{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T15:58:52Z","timestamp":1778860732173,"version":"3.51.4"},"reference-count":50,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Alcohol use disorder (AUD) is the most common substance use disorder in the United States. Despite availability of four FDA\u2010approved medications, fewer than 10% of patients are prescribed medication. This study aimed to evaluate the impact and feasibility of emergency department (ED)\u2010initiated oral naltrexone in patients with moderate to severe AUD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective, single\u2010arm, open\u2010label, nonrandomized clinical trial conducted a single ED. Consenting participants were adults with moderate to severe AUD who were provided a single 50\u2010mg dose of oral naltrexone, a 14\u2010day starter pack of naltrexone, and referral for treatment. Follow\u2010up was conducted at 14 and 30\u2009days post\u2013ED visit. The primary outcome was engagement in formal addiction treatment. Secondary outcomes included alcohol consumption, craving, quality\u2010of\u2010life measures, satisfaction, and safety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 761 patients screened, 21 enrolled and received at least one dose of naltrexone. At 14\u2009days, 29% were engaged in treatment, increasing to 33% at 30\u2009days. There was a decrease in the mean (\u00b1SD) number of drinks per day from 5.20 (\u00b14.67) at baseline to 2.23 (\u00b14.35) during the follow\u2010up period (<jats:italic>p<\/jats:italic>\u2009=\u20090.078). There was a decrease in alcohol craving scores, with median scores dropping from 19 at baseline to 8.27 during the follow\u2010up period (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Quality\u2010of\u2010life measures improved, with a statistically significant increase in the reported number of healthy days (<jats:italic>p<\/jats:italic>\u2009=\u20090.006) and decrease in depressive symptoms (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Reported side effects were mild and satisfaction with the screening process was high.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ED\u2010initiated oral naltrexone is feasible and acceptable for patients with moderate to severe AUD. While engagement in treatment was moderate, significant reductions in alcohol craving and improvements in quality of life suggest potential benefits. Further research is warranted to confirm these findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.15059","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T15:39:27Z","timestamp":1736350767000},"page":"488-497","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Emergency department\u2013initiated oral naltrexone for patients with moderate to severe alcohol use disorder: A pilot feasibility study"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7276-0549","authenticated-orcid":false,"given":"Ethan","family":"Cowan","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"},{"name":"Department of Emergency Medicine Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare","family":"O'Brien\u2010Lambert","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erick","family":"Eiting","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Bull","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline","family":"Ryder","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvette","family":"Calderon","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edwin","family":"Salsitz","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,1,8]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Global Status Report on Alcohol and Health 2018","author":"Poznyak V","year":"2018"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31310-2"},{"key":"e_1_2_11_4_1","volume-title":"Key Substance Use and Mental Health Indicators in the United States: Results from the 2021 National Survey on Drug Use and Health","author":"Substance Abuse and Mental Health Services Administration","year":"2021"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2015.05.031"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2020.108096"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.aax4043"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0087366"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.14655"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.12411"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.16126"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1992.01820110040006"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2001.961115654.x"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18168884"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2010.103077"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.83.3.372"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.7624"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-019-05128-x"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13559"},{"key":"e_1_2_11_20_1","first-page":"1","article-title":"National prevalence of alcohol and other substance use disorders among emergency department visits and hospitalizations: NHAMCS 2014\u20132018","volume":"37","author":"Suen LW","year":"2021","journal-title":"J Gen Intern Med"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2021.05.013"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2022.08.453"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.94.3.361"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.3109\/00952998908993411"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/0306-4603(82)90005-3"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.2307\/2095395"},{"key":"e_1_2_11_28_1","volume-title":"ASSIST\u2010Lite Screening Tool: how to Use","year":"2020"},{"key":"e_1_2_11_29_1","first-page":"971","volume-title":"Timeline followback: a technique for assessing self reported ethanol consumption","author":"Sobell L","year":"1992"},{"key":"e_1_2_11_30_1","volume-title":"Treatment Services Review (TSR)","author":"McLellan T","year":"1989"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.04.011"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1999.tb04349.x"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318160d093"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006842-200203000-00008"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-012-0326-7"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/00131746-200603000-00002"},{"key":"e_1_2_11_37_1","volume-title":"The ASAM Criteria: Treatment Criteria for Addictive, Substance\u2010Related, and Co\u2010occurring Conditions (4th ed.)","year":"2023"},{"key":"e_1_2_11_38_1","unstructured":"E6(R2) Good Clinical Practice: Integrated Addendum to ICH E6(R1).International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use.2016. Accessed November 20 2024.https:\/\/www.ich.org\/page\/efficacy\u2010guidelines"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2023.01.010"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14806"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2013.10.007"},{"key":"e_1_2_11_42_1","first-page":"40","article-title":"Alcohol use disorder and depressive disorders","volume":"40","author":"McHugh RK","year":"2019","journal-title":"Alcohol Res"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2010.10.001"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13350"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2004.00763.x"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.2080"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq304"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2010.03.004"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.13652"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20227028"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14860"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.15059","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T11:20:01Z","timestamp":1747221601000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.15059"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,8]]},"references-count":50,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1111\/acem.15059"],"URL":"https:\/\/doi.org\/10.1111\/acem.15059","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,8]]},"assertion":[{"value":"2024-08-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}