JAMA Clinical Reviews Medication Treatments for Alcohol Use Disorder
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Aug 19, 2026 Stephen Holt, Associate Professor of Medicine at Yale and addiction medicine specialist, outlines medication options for alcohol use disorder. He reviews first-line drugs like naltrexone and acamprosate. He discusses disulfiram and topiramate, safety and side effects. He covers treatment duration, starting meds in hospital, and why these effective therapies are underused.
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Alcohol Use Disorder Defined As Loss Of Control
- Alcohol use disorder is a pathologic relationship to alcohol marked by loss of control, consequences, and cravings.
- Stephen Holt emphasizes it causes physical and social harms and is common across all medical practices.
Alcohol Use Disorder Is More Burdensome Than Opioids
- Alcohol use disorder is remarkably common and causes more morbidity and mortality than opioid use disorder.
- Holt states AUD is one of the most prevalent preventable causes of illness and death globally.
Prefer Naltrexone Or Acamprosate As First Line
- Use naltrexone and acamprosate as first-line pharmacotherapy for AUD per major guidelines.
- Holt notes the VA additionally recommends topiramate and international guidelines mirror this approach.