Treatment of Alcohol Use Disorder in Hospitalized Patients: Some Sobering Findings

EditorialsAugust 2023Treatment of Alcohol Use Disorder in Hospitalized Patients: Some Sobering FindingsMichael F. Mayo-Smith, MD, MPH, David Lawrence, MDMichael F. Mayo-Smith, MD, MPHDepartment of Medicine, White River Junction VA Medical Center, White River Junction, Vermont, and Dartmouth Geisel School of Medicine, Hanover, New HampshireSearch for more papers by this author, David Lawrence, MDSubstance Use Disorders Program, VA Greater Los Angeles Healthcare System, and Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CaliforniaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-1419 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In their article, Bernstein and colleagues (1) report a study that analyzed pharmacologic treatment initiation among Medicare beneficiaries hospitalized in 2016 with a primary or secondary diagnosis of alcohol use disorder (AUD). This work is important due to its national scope and its ability to analyze predictors of initiating treatment with medications for AUD (MAUD). In a carefully selected cohort with available demographic data, discharge diagnoses, and pharmacologic data, the researchers found that only 1.3% of patients initiated MAUD treatment in the 30 days after discharge. Initiation was more likely among younger patients, those who received psychiatric or addiction medicine ...References1. Bernstein EY, Baggett TP, Trivedi S, et al. Pharmacologic treatment initiation among Medicare beneficiaries hospitalized with alcohol use disorder. Ann Intern Med. 2023;176:1137-1139. doi:10.7326/M23-0641 LinkGoogle Scholar2. Barnett ML, Meara E, Lewinson T, et al. Racial inequality in receipt of medications for opioid use disorder. N Engl J Med. 2023;388:1779-1789. [PMID: 37163624] doi:10.1056/NEJMsa2212412 CrossrefMedlineGoogle Scholar3. Jonas DE, Amick HR, Feltner C, et al. Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis. JAMA. 2014;311:1889-900. [PMID: 24825644] doi:10.1001/jama.2014.3628 CrossrefMedlineGoogle Scholar4. Cheng HY, McGuinness LA, Elbers RG, et al. Treatment interventions to maintain abstinence from alcohol in primary care: systematic review and network meta-analysis. BMJ. 2020;371:m3934. [PMID: 33239318] doi:10.1136/bmj.m3934 CrossrefMedlineGoogle Scholar5. Newman D. Statin drugs given for 5 years for heart disease prevention (without known heart disease). The NNT Group. 10 January 2015. Accessed at https://thennt.com/nnt/statins-for-heart-disease-prevention-without-prior-heart-disease-2 on 27 May 2023. Google Scholar6. Wei J, Defries T, Lozada M, et al. An inpatient treatment and discharge planning protocol for alcohol dependence: efficacy in reducing 30-day readmissions and emergency department visits. J Gen Intern Med. 2015;30:365-70. [PMID: 25092008] doi:10.1007/s11606-014-2968-9 CrossrefMedlineGoogle Scholar7. Englander H, King C, Nicolaidis C, et al. Predictors of opioid and alcohol pharmacotherapy initiation at hospital discharge among patients seen by an inpatient addiction consult service. J Addict Med. 2020;14:415-422. [PMID: 31868830] doi:10.1097/ADM.0000000000000611 CrossrefMedlineGoogle Scholar8. Englander H, Dobbertin K, Lind BK, et al. Inpatient addiction medicine consultation and post-hospital substance use disorder treatment engagement: a propensity-matched analysis. J Gen Intern Med. 2019;34:2796-2803. [PMID: 31410816] doi:10.1007/s11606-019-05251-9 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Michael F. Mayo-Smith, MD, MPH; David Lawrence, MDAffiliations: Department of Medicine, White River Junction VA Medical Center, White River Junction, Vermont, and Dartmouth Geisel School of Medicine, Hanover, New HampshireSubstance Use Disorders Program, VA Greater Los Angeles Healthcare System, and Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CaliforniaDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-1419.Corresponding Author: Michael F. Mayo-Smith, MD, MPH, Department of Medicine, Dartmouth Geisel School of Medicine, 15 Meadowood Drive, Franklin, NH 03235; e-mail, Michael.F.Mayo-Smith@Dartmouth.edu.This article was published at Annals.org on 27 June 2023. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPharmacologic Treatment Initiation Among Medicare Beneficiaries Hospitalized With Alcohol Use Disorder Eden Y. Bernstein , Travis P. Baggett , Shrunjal Trivedi , Shoshana J. Herzig , Timothy S. Anderson Metrics August 2023Volume 176, Issue 8Page: 1129-1130KeywordsAlcoholismDrug therapyHospital medicine ePublished: 27 June 2023 Issue Published: August 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...