Despite the therapeutic challenge of treating alcohol and opioid co-use, there is reason to believe that existing OUD medications may hold promise in treating comorbid AUD, thus potentially reducing alcohol-related risk among patients with AUD. For instance, some treatment options for dual-diagnosis patients overlap, such as naltrexone, which holds dual US Food and Drug Administration (FDA) indications for OUD and AUD treatment and has been found to be used more commonly in patients with both OUD and AUD than patients with OUD but without comorbid AUD (Mintz CM, Presnall NJ, Xu KY, et al, unpublished data, November 2020). However, few studies have directly evaluated the efficacy of OUD medications on alcohol-related outcomes among patients with OUD,15 and the limited research base has been marked by inconsistent results. For instance, although an open randomized study16 suggested that methadone and buprenorphine suppressed alcohol intake in heroin users, other analyses17 have not replicated these effects, with some studies18 showing increased problematic use of alcohol after initiation of opioid agonist treatment. Existing studies16,17,19 are also characterized by short follow-up periods, modest sample sizes, and self-reported data.
