[Pharmacological post-acute treatment of alcohol use disorder: Established strategies and innovative approaches].

Alcohol use disorders are a major contributor to the global disease burden. After the acute withdrawal phase, the main goal of post-acute treatment is long-term abstinence, though reducing consumption is also recognized as an intermediate aim. In Switzerland, four medications—acamprosate, naltrexone, nalmefene, and disulfiram—are approved for this phase and have well-established efficacy in reducing relapse risk, drinking days, and overall alcohol consumption. Off-label use of baclofen, topiramate, and gabapentin lacks sufficient evidence of effectiveness. Emerging treatments such as cannabidiol, psilocybin, and glucagon-like peptide-1 receptor agonists show promising potential that requires further clinical confirmation. Pharmacological interventions can improve patient outcomes, reduce inpatient treatment needs, and lower healthcare costs.

Study at a glance

Abstract

Alcohol use disorders are common and contribute significantly to the global burden of disease. The treatment of alcohol dependence includes the acute withdrawal phase and the post-acute rehabilitation phase. The primary goal of post-acute treatment is long-term abstinence, although reduction of alcohol consumption is also recognized as an intermediate goal. In addition to psychosocial and psychotherapeutic interventions, the use of medications is recommended. In Switzerland, four medications (acamprosate, naltrexone, nalmefene, and disulfiram) are approved for post-acute treatment. Their efficacy in reducing relapse risk, drinking days, and overall alcohol consumption is well established. Baclofen, topiramate, and gabapentin are used "off-label", but sufficient evidence of their effectiveness is still lacking. Innovative approaches such as cannabidiol, psilocybin, and glucagon-like peptide-1 receptor agonists show promising therapeutic potential, which needs to be confirmed in further clinical studies. The use of pharmacological interventions can help improve patient outcomes, reduce the need for inpatient treatment, and lower healthcare costs.