Alcohol use disorder is one of the most common psychiatric disorders. It is also among the best understood in terms of its pathophysiology, neuroanatomy, and neurochemistry, largely due to having perhaps the most valid animal models of any psychiatric disorder. It also has some of the most effective pharmacotherapies. There are three Food and Drug Administration (FDA)-approved alcohol use disorder medications in the United States—naltrexone, acamprosate, and disulfiram—and strong research evidence for a fourth, topiramate, plus several other potentially efficacious medications, such as ondansetron, baclofen, and gabapentin. Yet alcohol pharmacotherapy is employed much less frequently than medication for many other major psychiatric conditions, such as depression, schizophrenia, and anxiety disorders. There is an enormous gap between the number of alcohol use disorder patients who would potentially benefit from medications and the number of patients who actually receive medications. For example, a recent study of Veterans Health Administration facilities showed that nationally, only 3% of Veterans Health Administration patients with alcohol use disorder received treatment medications (1).