Supervised Disulfiram Should Be Considered First-Line Treatment for Alcohol Use Disorder.

Autor: Holt SR; From the Program in Addiction Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT (SRH).
Jazyk: angličtina
Zdroj: Journal of addiction medicine [J Addict Med] 2024 Aug 16. Date of Electronic Publication: 2024 Aug 16.
DOI: 10.1097/ADM.0000000000001345
Abstrakt: Abstract: Despite the prevalence of alcohol use disorder (AUD) in the United States, the armamentarium of FDA-approved medications available for AUD treatment is remarkably small. Disulfiram, 1 of only 3 approved medications, is consistently designated as a second-line option in national treatment guidelines, citing inconsistent evidence, lack of patient preference, and safety concerns. These concerns, however, stem from a misguided interpretation of the evidence that exclusively relies upon double-blind randomized controlled trials (RCT). When viewed instead as both a medication and a behavioral intervention, open-label RCTs become a more appropriate research method, yielding overwhelmingly favorable efficacy data for disulfiram, and supervised disulfiram, in particular. With these data in mind, supervised disulfiram should be redesignated as a first-line intervention in both treatment guideline creation and clinical pathway tools. The addiction medicine community can no longer afford to neglect this critical therapeutic resource.
Competing Interests: The author reports neither sources of funding nor any commercial or financial conflicts of interest to disclose.
(Copyright © 2024 American Society of Addiction Medicine.)
Databáze: MEDLINE