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Alcohol use disorder can be treated with an array of medications – but few people have heard of them

Joseph P. Schacht, University of Colorado Anschutz Medical Campus, The Conversation on

Published in Health & Fitness

More than 29.5 million Americans ages 12 and up had alcohol use disorder – the medical term for the disease commonly known as alcoholism – in 2022, when the most recent national data was published.

The condition is characterized by a pattern of heavy alcohol consumption with loss of control over drinking despite negative social, occupational or health consequences.

Deaths from excessive alcohol use have sharply increased in recent years, to 178,000 in the United States in 2021, up from 138,000 five years earlier. The greatest increase occurred during the first year of the COVID-19 pandemic.

Alcohol is responsible for more deaths than overdoses from opioids and all other substances combined, and it accounts for 1 in 5 of all deaths of people ages 20 to 49. Alcohol-associated deaths occur from a variety of causes. These include alcohol’s long-term effects such as cancer, liver disease and heart disease as well as its short-term effects such as motor vehicle accidents, poisoning and suicide.

Many effective treatments exist for alcohol use disorder, including psychotherapy, peer support groups such as Alcoholics Anonymous and SMART Recovery, and medications. I’m a clinical psychologist and neuroscientist, and for the past 15 years, my research has focused on evaluating medications for alcohol use disorder.

Over that time, I have seen substantial changes in the scientific understanding and treatment of alcohol use disorder. I am optimistic that our existing medications can reach more people with this condition, that we can better target these medications to the patients most likely to benefit from them, and that new effective medications are on the horizon.

 

With the onset of the opioid epidemic in the past two decades, medications for opioid use disorder, such as methadone and buprenorphine, have entered the public consciousness. But medications for alcohol use disorder are less familiar to the public and used less frequently.

While 22% of patients with opioid use disorder receive medications to treat it, the rate of medication treatment for alcohol use disorder is much lower. Less than 10% of people with alcohol use disorder receive any treatment in any year, and less than 3% receive medications for it.

Regrettably, many people with alcohol use disorder don’t recognize the severity of their drinking and its effects on others, and many do not realize that effective medications are available.

As of May 2024, three medications have been approved by the Food and Drug Administration for treatment of alcohol use disorder. The oldest and best known of these medications is disulfiramsold under the brand name Antabuse – a compound that was first used in the American rubber industry.

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