The correlates and extent of prescribing of medications for alcohol relapse prevention in England.

Aims: To determine the pattern and extent of prescribing of medications for alcohol relapse prevention (ARP) in England. Design Cross‐sectional. Setting: Specialist drug and alcohol treatment providers in England reporting to the National Drug Treatment Monitoring System. Participants: Service users aged 18+, with alcohol the primary substance of dependence, completing a treatment journey between April 2013 and March 2016 (n = 188 152). Measurements Prescription of medications for ARP during a treatment journey. Data on service users' demographics, treatment and clinical characteristics were extracted. Findings The rate of prescribing medications for ARP was 2.1% in 2013/14, 6.8% in 2014/15 and 7.8% in 2015/16. A greater likelihood of prescription was associated with treatment journey year [2014/15; adjusted odds ratio (aOR) = 3.269, 95% confidence intervals (CI) = 3.044–3.510, 2015/16; aOR = 3.823, CI = 3.560–4.106], age (25–34; aOR = 1.622, CI = 1.380–1.907, 35–54; aOR = 1.901, CI = 1.628–2.220 or 55+; aOR = 1.700, CI = 1.446–1.999), female gender (aOR = 1.129, CI = 1.077–1.184), white ethnicity (aOR = 1.219, CI = 1.077–1.380), regional prevalence of alcohol dependence (middle rate; aOR = 1.121, CI = 1.024–1.228), severity of alcohol dependence (moderate dependence without complex needs; aOR = 1.329, CI = 1.244–1.419, severe dependence without complex needs; aOR = 1.308, CI = 1.188–1.441, moderate/severe dependence with complex needs; aOR = 1.131, CI = 1.020–1.255), treatment setting (inpatient; aOR = 10.512, CI = 9.950–11.104, primary care; aOR = 2.264, CI = 2.050–2.500, residential; aOR = 3.216, CI = 2.807–3.685), prior treatment for alcohol dependence (aOR = 1.242, CI = 1.183–1.304), longer treatment journey (aOR = 1.002, CI = 1.002–1.002), more drinking days in the prior 28 days (aOR = 1.021, CI = 1.018–1.024) and drinking a higher number of alcohol units in the prior 28 days (aOR = 1.002 CI = 1.001–1.004). Living in a region of England with the lowest alcohol prevalence was associated with a lower likelihood of prescription of medication for aRP (AOR = 0.491, CI = 0.436–0.552). Conclusions: In England, medications for alcohol relapse prevention are rarely prescribed (e.g. 7.8% in 2015/16) and those prescriptions appear to be associated with specific service user demographics, treatment and clinical characteristics. [ABSTRACT FROM AUTHOR]