Alcohol Use Disorder

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Addressing the Treatment Gap in Alcohol Use Disorder: A Call to Action

Alcohol use disorder (AUD) affects millions of Americans, yet only a small fraction receive FDA-approved treatments. As of 2023, 28.8 million U.S. adults had AUD, but just 7.6% received treatment, and only 2.2% used medications (MAUD). This low treatment rate has serious public health implications, as alcohol-related deaths have surged, especially during the pandemic.

Drinking rates among women and young people have significantly increased. Women’s binge drinking now matches men’s, partly due to social media promoting "mommy wine culture." Young adults are also engaging in dangerous drinking trends like the "blackout rage gallon" popularized on TikTok.

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Despite effective screening and treatment strategies, including MAUD combined with psychotherapy and peer support, uptake remains low. The three FDA-approved medications for AUD are disulfiram, naltrexone, and acamprosate, each with distinct mechanisms and benefits. Disulfiram causes severe reactions when alcohol is consumed, naltrexone reduces cravings and the euphoric effects of alcohol, and acamprosate decreases cravings.

Barriers to treatment include stigma, insufficient screening, and lack of awareness among healthcare providers. AUD is a complex spectrum disorder with varying severity, and effective treatment requires a tailored approach combining medical, psychological, and social support.

Primary care providers should routinely screen for AUD, and emergency room providers should consider prescribing MAUD for alcohol-related issues. Outpatient treatment centers offering integrated care can help individuals manage AUD while maintaining their daily lives. Recognizing and treating AUD as a medical condition with comprehensive care and resources is crucial for recovery.

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