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Abstract
The review outlines the evolution of treatment approaches for co-occurring opioid and alcohol use disorders from the 1960s to the present.
- Four distinct eras of treatment for opioid use disorder (OUD) and alcohol use disorder (AUD) are identified, starting with methadone maintenance.
- Regulation and reimbursement policies have significantly influenced access to treatment options across different geographic and socioeconomic contexts.
- The recognition of co-occurring disorders has evolved alongside policy reforms like the Affordable Care Act, impacting the availability of medications for OUD and AUD.
- Emerging therapies targeting metabolic mechanisms, such as GLP-1 receptor agonists, may provide potential benefits for treating both disorders, though their effectiveness remains unproven.
- To achieve population-level benefits, comprehensive trials and reforms are necessary to ensure equitable access to integrated care.
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