Alcohol use disorders are among the most common and disabling problems in Australia. A number of pharmacotherapies available in Australia have been shown to be effective and are subsidised through the Australian Government's Pharmaceutical Benefits Scheme. The uptake of these medicines is poor, and the majority of those who start treatment do not complete the recommended course. Use of these medicines is significantly lower in regions that are disadvantaged or remote, and in patients who are younger. Taken together, these factors limit the potential benefit to population health from treatment of alcohol use disorders. Barriers to treatment have been identified at the level of the patient, the provider, the medicine and the healthcare system. An integrated strategy may be required to overcome these barriers.