The efficacy of the Food and Drug Administration (FDA)-approved medications for alcohol use disorder (AUD) is evidence-based and indisputable [1, 2]. Although not all medications always work for all patients, skepticism often contributes to the lack of their wider use in clinical practice. Therefore, a critical goal is expanding their use in clinical practice, so that more and more patients with AUD may benefit from these treatments.

The identification of new pharmacological targets and the development of new medications for AUD are also critical goals. Inspired by initial rodent work [3], researchers started testing the GABA-B receptor agonist baclofen in patients with AUD. However, human studies have generated inconsistent results, which have led to conflicting opinions and have left the question on the potential role of baclofen in AUD treatment unanswered. This uncertainly has been amplified by some skepticism because the baclofen studies were mainly positive in Europe but negative in the U.S. For example, baclofen 30 mg/day was effective in a trial, the first of its kind, in patients with AUD and cirrhosis in Europe [4], while another trial conducted by Garbutt and colleagues in the U.S. did not show differences between baclofen 30 mg/day and placebo [5]. The main authors of these two studies jointly pointed out the need for precision medicine approaches, as there were clear differences in patient characteristics between the U.S. and European studies, the latter reporting higher severity of dependence and drinking levels and receiving shorter behavioral interventions [6].

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