# Emergency Department-Initiated Medications for Alcohol Use Disorder

> **NIH NIH R01** · YALE UNIVERSITY · 2024 · $740,914

## Abstract

Project Summary/Abstract
Excessive alcohol consumption is the third leading preventable cause of death in the U.S. and responsible for
2.7 million years of potential life lost annually. Emergency departments (EDs) provide care for patients with
AUD experiencing a variety of alcohol related and unrelated health problems, including illness and injury. Thus,
the ED encounter presents a unique opportunity to screen, enhance motivation, initiate medication treatment,
and refer to continuation care patients who both seek and do not seek AUD treatment. While combined
pharmacological and behavioral therapies for alcohol use disorder (AUD) have demonstrated efficacy in
specialty and primary care settings, their effectiveness in the ED setting is unknown, and EDs do not routinely
provide comprehensive interventions for AUD. The proposed open label randomized clinical trial (RCT) will
evaluate two ED-based intervention models to increase AUD treatment provision and patient engagement. ED
patients with moderate to severe AUD (N=240) will be randomly assigned to: (1) Screening, Brief Intervention
and Referral to Treatment (SBIRT) (n=120); or (2) SBIRT with ED-initiated medications for AUD (SBIRT+ED-
MAUD) (n=120). Gabapentin and extended release or oral naltrexone will be offered as a combination
pharmacotherapy in the ED-MAUD component. SBIRT intervention in both study arms will utilize a facilitated
referral with direct linkage to continuation AUD treatment following the ED visit. The primary outcome measure
will be the rate of AUD treatment engagement assessed on day 30 post randomization in each of the two study
groups (Aim 1). The study will also evaluate the between-group difference in the reductions of heavy drinking
days from 30 days prior to 30 days post randomization (Aim 2). A statistically significant effect on the primary
outcome and a clinically meaningful effect on the reductions of heavy drinking days favoring the SBIRT+ED-
MAUD are hypothesized. All enrolled patients will be followed daily on days 1-7 using a brief electronic survey
to assess their alcohol cravings, withdrawal symptoms and medication adherence, and with comprehensive
follow-up assessments at 30- and 90-days post randomization. The primary outcome, AUD treatment
engagement on day 30 post the ED visit, will be based on clinical records documentation obtained from the
AUD treatment provider. Alcohol consumption outcomes, medication adherence, the intensity of alcohol
cravings and withdrawal symptoms, and other important study outcomes will be based on patient self-report
using validated assessment instruments. The planned study sample and the proposed analytical methods will
allow for additional meaningful exploratory evaluations of potential differential effects of gender, race, ethnicity,
insurance types, and housing instability on the evaluated outcomes. No prospective studies of ED-initiated
MAUD interventions have been reported. If successful, the proposed study will provid...

## Key facts

- **NIH application ID:** 10875360
- **Project number:** 5R01AA030568-02
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Kathryn Hawk
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $740,914
- **Award type:** 5
- **Project period:** 2023-07-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10875360

## Citation

> US National Institutes of Health, RePORTER application 10875360, Emergency Department-Initiated Medications for Alcohol Use Disorder (5R01AA030568-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10875360. Licensed CC0.

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