Effectiveness of Disulfiram as Adjunct to Addiction-Focused Treatment for Persons With Severe Alcohol Use Disorder

The consumption of alcohol affects 400 million people worldwide, where it is responsible for 7% of deaths. Treatment success rates in this field remain limited. Only 15% of those who need treatment get it. Despite treatment, alcohol intake reoccurs in up to 90% of the cases. The use of disulfiram in preventing alcohol reoccurrence is attributed to its unique mechanism of action as an aversive agent, which causes the patient to experience unpleasant physical symptoms when they consume alcohol. The objective of this study is to confirm and illustrate the efficacy of disulfiram in combination with non-pharmacological intervention for persons with severe AUD. Clinical data from 45 patients of an outpatient treatment programme, including the application of disulfiram (2011-2023) were analysed to assess abstinence rates, craving impact, and demographic factors. Moreover, our analyses aimed to identify predictors and moderators of continuous abstinence duration. The study cohort comprised patients with severe AUD and high rates of comorbidities, the majority of which were affective disorders. During treatment, 50% of patients remained abstinent for at least 1 year. No significant differences were identified in craving, sex or comorbidities compared with those who experienced a return to substance use after treatment initiation. Disulfiram underlined its efficacy and tolerability as an adjunct to addiction-focused treatment in a typical clinical cohort of patients severely affected by AUD. Moreover, our analyses align with previous research indicating that disulfiram appears to allow patients with AUD to resist craving episodes, therefore avoiding impulsive reoccurrences of alcohol intake.