Background: It is estimated that 20% of patients who encounter the ED suffer from Alcohol Use Disorder (AUD) . Hospitalists encounter many Alcohol Withdrawal admissions and are often tasked with providing short counseling sessions on AUD due to time restraints. Furthermore, up to 50% of of patents admitted for Alcohol withdrawal will be readmitted for Alcohol Withdrawal in 30 days. Although there are Medication Assisted Therapies (MAT) approved by the US Food and Drug Administration (FDA) to treat patients with AUD, many of these therapies were given as outpatient therapy or during inpatient rehabilitation programs. Limited studies have examined the use of these therapies upon discharge from a hospital setting.
Methods: The literature was then independently reviewed by two authors for relevant data for review. Each study was assessed for quality and each outcome within the study and reached consensus by discussion. Disagreements in study selection and issues related to data extraction for resolved by discussion among the two authors. Inclusion Criteria: (1) the study was conducted inpatient or in the ED; (2) use of naltrexone was implemented upon discharge or during hospital course; (3) readmissions were identified1) Exclusion Criteria: Outpatient, residential, or partial outpatient CD programs (we want inpatient medical only)2) No measurable outcomes3) Use of naltrexone for anything other than alcohol use disorder4) Psychiatric comorbidity as primary focus (studies only looking at patients with depression, bipolar, schizophrenia, etc) – these can be easily filtered by article title
Results: Three studies were identified as seen in the table attached.
Conclusions: Further studies are needed to assess the utility of prescribing Naltrexone upon discharge for patients admitted with Alcohol Withdrawl.
