AMA VICDOC_Spring 2026_09.09.2026 - Flipbook - Page 20
Enter naltrexone, one of the most
available and evidence-based
medications available for AUD
Psychosocial support
is often not enough
treatment. A safe, proven and
“When we first specialised in addiction
non-addictive opioid antagonist,
medicine in the early 2020s, we were
it has been available on the PBS
since 2001.
involved in withdrawal unit intake
processes where we’d meet people who
were often back for their fourth or eighth
or even 14th AUD-induced visit, or who
Naltrexone has
would be lined up for quarterly detoxes,
without ever having been offered
been shown to be
pharmacotherapy. Cyclical psychosocial
successful in
treatment clearly isn’t working for some.”
up to 75%
of people with AUD,
yet it’s prescribed to
less than 3%
of the one million + Australians
with alcohol use disorder.
Paul likens the prevalent psychosocial
support-only approach to only treating
diabetes with diet and exercise. He says
it’s time to step up the way we approach
management of alcohol use disorder and
add medications – as we do with diabetes.
The colleagues are GPs at community health
provider cohealth’s Collingwood site, in
Melbourne’s inner north. They have been
successfully treating people with AUD with
naltrexone for more than two decades.
AMA Victoria members and addiction
medicine specialists Dr Paul MacCartney
and Dr Dean Membrey are on a mission to
change this. The pair say that while the
psychosocial model of care is prevalent, it
doesn’t provide many people with enough
support to manage their AUD long-term.
“Addiction is formulated as a
biopsychosocial condition. While the
psychosocial model of care is useful
for some people, we should be using
all the tools at our disposal and offer
management of the biological elements
as well,” says Paul, who is also Victoria's
Chief Addiction Medicine Advisor.
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“We’d ask, has this person ever been
offered medication? They hadn’t, so we
started to introduce biological support
alongside the psychosocial support, and
over the years we’ve been able to transform
the lives of many people who are struggling
with alcohol.”
They also think promoting total abstinence
as the only end goal is unsustainable and
sets people up to fail.
