J Hosp Med

Hospitals show wide gaps in starting AUD medications during alcohol withdrawal care

November 21, 2025

A retrospective review of 5,993 alcohol withdrawal hospitalizations across 12 hospitals (2022–2024) found that only 19.8% of patients initiated medications for alcohol use disorder (MAUD), with rates ranging from 5.1% to 43.2% by site. Oral naltrexone accounted for two thirds of initiations, while topiramate was rarely used. Older adults (≥65 years) and patients without cirrhosis or with high liver enzymes were less likely to start MAUD. Hospitals with addiction consult services had higher initiation rates, highlighting system-level variation.

Clinical takeaway: Significant underutilization and site-level variation in MAUD initiation highlight missed opportunities and the need for targeted interventions to improve evidence-based care for AUD.

Source:

Bernstein EY, et al. (2025, October 8). J Hosp Med. Variation in initiation of medications for alcohol use disorder during alcohol withdrawal hospitalizations in a large health system: A retrospective cohort study. https://pubmed.ncbi.nlm.nih.gov/41060248/