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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Hauptverfasser: Bach, Patrick (VerfasserIn) , Franck, Johan (VerfasserIn) , Hällgren, Jonas (VerfasserIn) , Widing, Härje (VerfasserIn) , Gissler, Mika (VerfasserIn) , Westman, Jeanette (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: Aug 2025
In: Acta psychiatrica Scandinavica
Year: 2025, Jahrgang: 152, Heft: 2, Pages: 94-103
ISSN:1600-0447
DOI:10.1111/acps.13802
Online-Zugang: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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Verfasserangaben:Patrick Bach, Johan Franck, Jonas Hällgren, Härje Widing, Mika Gissler, Jeanette Westman

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520 |a 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. 
650 4 |a acamprosate 
650 4 |a alcohol use disorder 
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700 1 |a Gissler, Mika  |e VerfasserIn  |4 aut 
700 1 |a Westman, Jeanette  |e VerfasserIn  |4 aut 
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