Stainback 2020: which alcohol medicines Ria Health prescribes

What they tested

Ria Health treats alcohol use disorder through a smartphone app, with medicines, coaching and a breathalyzer used once or twice a day. Its authors pulled prescription records from the app and health records to see which medicines patients got: naltrexone, acamprosate, gabapentin, baclofen and topiramate, alone or combined.

They also reported average breath alcohol and non-drinking days over time, across all patients together.

What they found

At the start of treatment, 81.7% were prescribed naltrexone, 7.6% gabapentin, 4.46% naltrexone with gabapentin, 3.65% acamprosate, 1.01% baclofen and 0.71% topiramate.

At 6 months, naltrexone alone had fallen to 64.76% of prescriptions and naltrexone with gabapentin had risen to 14.04%. At day 365, naltrexone alone was still the most common, at 55.1%.

At 6 months, 36% of patients were still in treatment. Mean breath alcohol fell from 0.077 to 0.027 g/L (64.94%), and non-drinking days rose from 1.94 to 3.96 days a week.

The authors conclude that naltrexone with gabapentin appears safe and well tolerated, and that more research is needed. The poster doesn't present side-effect data.

Limits

• Ria Health authors wrote it about their own program, and it is a poster, not a peer-reviewed paper.
• Outcomes were averaged across all patients, not split by medicine, a limitation the poster itself names. It can't show which medicine worked better.
• Only 36% remained at 6 months, so later averages describe the people who stayed.
• Some figures don't match across the poster: the abstract says 612 patients remained at 6 months, but its table puts 612 at day 90 and 349 at day 180.

What it means if you're considering naltrexone

For someone considering Ria, the poster confirms that naltrexone is the usual medicine there, often paired with gabapentin over time. It says little about how well each medicine works, because results weren't broken down by medicine and there was no comparison group.