Assessing Naltrexone Prescribing and Barriers to Initiation for Alcohol Use Disorder: A Multidisciplinary, Multisite Survey

• Published in: Frontiers in psychiatry Vol. 13; p. 856938
• Main Authors: Leung, Jonathan G, Narayanan, Prasanna P, Markota, Matej, Miller, Nathaniel E, Philbrick, Kemuel L, Burton, M Caroline, Kirchoff, Robert W
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 10.05.2022
• Subjects: alcohol use disorder; naltrexone; prescribing; Psychiatry; substance use disorder; survey; alcohol use disorder; substance use disorder; survey; naltrexone; prescribing
• ISSN: 1664-0640; 1664-0640
• DOI: 10.3389/fpsyt.2022.856938

To survey barriers in prescribing naltrexone for alcohol use disorder. A 12-question survey related to naltrexone prescribing patterns, perceptions, and knowledge was sent to 770 prescribers in the departments of internal medicine, family medicine, and psychiatry across a health system with sites in Arizona, Florida, and Minnesota. Responses were obtained and included for 146/770 prescribers (19.0% response rate). Most respondents were in the department of internal medicine ( = 94, 64.4%), but the departments of psychiatry ( = 22, 15.1%) and family medicine ( = 30, 20.5%) were also represented. Only 34 (23.3%) respondents indicated they had prescribed naltrexone in the previous 3 months. The most common reasons for not prescribing naltrexone were "unfamiliarity with naltrexone for treatment of alcohol use disorder" and "patients do not have appropriate follow-up or are not in a formal treatment program." Compared with those representing internal/family medicine, psychiatry respondents were more likely to prescribe naltrexone and answer knowledge questions correctly. In this survey among primarily non-addiction-trained prescribers, a disparity was shown for prescribing naltrexone and in knowledge barriers between staff in internal/family medicine and psychiatry. There exist opportunities for education and quality improvement that promote the prescribing of naltrexone for alcohol use disorder by non-addiction specialists.