Evidence map›Paper›PMID 42266032›Full record

Observational studyAddiction (Abingdon, England)2026

Discontinuation of medications for alcohol use disorder in the United States: Patient, prescriber and medication predictors.

Alisa B Busch, Dominic Hodgkin, Alene Kennedy-Hendricks, Grant A Ritter, Lori Uscher-Pines, Constance M Horgan, Haiden A Huskamp

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Addiction (Abingdon, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Alisa B BuschMcLean Hospital, Mass General Brigham Department of Psychiatry, Harvard Medical School, Belmont, MA, USA.ORCID https://orcid.org/0000-0002-1828-9098
Dominic HodgkinHeller School for Social Policy and Management, Brandeis University, Waltham, MA, USA.
Alene Kennedy-HendricksDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Grant A RitterHeller School for Social Policy and Management, Brandeis University, Waltham, MA, USA.
Lori Uscher-PinesRAND Corporation, Arlington, VA, USA.
Constance M HorganHeller School for Social Policy and Management, Brandeis University, Waltham, MA, USA.
Haiden A HuskampDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA.

Funding

Medications for Alcohol Use Disorder:  Unfilled Prescriptions and Treatment TrajectoriesR01AA029267 · NIAAA · HARVARD MEDICAL SCHOOL · PI HODGKIN, DOMINIC, HUSKAMP, HAIDEN A. · 2021 to 2024
$2.9M
NIAAA NIH HHS R01 AA029267United States National Institute on Alcohol Abuse and Alcoholism (NIAAA) R01 AA029267
6 · The paper itself

Abstract

BACKGROUND AND

aimsLittle is known about medication for alcohol use disorder (MAUD) adherence. The goal of this study was to examine patient, prescriber and medication characteristics associated with time to discontinuation of MAUD. DESIGN, SETTING AND

participantsObservational cohort study from Optum Labs de-identified administrative claims data of a United States national sample of commercial and Medicare Advantage enrollees with alcohol use disorder (AUD) who initiated MAUD (naltrexone, acamprosate, disulfiram, topiramate) January 2017-June 2024 (n = 51 915). Using an accelerated failure time (AFT) log logistic survival model, we examined MAUD discontinuation, adjusting for patient demographic and clinical characteristics established within 6 months prior to or on date of initiation, specific MAUD initiated with, MAUD prescriber type and study year. We defined effect size of at least 10% change in AFT survival (i.e. AFT estimates > +/- 0.100) as being of clinical significance. MEASUREMENTS: Time-to-discontinuation of MAUD, defined as a gap in pharmacy fills or medication administrations of MAUD days-supply >7 days.

findingsIn unadjusted analyses, the median time to MAUD discontinuation was 30 days; median days-supply prior to discontinuation varied by medication (e.g. 30 days for acamprosate and naltrexone, 56 for disulfiram, 60 for topiramate). Adjusted analyses showed that among the patient characteristics, longer MAUD duration was associated with older age [e.g. AFT duration estimate (95% confidence interval) for age ≥65 vs. 18-30 = 0.164 (0.088-0.240)], while lower county median household income was associated with shorter duration [e.g. <$40 000 vs. ≥$200 000: -0.106 (-0.136 to -0.076)]. MAUD initiations via topiramate (vs. naltrexone) were associated with longer duration [0.339 (0.311-0.366)], as were initiations via disulfiram [0.103 (0.076-0.131)]. MAUD duration increased in recent study years, except 2024 [(e.g. 2023 vs. 2017 = 0.116 0.087-0.144)].

conclusionsAmong the few individuals in the United States who receive medication for alcohol use disorder (MAUD), early discontinuation is common, minimizing the opportunity for MAUD to support patients' recovery goals. While MAUD duration has increased in recent years, the improvements are small.

Indexed as

Alcohol DeterrentsAlcoholismDrug MonitoringAcamprosateAdultAgedCohort StudiesDisulfiramFemaleHumansMaleMiddle AgedNaltrexoneTime FactorsTopiramateUnited StatesAcamprosateAlcohol DeterrentsDisulfiramNaltrexoneTopiramatealcohol use disorderclaims datahealth services researchmedication adherencemedicationsquality of care

Identifiers

PMID42266032
PMCPMC13578879

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.