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Related Concept Videos

CNS Depressants: Alcohol and Nicotine01:27

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Ethanol, a clear colorless alcohol, has been consumed by humans for millennia, but its effects on the body are far from benign. At lower doses, it induces decreased inhibitions and loquaciousness, leading to its social appeal. However, it can cause severe consequences at higher doses, such as coma and respiratory depression, due to its zero-order elimination kinetics. Chronic ethanol abuse wreaks havoc on multiple organ systems, particularly the CNS and the liver. Abrupt cessation of ethanol...
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Oral vs Extended-Release Injectable Naltrexone for Hospitalized Patients With Alcohol Use Disorder: A Randomized

Kara M Magane1, Kimberly A Dukes2, Sarah Fielman1

  • 1Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.

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|April 21, 2025
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Summary
This summary is machine-generated.

Initiating oral or injectable naltrexone at hospital discharge for alcohol use disorder (AUD) showed similar effectiveness in reducing heavy drinking days and healthcare use. Patient preference and insurance should guide treatment choice.

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Area of Science:

  • Addiction Medicine
  • Clinical Pharmacology
  • Public Health

Background:

  • Alcohol use disorder (AUD) is prevalent among hospital patients, yet medication initiation is uncommon in this setting.
  • Comparative effectiveness of initiating oral versus extended-release injectable naltrexone for AUD in hospitalized patients is unknown.

Purpose of the Study:

  • To compare the effectiveness of initiating oral naltrexone versus extended-release injectable naltrexone in reducing alcohol consumption and healthcare utilization among hospitalized patients with AUD.

Main Methods:

  • A randomized clinical trial (Alcohol Disorder Hospital Treatment study) enrolled inpatients with AUD and recent heavy drinking.
  • Participants received either daily oral naltrexone or monthly extended-release injectable naltrexone, alongside medical management.
  • Outcomes, including percentage of heavy drinking days and acute healthcare utilization, were assessed at 3-month follow-up.

Main Results:

  • Both oral and extended-release injectable naltrexone groups showed significant reductions in heavy drinking days from baseline to 3-month follow-up.
  • No significant difference was observed between the groups in the reduction of heavy drinking days or in acute healthcare utilization.
  • The study included 248 participants, with 80.2% being male, and a mean age of 49.4 years.

Conclusions:

  • Initiating oral or extended-release injectable naltrexone at hospital discharge for AUD did not show a significant difference in effectiveness.
  • Hospitalization presents a key opportunity for initiating AUD pharmacotherapy.
  • Treatment decisions between oral and injectable naltrexone should consider patient preference and insurance coverage.