Targeted Oral Naltrexone for Mild to Moderate Alcohol Use Disorder Among Sexual and Gender Minority Men: A Randomized Trial

The study aimed to investigate the effects of targeted oral naltrexone (50 mg) on binge drinking and alcohol use in 120 Sexual or Gender Minority Men (SGM),  with mild to moderate alcohol use disorder. Participants were randomized in a 1:1 ratio to receive naltrexone or placebo with weekly counseling for 12 weeks. The study measured changes in alcohol use through self-report of drinking and alcohol biomarker measures.

The results showed that naltrexone significantly reduced the reported number of binge-drinking days, weeks with any binge drinking, number of drinks per month, and alcohol craving scores. Among those who took their medication on average at least 2.5 days per week, naltrexone also reduced any binge drinking, number of binge-drinking days, and PEth concentrations. The effects of naltrexone were sustained at 6 months posttreatment, as it continued to reduce the number of drinks per month, the number of binge-drinking days, and any binge drinking in the past week.

In conclusion, targeted naltrexone is a potentially important pharmacotherapy for addressing binge drinking in populations with mild to moderate alcohol use disorder, particularly among SGM. The study is consistent with previous research showing the beneficial effects of naltrexone in reducing cravings and binge drinkers across a spectrum of people who drink excessively.