Abstract
Why would the first new alcoholism treatment medication in over 40 years not be widely accepted? Alcoholism is a disease that affects millions of Americans with annual costs to the public in the billions of dollars. Treatment for alcoholism often has limited effectiveness in practice, and relapse rates are high. Through recent neuroscientific advances, new medications are available or in development to treat alcoholism and substance abuse problems, promising to improve treatment outcomes. Naltrexone, an opioid antagonist medication that decreases alcohol craving, was approved for alcoholism treatment in 1994, but has not achieved widespread use in the clinical community. This article describes the economic factors involved in successful diffusion of a new medication by substance abuse treatment providers, and examines economic barriers that may have limited the market success of naltrexone. This remains a significant issue as new medications are being developed to treat substance abuse disorders.