Dissemination, adoption, and implementation of acamprosate for treating alcohol use disorders

Objective: Acamprosate has been available in the United States for treating alcohol use disorders (AUDs) for nearly a decade, yet few studies have examined its use within AUD treatment organizations. In addition to describing dissemination and adoption of acamprosate, this study provides novel data regarding organizational processes that underlie its implementation within adopting programs. Method: Data were drawn from interviews with leaders of a nationally representative sample of 307 organizations delivering AUD treatment. Quantitative indicators of organizational characteristics, dissemination, adoption, and implementation of acamprosate, as well as qualitative measures of implementation processes, were measured during face-to-face interviews. Results: Only 18.0% (n = 55) of sampled organizations had adopted acamprosate for treating AUDs, and adoption was positively associated with accreditation, having a physician on staff, receiving information about acamprosate via pharmaceutical representatives, and learning about this medication from other treatment providers. Within adopting programs, an average of 6.0% of AUD patients were currently receiving acamprosate. Numerous implementation challenges were identifi ed, including appropriate patient selection, patient reluctance to be prescribed acamprosate, suboptimal adherence, its costs, and limited counselor training. Conclusions: The limited adoption and implementation of acamprosate likely limits the potential public health impact of this adjunct to AUD treatment. Research integrating the perspectives of organizational leaders, medical professionals, and patients is needed to determine whether specifi c strategies can address the implementation challenges identifi ed in the current study and increase use of acamprosate in specialty AUD treatment settings.