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Heroin Addiction and Related Clinical Problems: 2025, 27, 30

INTAUD – A Network for the Treatment of Alcohol Use Disorder, Developed within EUROPAD

Albrecht Ulmer

Digital Object Identifier:
https://doi.org/10.62401/2531-4122-2025-30

Summary: Background: Alcohol Use Disorder (AUD) remains one of the few chronic illnesses for which no widely accepted pharmacological treatment exists. Most patients receive no long-term medication and are referred only to psychological counselling, which is often insufficient, while therapeutic success rates remain unsatisfactory. Methods: To address this unmet need, INTAUD was founded at the EUROPAD 2024 conference as an international network of addiction specialists. It aims to collect and share clinical experiences in treating AUD, including innovative pharmacological strategies such as the use of opioids, combinations of acamprosate and baclofen, or naltrexone with aripiprazole, as well as renewed attention to disulfiram. Although these approaches, except for disulfiram, lack large-scale randomised clinical trials, they arise from daily practice with treatment-resistant patients. Results: Preliminary case-based evidence suggests that such strategies can reduce alcohol consumption or achieve abstinence in otherwise refractory patients, provided that rigorous standards are respected. For opioid treatment in particular, safety depends on three principles: structured introduction, binding dosage schedules, and continuous dialogue. Within INTAUD, physicians report that these conditions can be assured, minimising risks of unsafe prescribing. Experiences presented at regional meetings (e.g. Coimbra 2025) indicate that knowledge exchange helps identify promising combinations and encourages systematic documentation. Conclusions: The absence of an established pharmacological standard for AUD must be regarded as a therapeutic failure. While awaiting formal clinical trials—which remain difficult due to low commercial interest—networks such as INTAUD can bridge the gap by sharing experiences, promoting cautious innovation, and expanding the range of options available to desperate patients. Increased collaboration and openness to neglected treatments, including disulfiram, may reduce suffering, improve prognosis, and help overcome the longstanding therapeutic stagnation in AUD care.

Keywords: Alcohol Use Disorder; AUD; Alcohol; INTAUD; Opioids; Long Term Medication; Network