The 130th Annual Meeting of APHA

Abstract #33916

Tami L. Mark, PhD, Outcomes Research and Econometrics, The MEDSTAT Group, 4301 Connecticut Ave. NW, Suite 330, Washington, DC 20008, 202-719-7832, tami.mark@medstat.com, Henry Kranzler, MD, Department of Psychiatry, University of Connecticut School of Medicine, 263 Farmington Ave., Farmington, CT 06030-2103, and Peace Bransberger, Westat, 1650 Research Boulevard RA1418, Rockville, MD 20850.

Research Objectives: To understand why naltrexone, one of only two medications approved by the FDA to treat alcohol dependence, is not widely used.

Study Design: Survey of 1372 physicians who are specialists in substance abuse treatment. Questions about the use and preceptions of alcoholism medications. Stated preference questions in which physicians are asked to select medications for treating alcoholism based on hypothetical medication characteristics.

Principal Findings: We will present data on knowledge of naltrexone (e.g. only 2% of physicians had never heard of naltrexone), on usage of naltrexone (e.g., 37% of physicians did not prescribe naltrexone to any of their patients), and on reasons why physicians did not prescribe naltrexone more widely (e.g, 19% said patients “refused to take or comply with medications). Other analyses will also be presented that examine ratings of efficacy, side effects, and compliance with naltrexone relative to other more widely used medications. Physicians’ demand curves for alcoholism medications are estimated using stated preference data.

Conclusions: Although naltrexone is familiar to most specialists in substance abuse, is still not widely prescribed. A variety of reasons explain why naltrexone is not more widely prescribed. Efforts to increase its use will require efforts that focus on a number of areas, including educating physicians to prescribe the medication (including management of side effects and non-compliance) and increased availability of the medication outside of formal treatment programs.

Learning Objectives:

• To understand why alcoholism medications are not more widely used and to demonstrate the use of stated preference methodology for understanding the diffusion of new medications.

Keywords: Alcoholism, Prescription Drug Use Patterns

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: The study is being funded under a grant from NIAAA.