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Alcohol Treatment Medications

People in treatment for alcohol use disorder (AUD) can experience challenges when quitting due to uncomfortable and potentially dangerous withdrawal symptoms and ongoing cravings.2

Alcohol treatment medications can be an important part of the recovery process by helping a person safely manage the detox process, cravings, and in preventing relapse.1, 2 Medications for alcohol use disorder can be used as part of an individualized treatment plan developed with a doctor and may include behavioral therapy and other interventions.1

This article will explain:

  • What alcohol use disorder is
  • The dangers of withdrawal
  • How medications help during alcohol withdrawal
  • Medications to help you stop drinking
  • Treatment for AUD

What is Alcohol Use Disorder?

Alcohol use disorder is a brain condition marked by an inability to control alcohol use, even after experiencing harmful consequences affecting one or more areas of your life, such as health, social relationships, and school or work.2 It can only be diagnosed by a medical professional who uses the following criteria found in the Diagnostic and Statistical Manual of Mental Health Conditions, 5th Edition (DSM-5):3

  • Having difficulty controlling the amount you drink, or how long you drink
  • Genuinely wanting or trying to stop or cut back on your drinking, but not being able to
  • Spending much of your time focused on alcohol, either getting it, drinking it, or recovering from it
  • Having cravings or urges to drink
  • Ongoing drinking behavior that gets in the way of handling your responsibilities at home, school, and/or work
  • Inability to stop drinking alcohol even after knowing that it has caused or worsened ongoing problems within relationships with others
  • Stepping away from or quitting activities or hobbies due to drinking alcohol
  • Repeatedly drinking alcohol in situations that could be physically dangerous like driving
  • Inability to stop drinking even after being aware that it has caused or worsened ongoing physical or mental health problems
  • Developing a tolerance to the effects of alcohol or needing more alcohol to feel the same effects as you used to
  • Experiencing withdrawal symptoms that can range from uncomfortable to life-threatening if you stop drinking or cut back significantly.

While mild withdrawal can be uncomfortable to get through, strong cravings can make it difficult to successfully stop drinking without assistance.3 Severe withdrawal symptoms can be dangerous or even life-threatening, so undergoing medically supervised detox can help to address withdrawal symptoms as quickly as possible.1, 4

Naltrexone for Alcohol Treatment and Recovery

Naltrexone is a FDA-approved prescription alcohol treatment medication used to treat AUD and opioid use disorder.1, 5 It comes in pill form or in an extended-release form that is injected into the muscle.1, 5 For people with AUD, pills are taken daily or injections are given monthly.1, 6

Studies have shown that naltrexone is effective at reducing relapse, especially when combined with behavioral therapy.1 However, it has been shown to not be effective for people who haven’t completed detox before starting naltrexone.1 In studies comparing people who took naltrexone compared to those who did not, short-term results showed that:1

  • Less people resumed drinking heavily (38% vs. 60%)
  • Fewer people relapsed (61% vs. 69%)
  • Cravings were lessened
  • People drank on fewer days

Naltrexone is an opioid antagonist and blocks receptors in the brain that allow alcohol to have an effect, and reduces cravings for alcohol.1, 5 To be effective, a person must detox from alcohol before starting naltrexone.1, 5 Naltrexone is not addictive and will not cause withdrawal symptoms when you stop taking it, typically after about 3 to 4 months.5

Naltrexone should not be taken by people who are physically dependent on opioids, since it could cause severe withdrawal symptoms to occur.1 It can also block the effects of opioids that are taken, and if large doses are taken to try to overcome this, overdose can occur.1, 5

Acamprosate for Alcohol Use Disorder

Acamprosate, also known as Campral, is an FDA-approved prescription medication used to help maintain sobriety in people with AUD.1, 8 It is taken in pill form.1, 8 Acamprosate must be started after alcohol detox is completed, usually 5 days after last use of alcohol.1 If a person relapses, they should continue to take acamprosate.1, 8

This alcohol treatment medication works by rebalancing brain chemistry that is changed because of alcohol misuse and withdrawal and reduces lingering symptoms of withdrawal that some people experience.1, 8

Studies have shown acamprosate to be effective at treating AUD and works best when combined with a comprehensive treatment program and social supports.1, 8 Acamprosate has no potential for misuse, no development of tolerance, and no major interactions with other medications.1, 8 It can also be used safely in people who have liver damage.1

People with severe kidney impairment shouldn’t use acamprosate.1, 8 This medication can worsen depression and cause suicidal thoughts or behaviors. People with existing depression or other co-occurring disorders should be monitored closely.1, 8 This medication can be harmful to a fetus, so if you are or plan to become pregnant, this should be discussed with your physician.8

Disulfiram and Alcohol Addiction

Disulfiram, also known as Antabuse, is an FDA-approved prescription alcohol treatment medication that is used to treat alcohol dependence.1, 7 It is taken daily in pill form in varying dosages depending on the person’s needs and prescription from the doctor.1, 7

Since disulfiram is not a medication for alcohol cravings, it is typically used as a second-line treatment option after acamprosate and naltrexone. Disulfiram is only used for treating alcohol use disorder.7

Disulfiram works by interfering with how alcohol is broken down in the body, causing unpleasant side effects (that resemble a hangover) to occur if a person consumes alcohol.1, 7 Physical effects of drinking while on disulfiram can include:1, 7

  • Dizziness
  • Flushing of the face
  • Heart palpitations
  • Low blood pressure
  • Nausea
  • Racing heart
  • Sweating
  • Vomiting

It is important not to start taking this medication until you have completely detoxed from alcohol.1

When combined with a comprehensive treatment program and supports, disulfiram has been shown to help reduce relapse when taken consistently.1, 7 However, this medication can cause severe and potentially fatal breathing and heart problems if too much alcohol is ingested, and it isn’t recommended for people who have severe heart disease or psychosis.1, 7

Ongoing Treatment for Alcohol Use Disorder

Recovery from AUD is a life-long process that takes time but is treatable.9 Relapse is common during recovery; however, several factors may promote positive outcomes including:9

  • Individualized treatment plans.
  • Regularly reassessing a person’s treatment plan to ensure needs are being addressed.
  • Appropriate time in treatment based on reassessment.
  • Use of behavioral therapy and medications.

Treatment for AUD should be decided between you and your provider and may take place in outpatient or inpatient settings.1 This commonly includes some combination of elements such as:

  • Detox. The process of alcohol leaving the body, often while receiving medication to help you safely through withdrawal.10
  • Behavioral therapy. This is where you learn how to cope with stressors and cravings, improve how you interact with others and solve problems, and increase your motivation towards sobriety and attending treatment.2, 11
  • Aftercare. Interventions and services that can include alumni meetings, recovery housing, attendance in mutual support groups, or ongoing therapy to help you maintain sobriety after completing formal treatment.1
  • Mutual support groups. Supportive recovery communities may help you maintain sobriety by providing support and understanding. Examples include Alcoholics Anonymous (AA) or other support groups that allow you to develop sober support relationships.1, 2

If you or a loved one are struggling with AUD and are considering treatment but aren’t sure where to start, American Addiction Centers (AAC) is here to help. Reach out 24/7 at to connect with our caring team to discuss treatment options, including those which include treatment medications. They can also help you check your insurance and get started on the road to recovery today.

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