Frontiers in Psychiatry (May 2022)

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

  • Jonathan G. Leung,
  • Prasanna P. Narayanan,
  • Matej Markota,
  • Nathaniel E. Miller,
  • Kemuel L. Philbrick,
  • M. Caroline Burton,
  • Robert W. Kirchoff

DOI
https://doi.org/10.3389/fpsyt.2022.856938
Journal volume & issue
Vol. 13

Abstract

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ObjectiveTo survey barriers in prescribing naltrexone for alcohol use disorder.MethodsA 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.ResultsResponses were obtained and included for 146/770 prescribers (19.0% response rate). Most respondents were in the department of internal medicine (n = 94, 64.4%), but the departments of psychiatry (n = 22, 15.1%) and family medicine (n = 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.ConclusionIn 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.

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