Naltrexone: A safe and effective standard of care in treating alcohol use disorder

Naltrexone is prescribed for fewer than 3% of patients with AUD in Australia, including patients with alcohol-related liver disease who access tertiary care and for whom treatment can be lifesaving. Evidence indicates that naltrexone is safe for patients with severe alcohol-associated cirrhosis. Naltrexone's safety in patients with severe acute hepatitis or acute-on-chronic liver failure remains unknown; however, naltrexone's ability to reduce alcohol consumption may outweigh any risks. Prescribers can align treatment with the patient's goal: naltrexone can be initiated with or without prior alcohol withdrawal, and targeted (non-daily) dosing is suitable for some patients.