This viewpoint article highlights the high prevalence of unhealthy alcohol use in the United States, in contrast with the fact that less than 2% of individuals with alcohol use disorder (AUD) use naltrexone, despite its safety and efficacy. The authors advocate that oral naltrexone should be made available over the counter (OTC) without a prescription as a way to address the public health impact of unhealthy alcohol use and barriers leading to underutilization of medications for AUD. In this way, naltrexone could be utilized as a harm reduction tool for individuals with unhealthy alcohol use who are otherwise not able to access treatment—ideally before more serious consequences of alcohol use occur. The authors draw a parallel to nicotine replacement therapy becoming OTC in the 1990s, which significantly expanded access to smoking cessation treatment.

Full article:

https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2840624?asam.org#