Dispensing of medication for alcohol use disorder; an examination of large databases in a New Zealand context

N Z Med J. 2019 May 17;132(1495):48-53.

Abstract

Aim: To report dispensing of disulfiram, naltrexone, antidepressants and quetiapine for New Zealanders diagnosed with alcohol use disorder.

Method: The Pharmaceutical Collection is the national dispensing database for medications in New Zealand. PRIMHD is the national mental health and addiction service database. Dispensing data was extracted from the Pharmaceutical Collection and merged with diagnostic data from PRIMHD to report pharmacological treatment of alcohol use disorders in New Zealand.

Results: In 2014, there were 5,004 individuals diagnosed with an alcohol use disorder by mental health and addiction services. Four hundred and eighty-nine individuals also received a major depressive disorder diagnosis. 2.1% of the group with alcohol use disorder were dispensed disulfiram and 0.7% were dispensed naltrexone. Treatment with antidepressants (12.7%) and quetiapine (5.6%) was more common. In the group with comorbid alcohol use disorder and depression, 2% were dispensed disulfiram, 0.2% were dispensed naltrexone, 27.4% were dispensed antidepressants and 11.2% were dispensed quetiapine.

Conclusion: Overall rates of dispensing were relatively low. Antidepressants followed by quetiapine were the most common treatments. In contrast, disulfiram and naltrexone were only used for a minority of clients. This suggests inadequate and poorly targeted pharmacological treatments are used for the treatment of alcohol use disorders in New Zealand.

MeSH terms

  • Alcohol Deterrents* / administration & dosage
  • Alcohol Deterrents* / therapeutic use
  • Alcoholism* / complications
  • Alcoholism* / drug therapy
  • Alcoholism* / epidemiology
  • Antidepressive Agents* / administration & dosage
  • Antidepressive Agents* / therapeutic use
  • Depressive Disorder, Major* / complications
  • Depressive Disorder, Major* / drug therapy
  • Depressive Disorder, Major* / epidemiology
  • Disulfiram / therapeutic use
  • Female
  • Humans
  • Male
  • Middle Aged
  • Naltrexone / therapeutic use
  • New Zealand
  • Quetiapine Fumarate / therapeutic use

Substances

  • Alcohol Deterrents
  • Antidepressive Agents
  • Quetiapine Fumarate
  • Naltrexone
  • Disulfiram