When are these medications most helpful?
When are these medications most helpful?
l
Maisel and colleagues performed a review and meta-analysis to indentify when naxltrexone and acamprosate are most helpful by measuring the relative efficacy of each medication for what it is thought to do and whether different ways of implementing each medication (e.g. requiring abstinence before treatment) impacted its effect.
Naltrexone is thought to reduce cravings and help prevent relapse to heavy drinking by reducing the rewarding effects of alcohol if drinking does occur.
Acamprosate is thought to promote abstinence by resetting the balance in the brain that is disrupted in alcohol use disorders. Acamprosate is also thought to be ineffective if the patient begins using alcohol.
This study included randomized, placebo-controlled trials that tested the efficacy of naltrexone or acamprosate in adults over the age of 18, that were published between 1970-2009, and included at least one drinking outcome. The authors looked at abstinence, heavy drinking, craving, and heavy drinking and craving together as outcomes. There were 45 trials looking at naltrexone versus placebo (n= 5,434), 16 trials examining acamprosate versus placebo (n=4,349), and 3 studies comparing both medication (n=1,210).
Notably:
The majority of studies included in this research involved a behavioral intervention given to both groups; therefore, many of the studies were not simply comparing medication versus no medication.
The number needed to treat to achieve an additional case of abstinence for acamprosate is 8 and for naltrexone is 9. This suggests that both acamprosate and naltrexone have clinical relevance.
Alcohol use disorder (AUD) is a high volume, high burden, illness that is often chronic. While it is the third leading cause of preventable death in the United States, it is treatable and most people recover from AUD with time. Treatment can play a big role in aiding recovery efforts, yet because AUD is heavily stigmatized, many people avoid specialty treatment. Medications for AUD are important as they can help improve outcomes and have shown to be effective when delivered by more ubiquitous addiction non-specialists, like primary care physicians. Because seeing one’s primary care physician is not stigmatized it provides an opportunity for many more people with AUD to be treated.
The beneficial effects from naltrexone and acamprosate may differ to some degree in keeping with their purported relative targets: naltrexone to reduce heavy drinking and acamprosate to increase abstinence. More widespread use of medications for AUD in primary care and specialty care offers hope that more people can find a treatment that will help them on their road to remission and recovery.
Maisel, N. C., Blodgett, J. C., Wilbourne, P. L., Humphreys, K., & Finney, J. W. (2013). Meta‐analysis of naltrexone and acamprosate for treating alcohol use disorders: when are these medications most helpful?. Addiction, 108(2), 275-293.
l
Maisel and colleagues performed a review and meta-analysis to indentify when naxltrexone and acamprosate are most helpful by measuring the relative efficacy of each medication for what it is thought to do and whether different ways of implementing each medication (e.g. requiring abstinence before treatment) impacted its effect.
Naltrexone is thought to reduce cravings and help prevent relapse to heavy drinking by reducing the rewarding effects of alcohol if drinking does occur.
Acamprosate is thought to promote abstinence by resetting the balance in the brain that is disrupted in alcohol use disorders. Acamprosate is also thought to be ineffective if the patient begins using alcohol.
This study included randomized, placebo-controlled trials that tested the efficacy of naltrexone or acamprosate in adults over the age of 18, that were published between 1970-2009, and included at least one drinking outcome. The authors looked at abstinence, heavy drinking, craving, and heavy drinking and craving together as outcomes. There were 45 trials looking at naltrexone versus placebo (n= 5,434), 16 trials examining acamprosate versus placebo (n=4,349), and 3 studies comparing both medication (n=1,210).
Notably:
The majority of studies included in this research involved a behavioral intervention given to both groups; therefore, many of the studies were not simply comparing medication versus no medication.
The number needed to treat to achieve an additional case of abstinence for acamprosate is 8 and for naltrexone is 9. This suggests that both acamprosate and naltrexone have clinical relevance.
Alcohol use disorder (AUD) is a high volume, high burden, illness that is often chronic. While it is the third leading cause of preventable death in the United States, it is treatable and most people recover from AUD with time. Treatment can play a big role in aiding recovery efforts, yet because AUD is heavily stigmatized, many people avoid specialty treatment. Medications for AUD are important as they can help improve outcomes and have shown to be effective when delivered by more ubiquitous addiction non-specialists, like primary care physicians. Because seeing one’s primary care physician is not stigmatized it provides an opportunity for many more people with AUD to be treated.
The beneficial effects from naltrexone and acamprosate may differ to some degree in keeping with their purported relative targets: naltrexone to reduce heavy drinking and acamprosate to increase abstinence. More widespread use of medications for AUD in primary care and specialty care offers hope that more people can find a treatment that will help them on their road to remission and recovery.
Maisel, N. C., Blodgett, J. C., Wilbourne, P. L., Humphreys, K., & Finney, J. W. (2013). Meta‐analysis of naltrexone and acamprosate for treating alcohol use disorders: when are these medications most helpful?. Addiction, 108(2), 275-293.
l
Maisel and colleagues performed a review and meta-analysis to indentify when naxltrexone and acamprosate are most helpful by measuring the relative efficacy of each medication for what it is thought to do and whether different ways of implementing each medication (e.g. requiring abstinence before treatment) impacted its effect.
Naltrexone is thought to reduce cravings and help prevent relapse to heavy drinking by reducing the rewarding effects of alcohol if drinking does occur.
Acamprosate is thought to promote abstinence by resetting the balance in the brain that is disrupted in alcohol use disorders. Acamprosate is also thought to be ineffective if the patient begins using alcohol.
This study included randomized, placebo-controlled trials that tested the efficacy of naltrexone or acamprosate in adults over the age of 18, that were published between 1970-2009, and included at least one drinking outcome. The authors looked at abstinence, heavy drinking, craving, and heavy drinking and craving together as outcomes. There were 45 trials looking at naltrexone versus placebo (n= 5,434), 16 trials examining acamprosate versus placebo (n=4,349), and 3 studies comparing both medication (n=1,210).
Notably:
The majority of studies included in this research involved a behavioral intervention given to both groups; therefore, many of the studies were not simply comparing medication versus no medication.
The number needed to treat to achieve an additional case of abstinence for acamprosate is 8 and for naltrexone is 9. This suggests that both acamprosate and naltrexone have clinical relevance.
Alcohol use disorder (AUD) is a high volume, high burden, illness that is often chronic. While it is the third leading cause of preventable death in the United States, it is treatable and most people recover from AUD with time. Treatment can play a big role in aiding recovery efforts, yet because AUD is heavily stigmatized, many people avoid specialty treatment. Medications for AUD are important as they can help improve outcomes and have shown to be effective when delivered by more ubiquitous addiction non-specialists, like primary care physicians. Because seeing one’s primary care physician is not stigmatized it provides an opportunity for many more people with AUD to be treated.
The beneficial effects from naltrexone and acamprosate may differ to some degree in keeping with their purported relative targets: naltrexone to reduce heavy drinking and acamprosate to increase abstinence. More widespread use of medications for AUD in primary care and specialty care offers hope that more people can find a treatment that will help them on their road to remission and recovery.
Maisel, N. C., Blodgett, J. C., Wilbourne, P. L., Humphreys, K., & Finney, J. W. (2013). Meta‐analysis of naltrexone and acamprosate for treating alcohol use disorders: when are these medications most helpful?. Addiction, 108(2), 275-293.
SIGN UP FOR THE BULLETIN
151 Merrimac St., 4th Floor. Boston, MA 02114
