A Retrospective Study of Hospital Recidivism Among Patients with Alcohol Use Disorders Treated with Intramuscular Naltrexone

Abstract

Introduction Alcohol use disorder is a chronic, relapsing condition that is associated with compulsive alcohol use and loss of control of alcohol intake. It is a common problem in the hospital setting. It has also become a public health dilemma. This study seeks to analyze the benefit of longacting naltrexone. This well-studied agent is indicated for alcohol use disorder. Methods This was a retrospective cohort study between July 1, 2016, and October 31, 2017, using Meditech's Pharmacy Admission Report (MPAR), which is the community hospital's network's electronic medical record (EMR) system as the data source "alcohol use disorders" covers a broad spectrum of sub-diagnoses. The patients were selected after they were admitted with a primary diagnosis of alcohol abuse dependence (APDRG v34code). Results The readmission rate in the study population (intramuscular naltrexone) was 2.86% and readmission in the control population (standard of care) was 25.70%. Patients diagnosed with alcohol abuse dependence are at a significantly decreased risk for readmission if treated with intramuscular naltrexone (odds ratio (OR) 8.5%; 95% confidence interval (CI) 0.0115, 0.6300; p=0.0159). Conclusion This study showed that treating patients admitted under the diagnosis of alcohol abuse dependence with intramuscular naltrexone may be an effective intervention in reducing hospital readmission. Additional studies are warranted to clarify and establish optimal treatment strategies.

Acamprosate may be safer than baclofen for the treatment of alcohol use disorder in patients with cirrhosis: a first description of use in real-world clinical practice

“…Furthermore, a higher rate of hospitalisation has previously been seen in otherwise healthy patients without liver disease treated with baclofen for AUD, in contrast to those treated with medications such as acamprosate [16]. In this highly motivated cohort, the majority of whom attended an alcohol clinic or specialist community alcohol programmes, most patients were still drinking alcohol at last follow-up: only a third were abstinent, consistent with historical response rates [3][4][5][6][7]. However, encouragingly half of the patients still drinking alcohol had reduced their intake considerably.…”

“…In this highly motivated cohort, the majority of whom attended an alcohol clinic or specialist community alcohol programmes, most patients were still drinking alcohol at last follow-up: only a third were abstinent, consistent with historical response rates [3–7]. However, encouragingly half of the patients still drinking alcohol had reduced their intake considerably.…”

“…AUD is a chronic, relapsing condition, which can be challenging to treat [2]. A quarter of inpatients treated for AUD relapse within a month [3,4], over half at 1-year [5,6] and over two-thirds by 5 years [7] – including those with significant ARLD [5,7].…”

The life and times of endogenous opioid peptides: Updated understanding of synthesis, spatiotemporal dynamics, and the clinical impact in alcohol use disorder

“…Consistent with this model, oral NTX decreased total drinking days per month, decreased heavy drinking days per month, and increased days until the first heavy drinking event ( O’Malley et al, 2007 ; Pettinati et al, 2011 ). Extended release NTX also decreased the number of heavy drinking days for patients with high severity AUD ( Espiridion, 2019 ; Pettinati et al, 2011 ). Fewer heavy drinking days can improve mental and physical health, mitigating many of the problems associated with AUD.…”