What is the first-line treatment for alcohol use disorder?

Naltrexone is recognized as a first-line treatment for alcohol use disorder due to its mechanism of action as an opioid receptor antagonist. It works by blocking the euphoric effects and feelings of intoxication associated with alcohol consumption. This reduction in pleasure can help decrease the cravings for alcohol, making it a valuable option for individuals seeking to reduce or eliminate their drinking.

Research shows that naltrexone can be effective across various patient populations, making it a widely accepted option in clinical settings. Furthermore, it is well-tolerated by many patients, and does not cause aversive reactions when alcohol is consumed, which allows for a more patient-friendly approach compared to medications like disulfiram, which causes unpleasant effects if alcohol is ingested.

In contrast, while acamprosate is also used in the treatment of alcohol use disorder, it primarily helps to maintain abstinence rather than being effective in reducing cravings. Disulfiram is a deterrent that produces adverse effects when alcohol is consumed, which might not be conducive for every patient. Topiramate has shown some promise in helping with alcohol use disorder but is not considered first-line due to limited overall evidence compared to naltrexone and acamprosate. Thus, naltrexone