Background and objectives: Several medications for alcohol use disorder (MAUDs) are recommended to treat alcohol use disorder (AUD) in the Veterans Affairs (VA) guidelines. This study descriptively characterized treatment patterns and healthcare resource utilization (HCRU) among VA patients with AUD treated with VA-recommended MAUDs.
Methods: Veterans Health Administration data (VHA; 08/01/2013-11/30/2019) were used to identify 31,384 adults aged ≥18 years with AUD who initiated disulfiram (n = 2115), acamprosate (n = 3756), oral naltrexone (n = 25,082), or extended-release naltrexone (XR-NTX; n = 431) following AUD diagnosis. Study measures, stratified by medication received, included treatment adherence (proportion of days covered), discontinuation, and HCRU over 1 year.
Results: Mean time to treatment discontinuation was high for all MAUDs but longest for XR-NTX (92 vs. 55-59 days; all p < .001). Relative to the year preceding AUD diagnosis, treatment with MAUDs was associated with fewer hospitalizations (XR-NTX: 0.48 vs. 0.42; oral naltrexone: 0.58 vs. 0.47; acamprosate: 0.67 vs. 0.60; disulfiram: 0.63 vs. 0.57) and more outpatient visits per patient (XR-NTX: 20.0 vs. 36.0; oral naltrexone: 19.0 vs. 30.0; acamprosate: 19.0 vs. 31.0; disulfiram: 17.0 vs. 29.0).
Conclusion: Among veterans with AUD, this descriptive analysis found that MAUD use was associated with reduced hospitalizations, and XR-NTX was associated with a longer treatment duration versus oral MAUDs.
Scientific significance: This real-world study is among the first to describe clinical characteristics, treatment patterns, and HCRU in VHA patients who initiated MAUDs when all MAUDs were included in the VHA formulary.
© 2025 The Author(s). The American Journal on Addictions published by Wiley Periodicals LLC on behalf of The American Academy of Addiction Psychiatry (AAAP).