Hospital Treatment for Alcohol Use Disorder Significantly Reduces Heavy Drinking

A groundbreaking study from Boston University’s School of Public Health, BU Chobanian & Avedisian School of Medicine, and Boston Medical Center reveals that administering alcohol use disorder (AUD) treatment to hospitalized patients can lead to meaningful reductions in heavy drinking. Despite nearly 30 million adults in the U.S. suffering from AUD, many do not receive adequate care. This research highlights hospitals as strategic settings to bridge this treatment gap.

Published in JAMA Internal Medicine, the study demonstrates that patients discharged with naltrexone—an approved medication for AUD—showed significant decreases in heavy drinking over three months. Both oral and extended-release injectable forms of naltrexone proved similarly effective in reducing alcohol consumption, with the injectable form showing slightly higher adherence rates.

Specifically, after three months, heavy drinking—defined as consuming five or more drinks daily for men or four for women—declined by approximately 38 percentage points among pill users and about 46 points among those receiving injections. The research marks the first randomized clinical trial directly comparing both formulations, encouraging healthcare providers to incorporate this medication routinely at discharge.

Dr. Jeffrey Samet, the study's lead author, emphasizes that hospital stays are critical opportunities to address chronic drinking problems, which are often overlooked amid acute health issues. The study underscores the importance of integrating evidence-based medication treatment into standard hospital care to improve patient outcomes.

Utilizing data from the ADOPT study, researchers enrolled 248 patients with AUD who completed a hospital stay between June 2016 and March 2020. Participants received their medication on discharge—either a daily pill or a monthly injection—and were monitored for reduction in heavy drinking and healthcare utilization. Interestingly, adherence was slightly higher with the injectable, though cost and convenience factors may influence patient choice.

The injectable version at $1,064 per dose offers the advantage of not requiring daily compliance, unlike the $38.10 monthly pills. The study found no difference in hospital readmissions or AUD-related visits between the two medication types in the follow-up period.

Sara Magane, a senior research director involved in the study, advocates for broader access to AUD treatments in hospital settings. "Effective, evidence-based medication options are available, and it's crucial to make them more accessible upon discharge," she states. Future directions include exploring patient preferences, adherence barriers, and optimizing treatment delivery. This work honors the legacy of Dr. Richard Saitz, who initiated the study before his passing, and reflects his committed vision for addressing addiction with compassion and scientific rigor.

This research supports incorporating AUD medication treatment as a routine, patient-centered approach in hospitals, ultimately aiming to improve long-term recovery and health outcomes for individuals battling alcohol dependence.