Pharmacological treatments in alcohol use disorder and risk of alcohol-related hospitalizations: A Register Study
Objectives Despite the high prevalence of alcohol use disorder (AUD), only a minority of patients receive recommended pharmacological treatments, possibly owing to uncertainty about the real-world effectiveness of these medications. Here, we analyzed nationwide, register-based data to investigate th...
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| Main Authors: | , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
Aug 2025
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| In: |
Acta psychiatrica Scandinavica
Year: 2025, Volume: 152, Issue: 2, Pages: 94-103 |
| ISSN: | 1600-0447 |
| DOI: | 10.1111/acps.13802 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1111/acps.13802 Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/acps.13802 
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| Author Notes: | Patrick Bach, Johan Franck, Jonas Hällgren, Härje Widing, Mika Gissler, Jeanette Westman |
| Summary: | Objectives Despite the high prevalence of alcohol use disorder (AUD), only a minority of patients receive recommended pharmacological treatments, possibly owing to uncertainty about the real-world effectiveness of these medications. Here, we analyzed nationwide, register-based data to investigate the association between approved AUD medications (naltrexone, acamprosate, disulfiram, and nalmefene) and the risk of alcohol-related hospitalizations among individuals with AUD. Methods People aged 18-64 with a registered first-time diagnosis of AUD between 2009 and 2019 (N = 93,727) were identified from the Swedish National Patient Register. Cox regression models were used to analyze the association between AUD medication exposure and the risk of alcohol-related hospitalizations. Results Exposure to naltrexone (hazard ratio [HR] = 0.80; 95% confidence interval [CI] = 0.73-0.87) or disulfiram (HR = 0.83, 95% CI = 0.79-0.88) as monotherapy, or a combination of naltrexone/disulfiram (HR = 0.68, 95% CI = 0.49-0.96), or disulfiram/acamprosate (HR = 0.57 95% CI = 0.44-0.74) was significantly associated with a lower risk of alcohol-related hospitalizations compared to periods without exposure to any of these medications. In contrast, no significant associations were observed for acamprosate, nalmefene, or the combination of acamprosate/naltrexone. Sensitivity analyses in individuals with severe AUD and stratified subgroup analyses by different socioeconomic groups confirmed the robustness of the results. Conclusion Results indicate a significant association between disulfiram and naltrexone monotherapy, as well as the combination of disulfiram with naltrexone or acamprosate, with a lower risk of alcohol-related hospitalizations among individuals with AUD. Low prescription rates suggest that AUD medications are currently underutilized. Increasing the availability of these medications for individuals with AUD could help reduce alcohol-related hospitalizations. |
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| Item Description: | Gesehen am 28.07.2025 |
| Physical Description: | Online Resource |
| ISSN: | 1600-0447 |
| DOI: | 10.1111/acps.13802 |