{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T08:33:59Z","timestamp":1777883639954,"version":"3.51.4"},"reference-count":8,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018529","name":"Alkermes","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018529","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Use: Research and Treatment"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The US Department of Veterans Affairs, Department of Defense (VA\/DoD) clinical guidelines recommend extended-release naltrexone (XR-NTX) as a treatment option for moderate-to-severe alcohol use disorder (AUD); however, contemporary real-world outcomes related to this guideline are lacking. This retrospective, observational, descriptive study examined treatment patterns and healthcare resource use (HCRU) among veterans with an AUD diagnosis who initiated XR-NTX.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Veterans with incident AUD who initiated XR-NTX between 8\/2014 and 11\/2018 were identified. Treatment patterns and HCRU were assessed during the 1-year baseline period before and following XR-NTX initiation (the index date).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of the 3665 VA patients (mean [SD] age: 46 [12.5] years; male: 89.7%; White: 76.9%) included in the study, time from AUD diagnosis to XR-NTX initiation was highly variable (mean [range]: 13.6 [0-50.5\u2009months]). Patients received a mean [SD] of 6.8 [6.1] XR-NTX administrations; 44.4% received \u2a7e6. Mean [SD] time to XR-NTX discontinuation was 93.4 [75.7] days, and 31.3% of discontinuing patients resumed XR-NTX therapy. Of those who received other subsequent medications for AUD, 38.6% (acamprosate) to 47.8% (disulfiram) re-initiated XR-NTX. The proportion of patients with \u2a7e1 inpatient admissions decreased during follow-up compared with baseline (all-cause: 61.5% to 37.8%; AUD-related: 58.0%-35.4%); with a smaller decrease observed in emergency department (ED) visits. In contrast, more patients had \u2a7e1 outpatient visits during follow-up (all-cause: 97.5%-99.7%; AUD-related: 84.4%-92.7%). Compared with baseline, mean number of inpatient admissions and ED visits decreased during follow-up, while the number of outpatient visits increased for both all-cause and AUD-related care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Among VA patients with AUD who initiated XR-NTX, we observed reductions in all-cause and AUD-related acute care, and increases in outpatient care. This finding demonstrates a possible transition from acute, inpatient treatment to long-term, outpatient care that may reflect a reduction in disease severity. Additional research is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/29768357241280713","type":"journal-article","created":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T02:17:53Z","timestamp":1727403473000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment Journey and Healthcare Resource Use Among Patients With Alcohol Use Disorder Who Initiated Extended-Release Naltrexone: An Analysis of Veterans Affairs Data"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7235-7584","authenticated-orcid":false,"given":"Regina","family":"Grebla","sequence":"first","affiliation":[{"name":"Alkermes, Inc., Waltham, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jieruo","family":"Liu","sequence":"additional","affiliation":[{"name":"Alkermes, Inc., Waltham, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy K","family":"O\u2019Sullivan","sequence":"additional","affiliation":[{"name":"Alkermes, Inc., Waltham, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherry","family":"Shi","sequence":"additional","affiliation":[{"name":"Groupe d\u2019Analyse, Montr\u00e9al, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elyse","family":"Swallow","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc., Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Lax","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc., Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria A","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Alkermes, Inc., Waltham, MA, USA"},{"name":"Columbia University, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuqian","family":"Liu","sequence":"additional","affiliation":[{"name":"Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA. 6Tulane University, New Orleans, LA, USA"},{"name":"Tulane University, New Orleans, LA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lizheng","family":"Shi","sequence":"additional","affiliation":[{"name":"Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA. 6Tulane University, New Orleans, LA, USA"},{"name":"Tulane University, New Orleans, LA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie","family":"Witkiewitz","sequence":"additional","affiliation":[{"name":"University of New Mexico, Albuquerque, NM, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Drexler","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,9,26]]},"reference":[{"key":"bibr1-29768357241280713","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"bibr2-29768357241280713","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.109240"},{"key":"bibr3-29768357241280713","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2013.02.036"},{"key":"bibr4-29768357241280713","unstructured":"Department of Veteran Affairs Department of Defense. VA\/DoD clinical practice guideline for management of substance use disorders. 2021. Accessed November 30, 2023. https:\/\/www.healthquality.va.gov\/guidelines\/MH\/sud\/VADoDSUDCPG.pdf"},{"key":"bibr5-29768357241280713","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201000553"},{"key":"bibr6-29768357241280713","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2019.80.572"},{"key":"bibr7-29768357241280713","doi-asserted-by":"publisher","DOI":"10.1111\/acer.12597"},{"key":"bibr8-29768357241280713","volume-title":"Paper presented at: American Academy of Addiction Psychiatry - 32nd Annual Meeting & Symposium","author":"Kauf TL"}],"container-title":["Substance Use: Research and Treatment"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29768357241280713","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/29768357241280713","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29768357241280713","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T01:53:01Z","timestamp":1777600381000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/29768357241280713"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":8,"alternative-id":["10.1177\/29768357241280713"],"URL":"https:\/\/doi.org\/10.1177\/29768357241280713","relation":{},"ISSN":["2976-8357","2976-8357"],"issn-type":[{"value":"2976-8357","type":"print"},{"value":"2976-8357","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"article-number":"29768357241280713"}}