Trends in the Use of Naltrexone for Addiction Treatment among Alcohol Use Disorder Admissions in U.S. Substance Use Treatment Facilities

Abstract

Background: Naltrexone, a medication for addiction treatment (MAT), is an FDA-approved medication recommended for the treatment of alcohol use disorder (AUD). Despite the high prevalence of AUD and efficacy of naltrexone, only a small percentage of individuals with AUD receive treatment. Objectives: To identify trends for the prescription of naltrexone in AUD admissions in substance use treatment centers across the U.S. Methods: Data from the 2000–2018 U.S. Treatment Episode Data Set: Admissions (TEDS-A) were used in temporal trend analysis of naltrexone prescription in admissions that only used alcohol. Data from the 2019 National Survey of Substance Abuse Treatment Services (N-SSATS) were also used to characterize medication use among AUD clients across different treatment service settings. Results: Treatment of AUD with naltrexone was 0.49% in 2000 and tripled from 0.53% in 2015 to 1.64% in 2018 in AUD admissions (p < 0.0001 for the Cochran–Armitage trend test). Women, middle-aged adults, and admissions for clients living in the Northeast U.S. were more likely to be prescribed naltrexone than their respective counterparts, as were admissions with prior treatment episodes and referrals through alcohol/drug use care providers, who paid for treatment primarily through private insurance, used alcohol daily in the month prior to admission, and waited 1–7 days to enter treatment. Naltrexone was more commonly prescribed by AUD admissions compared to acamprosate and disulfiram and was more frequently prescribed in residential and outpatient services as opposed to hospital inpatient services. Conclusions: Naltrexone remains underutilized for AUD, and factors that influence prescription of medication are multifaceted. This study may contribute to the creation of effective interventions aimed at reducing naltrexone disparities for AUD.

Naltrexone blocks alcohol-induced effects on kappa-opioid receptors in the plasma membrane

“…Moreover, effectiveness of extendedrelease NTX medication [34] was recently demonstrated. However, NTX-based prescriptions were primarily given to higher income males with private insurance, leaving women and minorities without such intervention [35]. A certain rise in AUD have been recorded during the covid-19 pandemic [36], prompting an editorial advocating higher rate of NTX prescriptions [1].…”

Predicting severe alcohol use disorders in primary care using number of heavy drinking days

“…In addition, we were unable to examine the extent of under‐documenting of severe AUD based on DSM‐5 criteria which here, as in many health systems, is most often diagnosed in specialty addiction treatment. While most severe AUD diagnoses in our study came from specialty care, AUD is known to be under‐identified and under‐treated [10, 39]. Also, patients may have used other treatment services (e.g.…”