A meta-analysis of 22 RCTs (N=2,414 participants) compared the success rate of disulfiram and controls, with success in the studies defined as one of the following: total abstinence, percent abstinent days, mean days of alcohol use, likelihood of no relapse, longer time to first heavy drinking day, or three or more weeks of consecutive abstinence. Disulfiram was associated with a higher success rate than control conditions only in open-label studies (Hedges’ g=0.70, 95%CI=0.46–0.93), with no statistically significant association in blinded trials (Hedges’ g=0.01, 95%CI=0.29–0.32).13 Although, overall, the lack of evidence from controlled, blinded trials does not support the use of disulfiram for treating AUD, the supervised ingestion of the drug to ensure adherence was associated with a significantly better outcome (Hedges’ g=0.82, 95%CI=0.59–1.05) than non-supervised treatment (N=9 studies; g =0.26, 95%CI = −0.02–0.53).13
