Roberts 2025: few birthing people with alcohol diagnoses get medicine

What they tested

Researchers used MarketScan, a national US private insurance claims database, to find people aged 25–50 who gave birth to one baby between 2006 and 2019 and could be matched to their infant.

Among those with an alcohol-related diagnosis within a year of the birth, they counted who received a prescription for a medicine related to alcohol use disorder treatment, including naltrexone, acamprosate, disulfiram, gabapentin, benzodiazepines for withdrawal and phenobarbital.

What they found

Of 1,432,979 birthing person-infant pairs, 2,517 (0.18%) had an alcohol-related diagnosis. Of those, 219 (8.70%) received any related medicine.

Gabapentin was the most common (4.69%), followed by benzodiazepines for withdrawal (2.19%). Naltrexone went to 1.91% (48 people), disulfiram to 1.39% and acamprosate to 0.56%. No one received phenobarbital.

Almost all medicines were received after the birth.

Limits

• It used private insurance claims only, so it doesn't cover people on Medicaid or without insurance.
• An alcohol-related diagnosis isn't the same as alcohol use disorder, and a prescription doesn't show the medicine was taken.
• The data end in 2019.

What it means if you're considering naltrexone

Naltrexone was rarely prescribed around pregnancy in this group, and mostly after birth. The authors say research is needed on whether the benefits of these medicines in pregnancy outweigh the harms, so this study describes practice rather than answering the safety question.