In Treating Alcoholism, Pharmacotherapy Underused But Effective
the MPR take:
While approximately 18 million people in the U.S. have an alcohol use disorder (AUD), less than a third receive treatment and fewer than 10% receive medications to help reduce alcohol cravings and consumption. However, research in JAMA found that the use of acamprosate and oral naltrexone (50mg/d) can improve alcohol consumption outcomes. In this meta-analysis of 123 studies, both acamprosate and oral naltrexone were associated with improvement in consumption outcomes; to prevent 1 person from returning to any drinking, the numbers needed to treat (NNTs) were 12 and 20 for acamprosate and oral naltrexone, respectively. No statistically significant difference was seen between these two drug treatments and researchers were unable to determine if health outcomes were improved due to these medications. Barriers to prescribing these medications for patients with AUDs could include lack of knowledge regarding the drugs, being unsure about their efficacy, and inability to provide complimentary psychosocial co-interventions.
Data Sources: PubMed, Cochrane Library, PsycINFO, CINAHL, EMBASE, FDA website, and clinical trials registries (January 1, 1970, to March 1, 2014). The NNT to prevent return to any drinking for acamprosate was 12 (95% CI, 8 to 26; risk difference [RD], 0.09; 95% CI, 0.14 to 0.04) and was 20 (95% CI, 11 to 500; RD, 0.05; 95% CI, 0.10 to 0.002) for oral naltrexone (50 mg/d).
READ FULL ARTICLE From jama.jamanetwork.com