Alcohol Use Disorder (AUD) is a pervasive issue in the United States, with millions of individuals struggling to manage their drinking habits. However, despite its wide prevalence, a surprisingly small percentage of people with AUD receive potentially lifesaving and effective treatment. One such treatment that is often overlooked by both patients and healthcare providers is Medication-Assisted Treatment for Alcohol Use Disorder (MAT for AUD).
The Hidden Struggles of AUD in a Society That Encourages Alcohol Consumption
Unlike many other substances, alcohol is widely accepted and even encouraged in American society. The alcohol industry is a massive force, generating billions of dollars in sales each year, with spirits alone accounting for $38 billion in the U.S. alone. This societal endorsement of alcohol consumption creates significant challenges for those suffering from AUD.
Brian Dawson, Chief Medical Officer at Ideal Option, a treatment provider with 82 locations across nine states, emphasizes that “a huge aspect of American social culture is using substances like alcohol.” He notes that for individuals with AUD, it is extremely difficult to avoid the constant triggers and pervasive availability of alcohol. In many social settings, alcohol is the central element, often driving the occasion itself.
Despite these challenges, Medication-Assisted Treatment for Alcohol Use Disorder (MAT for AUD) remains an underutilized solution for those seeking recovery. In fact, recent statistics show that only a small fraction of people with AUD access MAT. According to the 2022 National Survey on Drug Use and Health (NSDUH), only 2.1% of individuals with AUD received MAT in the past year—representing just 634,000 people out of the 29.5 million with the disorder.
What Is Medication-Assisted Treatment for Alcohol Use Disorder?
Medication-Assisted Treatment for Alcohol Use Disorder (MAT for AUD) involves the use of FDA-approved medications to help individuals reduce cravings and the physical effects of alcohol consumption. MAT is considered an essential part of a comprehensive treatment plan, which typically includes counseling and behavioral therapies. There are three primary medications approved by the FDA for treating AUD: disulfiram, acamprosate, and naltrexone.
Each of these medications works in different ways to help individuals with AUD. Disulfiram causes unpleasant side effects when alcohol is consumed, deterring individuals from drinking. Naltrexone blocks the euphoric effects of alcohol, reducing the desire to drink. Acamprosate helps reduce cravings by restoring the balance of chemicals in the brain that are disrupted by alcohol use. These medications can be powerful tools for those committed to overcoming AUD, yet they remain underutilized.
The Impact of Alcohol’s Ubiquity on Treatment Access
The societal acceptance of alcohol consumption has created a unique challenge for those suffering from AUD. The very forces that encourage alcohol use also make it difficult for individuals to recognize the severity of their disorder and seek help. In many cases, people with AUD may not even be aware that Medication-Assisted Treatment for Alcohol Use Disorder (MAT for AUD) is a viable treatment option.
This challenge is compounded by the fact that alcohol is not as closely monitored or regulated as other substances like opioids. While prescription opioid use is closely tracked by state registries, there are no such systems in place for monitoring alcohol purchases or use. This lack of oversight means that individuals struggling with AUD may not receive the timely interventions they need, and Medication-Assisted Treatment for Alcohol Use Disorder may not be considered as a treatment option until the disorder has reached a more advanced stage.
Why Medication-Assisted Treatment for Alcohol Use Disorder Is Underutilized
One reason why MAT for AUD is underutilized is the stigma surrounding it. While there is growing acceptance of MAT for opioid use disorder (OUD), the same cannot be said for AUD. Society often perceives addiction as a moral failing or as a condition that can only be treated through complete abstinence. This belief can lead to the misconception that medications used for treating AUD are a form of “cheating” or that they are somehow less effective than traditional abstinence-based approaches like Alcoholics Anonymous (AA).
Dr. Brian Dawson of Ideal Option explains, “It’s not like treating opioid use disorder with methadone or buprenorphine, where you’re taking someone who’s addicted to opioids and you’re giving them an opioid to make them feel normal.” In contrast, the medications used for Medication-Assisted Treatment for Alcohol Use Disorder such as disulfiram, naltrexone, and acamprosate work by either making individuals feel sick if they drink or by blocking the pleasurable effects of alcohol. As Dawson points out, this difference in how the medications work may contribute to the stigma surrounding them.
The Benefits of Medication-Assisted Treatment for Alcohol Use Disorder
Despite the challenges and misconceptions, Medication-Assisted Treatment for Alcohol Use Disorder offers significant benefits. When combined with behavioral therapy and counseling, MAT can help individuals with AUD manage cravings, reduce relapse rates, and regain control over their lives. The goal of MAT is not always complete sobriety, but rather an improvement in life circumstances and a reduction in alcohol consumption.
Dr. Mimi Winsberg, Chief Medical Officer at Brightside Health, emphasizes that MAT is particularly beneficial for those at high risk of relapse. “It will vary based on where they’re beginning, what their relationship to alcohol is, and what the desired end point is,” she explains. For some, this means achieving complete sobriety, while for others, it may involve managing alcohol use in a way that allows them to lead a healthier, more functional life.
Overcoming the Barriers to MAT for AUD
The low uptake of Medication-Assisted Treatment for Alcohol Use Disorder is not solely due to societal perceptions; it’s also a matter of education and access. Many healthcare providers may not be aware of the effectiveness of MAT for AUD, and patients may not know that such treatment exists. Furthermore, retention rates for AUD treatment are often lower than for other substance use disorders, such as opioid addiction. Patients may feel that they’ve overcome their physical dependence after the withdrawal phase and therefore may not continue with the medication.
However, as treatment providers like Ideal Option and Spero Health continue to expand their offerings, more individuals are gaining access to Medication-Assisted Treatment for Alcohol Use Disorder and seeing its potential. These providers recognize the importance of a comprehensive approach that includes MAT, counseling, and support to address the complex nature of alcohol addiction.
The Road Ahead for MAT for AUD
As more addiction treatment centers and healthcare providers become aware of the benefits of Medication-Assisted Treatment for Alcohol Use Disorder, it is likely that more individuals will be able to access this valuable treatment option. The growing recognition of harm reduction approaches in addiction treatment is also contributing to a shift in how AUD is viewed and treated. Harm reduction, which focuses on reducing the negative consequences of substance use, is gaining acceptance, and MAT is seen as an important part of this approach.
In the future, as public awareness of MAT for AUD continues to grow, and as more people embrace harm reduction strategies, Medication-Assisted Treatment for Alcohol Use Disorder could become a cornerstone of effective treatment. Through education, access, and a shift in societal attitudes, more individuals with AUD can find the support they need to live healthier, more fulfilling lives.
 remains an underutilized..){kind=link}