A Game-Changer for Alcohol Use Disorder Treatment

In the U.S., nearly 30 million adults grapple with alcohol use disorder (AUD), yet many go without treatment. A groundbreaking study from the Boston University School of Public Health, in collaboration with the BU Chobanian & Avedisian School of Medicine and Boston Medical Center, underscores hospitals as crucial spaces for bridging this treatment gap.

Naltrexone: A Powerful Tool for Recovery

Published in JAMA Internal Medicine, the research reveals impressive findings: hospitalized patients with AUD who started treatment with naltrexone before leaving the hospital significantly reduced their heavy drinking in the following three months. Whether as a daily pill or a monthly injection, both forms of naltrexone proved effective.

Patients on the oral version of naltrexone saw a staggering 38% reduction in heavy drinking within 30 days, while those who received the injection experienced an even greater 46% decrease.

Bringing Attention to a Overlooked Problem

Dr. Jeffrey Samet, the study's lead author, highlights the often-neglected issue of chronic drinking in hospitals filled with immediate health concerns. He emphasizes that addressing AUD during hospital stays offers a golden opportunity for substantial improvement in patient outcomes.

Innovative Research Design

The study drew from the Alcohol Disorder Hospital Treatment (ADOPT) project and evaluated 248 patients treated at an urban hospital from June 2016 to March 2020. Patients began their naltrexone on discharge day, with follow-ups assessing heavy drinking and healthcare use over three months.

The Cost-Benefit Analysis of Treatment

While both naltrexone versions had similar effectiveness, the injectable form demonstrated slightly better adherence, an important metric for ongoing treatment. The injectable method does come with higher costs—$1,064 for each injection compared to just $38.10 for a month of pills.

Future Implications for Policy and Practice

Study co-author Ms. Kara Magane calls on policymakers to ensure that this established, effective medication becomes standard procedure at hospital discharges. She suggests further investigations into patient choices and the impact of social factors like housing on treatment outcomes.

This research project is particularly poignant as it concludes the vision of Dr. Richard Saitz, the principal investigator who passed away before the study's release. Ms. Magane honors Dr. Saitz’s legacy, noting his immense contributions to addiction medicine.