Physicians’ opinions about medications to treat alcoholism
Article first published online: 7 MAY 2003
Volume 98, Issue 5, pages 617–626, May 2003
How to Cite
Mark, T. L., Kranzler, H. R., Song, X., Bransberger, P., Poole, V. H. and Crosse, S. (2003), Physicians’ opinions about medications to treat alcoholism. Addiction, 98: 617–626. doi: 10.1046/j.1360-0443.2003.00377.x
- Issue published online: 7 MAY 2003
- Article first published online: 7 MAY 2003
- Submitted 12 June 2002; initial review completed 1 October 2002; final version accepted 14 December 2002
- alcohol dependence;
- alcoholism treatment;
Aims Medications play a limited role in the treatment of alcoholism. This paper examines physicians’ opinions about and use of two alcoholism medications currently approved in the US—disulfiram and naltrexone—and one alcoholism medication—acamprosate—that might be approved.
Design A total of 1388 substance abuse specialist physicians who were members of the American Academy of Addiction Psychiatry or the American Society of Addiction Medicine completed a questionnaire in 2001 (65% response rate).
Findings The average percentages of physicians’ patients with alcoholism who were prescribed the following medications were: 13% (naltrexone), 9% (disulfiram), 46% (antidepressants) and 11% (benzodiazepines). Almost all physicians had heard of naltrexone and disulfiram, but their self-reported level of knowledge about these medications was lower than for antidepressants. Physicians estimated that naltrexone had a small-to-medium effect size, which was similar in magnitude to the effect size reported in recent meta-analyses of randomized clinical trials. Physicians identified the following three courses of action as the most likely to result in greater use of medications to treat alcohol dependence: more research to develop new medications (33%), more education of physicians about existing medications (17%), and increased involvement of physicians in alcoholism treatment (17%).
Conclusions Physicians’ low rate of use of naltrexone may reflect its small-to-medium effect size.