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Oral Naltrexone for Alcohol Use Disorder and Binge Drinking Among Sexual and Gender Minority Men

Oral naltrexone significantly improved drinking outcomes among sexual and gender minority men (SGM; men who have sex with men and transgender men) with mild-to-moderate alcohol use disorder that was fueled by binge drinking, a study shows. Effects were sustained at 6 months, leading the authors to conclude, “Naltrexone may be an important pharmacotherapy to address binge drinking in populations with mild to moderate alcohol use disorder.”

Randomized to targeted oral naltrexone 50 mg or placebo with weekly medication-management counseling for 12 weeks, 120 SGM were instructed to take 1 pill (naltrexone or placebo) during periods of alcohol craving and/or when they perceived a high risk for heavy alcohol consumption (i.e., when binge drinking was anticipated). Results showed that naltrexone was associated with a significantly reduced reported binge-drinking intensity: fewer binge-drinking days, weeks with any binge drinking, and number of drinks per month, and lower alcohol-craving scores.

With targeted dosing used in this study, patients took doses on a median of 2.5 days per week. Those at or above this level of naltrexone use had significantly less binge drinking, fewer binge-drinking days, and lower amounts of an alcohol biomarker, phosphatidylethanol, in dried blood spot samples. These reductions were sustained at 6 months.

“This study supports the use of a targeted dosing approach for naltrexone in SGM who are interested in reducing their heavy alcohol consumption on an event-driven, as-needed basis,” the investigators conclude. “Efforts to expand access to this treatment approach can enhance public health efforts to address binge drinking and associated harms.”

Source: American Journal of Psychiatry