What is the first line treatment for alcohol use disorder?

The first-line treatment for alcohol use disorder is naltrexone. Naltrexone is an opioid receptor antagonist that helps to reduce cravings for alcohol and also diminishes the pleasurable effects associated with drinking. This can lead to a reduction in alcohol consumption and overall improvement in abstinence rates.

The effectiveness of naltrexone has been well-documented in various clinical trials, showing that it not only reduces the risk of relapse but also contributes to improved outcomes when used in conjunction with psychosocial interventions.

While disulfiram, acamprosate, and topiramate are also options for treating alcohol use disorder, they are typically considered second-line treatments. Disulfiram works by creating an aversive reaction to alcohol, which may not be suitable for all patients. Acamprosate is used primarily for maintaining abstinence but is less effective in reducing cravings compared to naltrexone. Topiramate is an anticonvulsant that has shown some effectiveness in reducing alcohol intake but is not as widely recommended as first-line treatment compared to naltrexone.

Therefore, naltrexone's established efficacy in decreasing cravings and preventing relapse underpins its status as the preferred initial treatment choice for alcohol use disorder.