JAMA Intern Med

Injectable and oral naltrexone initiated at hospital discharge both effective for alcohol use disorder

April 23, 2025

Study details: The Alcohol Disorder Hospital Treatment (ADOPT) study was a randomized trial conducted at an urban teaching hospital in the U.S., enrolling 248 medical inpatients with AUD and recent heavy drinking between June 2016 and March 2020. Participants were randomized to receive either daily oral naltrexone or monthly extended-release (ER) injectable naltrexone, with outcomes assessed at 3-month follow-up.

Results: Both treatment groups showed substantial reductions in the percentage of heavy drinking days (HDDs) from baseline to 3-month follow-up. HDDs were lower by 38.4 percentage points (95% confidence interval [CI], -125.0 to 48.2) in the oral naltrexone group, while the ER injectable naltrexone group saw a reduction of 46.4 percentage points (95% CI, -123.4 to 30.6; P = 0.14). Acute healthcare utilization was reported by 54.1% in the oral naltrexone group and 61.1% in the ER injectable group, with no significant difference between groups.

Clinical impact: Both oral and ER injectable naltrexone are both effective in reducing HDDs among hospitalized patients with AUD. The choice between oral and ER injectable naltrexone should be guided by patient preference and insurance coverage.

Source:

Magane KM, et al. (2025, April 21). JAMA Intern Med. Oral vs Extended-Release Injectable Naltrexone for Hospitalized Patients With Alcohol Use Disorder: A Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/40257810/