{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T10:48:17Z","timestamp":1790938097439,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Little is known about medication for alcohol use disorder (MAUD) adherence. The goal of this study was to examine patient, prescriber and medication characteristics associated with time to discontinuation of MAUD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting and participants<\/jats:title>\n                    <jats:p>\n                      Observational cohort study from Optum Labs de\u2010identified administrative claims data of a United States national sample of commercial and Medicare Advantage enrollees with alcohol use disorder (AUD) who initiated MAUD (naltrexone, acamprosate, disulfiram, topiramate) January 2017\u2013June 2024 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200951\u2009915). Using an accelerated failure time (AFT) log logistic survival model, we examined MAUD discontinuation, adjusting for patient demographic and clinical characteristics established within 6\u00a0months prior to or on date of initiation, specific MAUD initiated with, MAUD prescriber type and study year. We defined effect size of at least 10% change in AFT survival (i.e. AFT estimates &gt; +\/\u2212 0.100) as being of clinical significance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Time\u2010to\u2010discontinuation of MAUD, defined as a gap in pharmacy fills or medication administrations of MAUD days\u2010supply &gt;7\u00a0days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>In unadjusted analyses, the median time to MAUD discontinuation was 30\u2009days; median days\u2010supply prior to discontinuation varied by medication (e.g. 30\u2009days for acamprosate and naltrexone, 56 for disulfiram, 60 for topiramate). Adjusted analyses showed that among the patient characteristics, longer MAUD duration was associated with older age [e.g. AFT duration estimate (95% confidence interval) for age \u226565 vs. 18\u201330\u2009=\u20090.164 (0.088\u20130.240)], while lower county median household income was associated with shorter duration [e.g. &lt;$40\u2009000 vs. \u2265$200\u2009000: \u22120.106 (\u22120.136 to \u22120.076)]. MAUD initiations via topiramate (vs. naltrexone) were associated with longer duration [0.339 (0.311\u20130.366)], as were initiations via disulfiram [0.103 (0.076\u20130.131)]. MAUD duration increased in recent study years, except 2024 [(e.g. 2023 vs. 2017\u2009=\u20090.116 0.087\u20130.144)].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among the few individuals in the United States who receive medication for alcohol use disorder (MAUD), early discontinuation is common, minimizing the opportunity for MAUD to support patients' recovery goals. While MAUD duration has increased in recent years, the improvements are small.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70498","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:32:53Z","timestamp":1781073173000},"page":"2691-2700","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Discontinuation of medications for alcohol use disorder in the United States: Patient, prescriber and medication predictors"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1828-9098","authenticated-orcid":false,"given":"Alisa B.","family":"Busch","sequence":"first","affiliation":[{"name":"McLean Hospital, Mass General Brigham Department of Psychiatry Harvard Medical School  Belmont MA USA"},{"name":"Department of Health Care Policy Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Hodgkin","sequence":"additional","affiliation":[{"name":"Heller School for Social Policy and Management Brandeis University  Waltham MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alene","family":"Kennedy\u2010Hendricks","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant A.","family":"Ritter","sequence":"additional","affiliation":[{"name":"Heller School for Social Policy and Management Brandeis University  Waltham MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Uscher\u2010Pines","sequence":"additional","affiliation":[{"name":"RAND Corporation  Arlington VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constance M.","family":"Horgan","sequence":"additional","affiliation":[{"name":"Heller School for Social Policy and Management Brandeis University  Waltham MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiden A.","family":"Huskamp","sequence":"additional","affiliation":[{"name":"Department of Health Care Policy Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"SAMHSA CBHSQ.Section 5 PE Tables \u2010 Results from the 2024 National Survey on Drug Use and Health: Detailed Tables. 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