use disorder. However, there are treatment options available.
Many addiction experts believe that patients with moderate or severe alcohol-related problems should routinely be offered medication-assisted treatment. Unfortunately, current evidence shows that medications are underused in the treatment of alcohol use disorders. In fact, of the 18.0 million people who met the criteria for alcohol dependence or abuse in 2013, only 1.4 million received any type of treatment (excluding mutual-help groups)—ranging from a single meeting with a counselor to participation in a specialized treatment program.
To address this gap, the SAMHSA and National Institute on Alcohol Abuse and Alcoholism (NIAAA) jointly convened a Consensus Panel on New and Emerging Pharmacotherapies for Alcohol Use Disorders and Related Comorbidities. The panel brought together experts in alcohol research, clinical care, medical education, and public policy to review the current evidence on the effectiveness of available medications for the treatment of alcohol use disorder. Today, SAMHSA and NIAAA are releasing Medication for the Treatment of Alcohol Use Disorder: A Brief Guide, which contains the guidance of this panel of experts.
This report is intended for use by primary care and specialty providers, and contains information about:
- The use of medications in clinical practice to treat alcohol use disorder,
- The four medications approved by the U.S. Food and Drug Administration (FDA) to treat alcohol use disorder, prevent relapse to alcohol use, or both: disulfiram, oral naltrexone, extended-release injectable naltrexone, and acamprosate,
- Considering medications based on FDA-approved indications and a patient’s unique needs and circumstances, and
- Sreening patients for risky alcohol use, assessing the need for medication-assisted treatment, developing a treatment plan, selecting a medication, and monitoring patient progress.
Medication-assisted treatment shows a lot of promise in reducing alcohol use and promoting abstinence in patients diagnosed with alcohol use disorder. As new patient care models are encouraged by the Patient Protection and Affordable Care Act (ACA) and the accompanying improvements in the quality and quantity of treatment options that are anticipated as the ACA is implemented, there is considerable potential for expanding the use of medication-assisted treatment in the treatment of alcohol use disorder as clinicians recognize their safety, efficacy, and cost-effectiveness.