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). |
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| Jazyk: | angličtina |
| Zdroj: | Journal of addiction medicine [J Addict Med] 2024 Nov-Dec 01; Vol. 18 (6), pp. 614-616. 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 |
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