Lifelong Learning: Targeted Oral Naltrexone for Mild to Moderate Alcohol Use Disorder Among Sexual and Gender Minority Men: A Randomized Trial-View Article

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The study aimed to evaluate the efficacy of targeted oral naltrexone in reducing binge drinking among sexual and gender minority (SGM) men with mild to moderate alcohol use disorder. Conducted as a double-blind, placebo-controlled trial, 120 SGM men were randomized to receive either naltrexone (50 mg) or a placebo, alongside weekly counseling, over a 12-week period. The primary outcomes measured included binge-drinking intensity through factors like the number of drinks in the past month, any binge drinking in the past week, and the number of binge-drinking days. The study also examined alcohol use using biomarkers such as ethyl glucuronide (EtG) in urine and phosphatidylethanol (PEth) in blood samples.<br /><br />Results indicated that targeted naltrexone use significantly reduced the number of binge-drinking days, with participants also reporting fewer weeks with binge drinking and decreased monthly alcohol consumption. Furthermore, the naltrexone group experienced reduced alcohol craving scores. In as-treated analyses, naltrexone still showed efficacy in reducing binge drinking and PEth concentrations among participants who took their medication regularly. The effects were sustained at a six-month follow-up.<br /><br />The study concluded that targeted naltrexone effectively reduces alcohol consumption among SGM men, providing sustained results post-treatment. These findings suggest that naltrexone could serve as a vital pharmacotherapy for managing binge drinking in this population. The study supports expanding naltrexone use beyond individuals with severe alcohol use disorder to include those with milder forms of the disorder. Notably, the study demonstrated targeted dosing's safety and acceptability, with minimal adverse events and high participant satisfaction. Despite not finding significant differences in some alcohol-related biomarkers and sexual risk behaviors, the study supports targeted naltrexone as a feasible treatment strategy to reduce binge drinking among SGM men.

Keywords

naltrexone

binge drinking

SGM men

alcohol use disorder

double-blind trial

placebo-controlled

ethyl glucuronide

phosphatidylethanol

alcohol craving

pharmacotherapy