Medications for Alcohol Use Disorder Are Increasingly Being Prescribed in American Patients With Advanced Liver Disease.

Abstract

The number of alcohol use disorder patients with mild (n = 101) and severe alcoholic liver disease (n = 112) increased between 2013 and 2023 ( P = 0.06). Naltrexone was prescribed in 65%, acamprosate in 26%, and disulfiram in 9%. Internal medicine providers were the most frequent prescribers (51%), followed by psychiatry (30%) and gastroenterology/hepatology (9%) ( P = 0.001). Duration of use was longest with naltrexone compared with acamprosate and disulfiram (360 vs 251 vs 190 days, P = 0.032). The rate of alcohol use disorder medication discontinuation for adverse events was similar in both groups (14% vs 12%). Naltrexone, acamprosate, and disulfiram are increasingly being prescribed in American patients with mild and severe alcohol-related liver disease with similar tolerability and efficacy.