There is approved and studied medication available for alcohol use disorder. However, these medications are rarely used, especially in the United States. Why is Medication-Assisted Treatment (MAT) so underused in the US?

 

What the Research Shows on MAT and Alcohol

Research shows that few people can access Medication-Assisted Treatment in Federal guidelines recommend using MAT for people with alcohol use disorder. However, traditionally 12-step programs like AA have viewed this treatment as “cheating.” While perceptions have begun to change, many people in the addiction industry still feel like the medication is taboo.

In research compiled by JAMA Psychiatry, Beth Han, MD, Ph.D., MPH, of the NIH’s National Institute on Drug Abuse discovered that MAT treatment rates for alcohol use disorder were only 7.6% in 2019. In contrast, around 36% of people diagnosed with opioid use disorder in 2019 could access medication-assisted treatment.

What MAT is Available for Alcohol Addiction?

Three medications are officially approved to treat AUD in the United States. These drugs are naltrexone, acamprosate, and disulfiram. Each of these helps people who are physically addicted to alcohol, each in a different manner.

Naltrexone can reduce cravings. In clinical studies, it can help people with harm reduction as well. However, some people continue to drink while taking it, although in smaller quantities. It’s also available as a convenient injection.

Acamprosate, however, is meant to quell the desire to drink, but if a person takes it and relapses can suffer dangerous consequences. Disulfiram makes a person feel incredibly sick if they drink, which can deter drinking. The premise of punishment makes it a bit of an old-fashioned drug now that we better understand the disease addiction.

Other drugs are often prescribed off-label to help cope with withdrawal symptoms, but are not appropriate for longer-term use. Naltrexone is considered to be one of the safest MAT options for alcohol addiction.