Addiction Disorders

Few Americans With Alcohol Use Disorder or Dependence Have Access to or Use Medications for Alcohol Treatment

Jessica Nye, PhD
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Young guy holding glass of alcohol.
alcohol
In an effort to improve the use of medications for treating alcohol use disorder (AUD), in 2017 the American Psychiatric Association released guidelines for pharmacological treatment of AUD. But with little known about the prevalence and associations of using medications for AUD, researchers turned their attention to this issue.

A survey of the general population in the United States indicated that medications for alcohol use disorder (AUD) were not widely used or available, according to a research letter published in JAMA Psychiatry.

Responses to the 2019 National Survey on Drug Use and Health (NSDUH) were analyzed for this study by researchers at the National Institutes of Health and Centers for Disease Control and Prevention. Participants (N=42,739, 53.4% women) were surveyed about their demographics, alcohol use, illicit drug use, mental health care, and visits to the emergency department during the previous year.

During the past-year, prevalence of AUD in the US was 5.6% (95% CI, 5.3%-6.0%) corresponding with 14.1 million people.

Among individuals with AUD, only 7.3% (95% CI, 5.8%-8.8%) or 1.0 million people received any treatment for AUD during the same period. Use of medication for AUD were reported by 1.6% (95% CI, 0.9%-2.3%) or 223,000 individuals.

Of the 7.9 million individuals with alcohol dependence, 2.7% (95% CI, 1.6%-3.8%) received medications for AUD.

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The use of medications for AUD associated with alcohol dependence (adjusted odds ratio [aOR], 16.1; 95% CI, 1.8-149.2; P <.05), receiving mental health care (aOR, 10.6; 95% CI, 3.1-35.9; P <.05), visiting the emergency department ≥3 times the previous year (aOR, 6.6; 95% CI, 1.7-25.5; P <.05), and living in a large metropolitan area (aOR, 6.2; 95% CI, 1.6-24.0; P <.05) compared with no treatment for AUD.

Nonmedication treatment for AUD associated with unemployed status (aOR, 3.4; 95% CI, 1.2-9.4; P <.05), illicit drug use disorder (aOR, 2.8; 95% CI, 1.7-4.6; P <.05), alcohol dependence (aOR, 2.6; 95% CI, 1.4-4.9; P <.05), receiving mental health care (aOR, 2.5; 95% CI, 1.6-3.9; P <.05), having some college education (aOR, 2.4; 95% CI, 1.4-3.9; P <.05), and visiting the emergency department on 1 occasion the previous year (aOR, 1.9; 95% CI, 1.1-3.2; P <.05) compared with no treatment for AUD.

Medications for AUD compared with nonmedication alcohol treatment associated with visiting the emergency department ≥3 times the previous year (aOR, 8.9; 95% CI, 2.0-38.6; P <.05), living in a large metropolitan area (aOR, 5.9; 95% CI, 1.3-26.2; P <.05), and receiving mental health care (aOR, 4.3; 95% CI, 1.2-15.8; P <.05).

Data from the NSDUH survey may have been prone to recall or social-desirability biases.

These data indicated that use of medications for AUD associated with living in a large metropolitan area and frequent visits to the emergency department may indicate individuals living outside of large cities have limited access. Use of these medications has been associated with improved treatment effectiveness and efforts to increase availability and use are needed.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.

Reference

Han B, Jones CM, Einstein EB, Powell PA, Compton WM. Use of medications for alcohol use disorder in the US: Results from the 2019 national survey on drug use and health. JAMA Psychiatry. Published online June 16, 2021. doi:10.1001/jamapsychiatry.2021.1271