Pharmacotherapy for Alcohol Use Disorders in Outpatient Settings

The review and meta-analysis by Jonas and colleagues examines the benefits and potential harms of approved medication for adults with alcohol use disorders.

The medications that were examined are often combined with other behavioral outpatient treatment. In particular, the researchers examined acamprosate, disulfiram, and naltrexone (both oral and injection).

The authors included randomized controlled trials comparing one of the medications with a placebo, and prospective cohort studies that compared two medications. This study included 151 articles about 123 studies that included sample sizes from 21-1383 participants. Most studies enrolled participants after detoxification or a brief period of sobriety.  There were 22 placebo controlled trials of acamprosate, 4 of disulfiram and 44 of naltrexone. The authors also included the drug nalmefene in their review.

Acamprosate and naltrexone were both associated with improvements in consumption outcomes.

 

The authors found that:

 

When combined with behavioral interventions, the addition of several medications resulted in better alcohol consumption outcomes.

 

 

CITATIONS

Jonas, D. E., Amick, H. R., Feltner, C., Bobashev, G., Thomas, K., Wines, R., … & Garbutt, J. C. (2014). Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis. Jama, 311(18), 1889-1900.