SAMHSA Releases New Guidance on Medication Treatment for Alcohol Use Disorder

During National Alcohol Awareness Month in April, the Substance Abuse and Mental Health Services Administration (SAMHSA) marked the occasion by issuing new guidelines on medication-assisted treatment for alcohol use disorder. The guidelines were designed for the benefit of primary care and specialty providers. The goal of the guidelines is to establish clear benchmarks for the use of such medications in clinical practice.

Generated in partnership with the National Institute on Alcohol Abuse and Alcoholism, the production of the guide was accomplished by a panel of experts from a number of distinct fields, including research, clinical care, medical education, and public policy. The team examined the overall effectiveness of the available medications.

Based on a review of the current evidence available, Medication for the Treatment of Alcohol Use Disorder: A Brief Guide summarizes information on the four medications approved by the U.S. Food and Drug Administration (FDA) to treat alcohol use disorder, prevent relapse to alcohol use, or both.

The four medications currently approved are:

1. Disulfiram
2. Oral Naltrexone
3. Extended-Release Injectable Naltrexone
4. Acamprosate

Since the latest findings reveal such medications are underused in the treatment of alcohol use disorder, the hope is that offering the new guide to medical professionals will help shift this trend. Such a shift is particularly important since an estimated 10% to 20% of patients seen in primary care or hospital settings have a diagnosable alcohol use disorder. Despite 18 million people meeting the criteria for alcohol dependence or abuse in 2013, only 1.4 million received any type of treatment.

It is important to note these figures do not include mutual help and support groups like Alcoholics Anonymous, Moderation Management, or the Secular Organization for Sobriety.

The SAMHSA guide addresses six key topics:

1. How to balance FDA-approved indications with a patient’s unique circumstances
2. How to screen patients for alcohol abuse 
3. How to assess the need for medication-assisted treatment
4. How to develop a treatment plan and select a medication
5. How to treat patients with co-occurring disorders
6. How to monitor a patient’s progress on such medication

Although medication-assisted treatment has shown much promise in reducing alcohol abuse, it remains widely underused. As the Patient Protection and Affordable Care Act is implemented, there is considerable potential for expanding use of such treatments. SAMHSA believes their educational efforts will raise awareness among medical professionals while providing patients with a higher degree of care.