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September 2026
Baclofen for alcohol use disorder: A Cochrane Review summary with commentary
Key Points
- Impact Statement: The review and original commentary acknowledge the limitations of the evidence, suggesting that future research should prioritize direct comparisons between medications, studies in primary care settings, and investigation of treatment effectiveness in diverse populations.
- Alcohol use disorder (AUD) affects approximately 5% of adults globally, with only about 1% receiving medication-assisted treatment, despite evidence of effectiveness.
- A Cochrane Review found moderate-certainty evidence that baclofen probably reduces relapse risk and increases abstinent days, particularly among patients who have completed detoxification.
- An RTI–University of North Carolina Evidence-based Practice Center review found low certainty of evidence for baclofen in reducing return to any drinking.
- Treatment decisions should consider medication effectiveness, ease of use, side effects, and patient preferences, with stronger evidence supporting Food and Drug Administration–approved medications like naltrexone and acamprosate compared with off-label options like baclofen.
- Future research should prioritize direct comparisons between medications, studies in primary care settings, and investigation of treatment effectiveness in diverse populations.
Abstract
This brief summarizes the Cochrane Review, “Baclofen for Alcohol Use Disorder,” by R. Agabio, R. Saulle, S. Rösner, and S. Minozzi (https://doi.org/10.1002/14651858.CD012557.pub3). The Cochrane Review examines evidence for benefits and harms of baclofen on achieving and maintaining abstinence or reducing alcohol consumption in people with alcohol use disorder (AUD) compared to placebo, no treatment, or any other pharmacological relapse prevention treatment. Review authors conclude that baclofen likely reduces the risk of relapse to any drinking and increases the percentage of abstinent days, mainly among participants who completed alcohol detoxification. Overall, the review suggests that baclofen may help people with AUD in maintaining abstinence. Evidence from a recent review by the RTI–University of North Carolina Evidence-based Practice Center on pharmacotherapy for the treatment of AUD also supports the use of Food and Drug Administration–approved medications like naltrexone and acamprosate. Treatment decisions should consider medication effectiveness, ease of use, side effects, and patient preferences. The review and original commentary acknowledge the limitations of the evidence, suggesting that future research should prioritize direct comparisons between medications, studies in primary care settings, and investigation of treatment effectiveness in diverse populations.
© 2026 RTI International. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
