How Vital is Medication for Alcohol Use Disorder at Hospital Discharge?

In the revolving door of hospital admissions for alcohol use disorder (AUD), the critical moments of discharge offer a unique opportunity to alter the trajectory of a patient’s recovery. Shame, stigma, and a lack of information about AUD may cause you to avoid the problem until you end up in the hospital. But how do we slow the cycle of hospital stay, discharge, relapse, and going back to the hospital? 

Recent findings, like those from Massachusetts General Hospital, offer a potential solution. It revealed that discharging patients with medication for alcohol use disorder (MAUD) can significantly reduce the likelihood of readmission.

This blog explores:

• The significance of MAUD at discharge
• Its impact on relapse prevention
• Broader treatment strategies, like those used at Zinnia Health

Analyzing the Data: Medication for Alcohol Use Disorder

Data included in the study consisted of 6,794 Medicare patients and 9,834 hospital stays in the United States. The research analyzed Medicare claims data from 2015 to 2017, focusing on hospitalized patients with AUD.

A propensity-matching method revealed that MAUD at discharge led to a large decrease in rehospitalization within 30 days.

Key Findings

Reduced Rehospitalization

Patients discharged with MAUD saw a 42% decrease in the likelihood of returning to the hospital within 30 days.

Increased Follow-Up Visits

Patients discharged with MAUD were 22% more likely to attend primary care or mental health follow-up visits.

After reviewing the data, Dr. David Hu, Medical Director at Zinnia Health, expressed the following.

Many hospitalist doctors are aware that alcohol abuse is a contributing factor to the medical problems that caused their patients to be admitted to the hospital. Thus, it would serve them well at the time of discharge to prescribe one of multiple medications that the U.S. Food and Drug Administration (FDA) has approved for the treatment of alcohol use disorder. These medications work in different ways, but they have all been shown to be somewhat helpful in cutting down or quitting drinking completely when they are taken as prescribed.

Despite the promising findings, the study acknowledges its limitations. These include the lack of information on alcohol rehab treatment programs that do not use medication, like:

• 12-step groups like Alcoholics Anonymous (AA)
• Behavioral therapy
• Holistic therapy

We emphasize the importance of treating a whole person when they want to stop drinking. Why not use every avenue available to slow or stop the chronic disease of alcohol addiction?

Taking advantage of the window once patients have reached the hospital and left their environment is important.

This is the best time to:

• Treat
• Educate
• Refer them for alcohol substance abuse treatment

What Are Common Medications for Alcohol Use Disorder?

Doctors may choose from a few different MAUDs as part of your treatment plan. These options include acamprosate, disulfiram, and naltrexone for alcohol use.

1. Acamprosate helps to reduce alcohol cravings. It balances the chemicals in the brain that heavy drinking affects.
2. Disulfiram creates a deterrent to drinking by causing unpleasant side effects like nausea and vomiting.
3. Naltrexone blocks the pleasurable effects of alcohol in the brain, making it less appealing to drink.

Despite the well-documented efficacy of MAUD, the study reveals only 2% of patients received MAUD prescriptions upon discharge.

Health care and hospital doctors should discuss medical management benefits and potential side effects before prescribing. They can help patients with alcohol dependence by including medication-assisted treatment in their discharge plans.

They can also recommend another type of treatment, like outpatient alcohol treatment, which includes lifestyle changes and ongoing support. Together, these interventions greatly benefit people with alcohol use disorders in their recovery journey.

Long-term recovery and reduction in the likelihood of readmission by alcohol-related medical issues depend on it.