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Reviewed by Alcohol misuse is a significant global health crisis, responsible for several preventable diseases. In the U.S. alone, it contributes to 140,000 deaths annually and nearly 3.6 million years of potential life lost. These numbers underscore the urgent need for effective treatments to combat alcohol use disorder (AUD).
One promising approach involves the use of medications that target the neurobiological mechanisms underlying alcohol dependence. By addressing the cravings and other symptoms associated with AUD, these medications offer valuable support in the journey toward recovery.
In the U.S., the FDA has approved three specific medications: naltrexone, acamprosate, and disulfiram, each with a proven ability to reduce alcohol consumption and cravings. Keep reading to know how these FDA-approved medications, along with others, can make a difference in treating alcohol addiction.
Table Of Contents:
What Is Anti Alcohol Medication?
Anti-alcohol medications are pharmaceutical treatments designed to help individuals reduce or eliminate their alcohol consumption. These medications operate on the premise that specific neurobiological and behavioral mechanisms drive alcohol dependence.
By targeting these mechanisms, anti-alcohol medications disrupt the cycle of alcohol craving and consumption, making it easier for individuals to maintain sobriety. The FDA has approved three medications for treating alcohol use disorder (AUD) in the U.S., including:
- Naltrexone: Blocks the euphoric effects of alcohol and reduces dopamine release.
- Acamprosate: Reduces alcohol cravings by stabilizing chemical signaling in the brain.
- Disulfiram: Causes unpleasant physical reactions if you drink alcohol.
Some other medications that are not yet FDA-approved for AUD but are used โoff-labelโ; include Gabapentin, Topiramate, Baclofen, Psilocybin, and GLP-1 agonists. Research indicates that high levels of craving are strongly associated with an increased likelihood of relapse, especially during the critical early stages of recovery.
Despite the clear benefits, medication for alcohol addiction is underused. In 2021, only 2% of Americans with AUD received pharmacotherapy. A study of nearly 30,000 Medicare beneficiaries with alcohol-related hospitalizations in 2016 found that only about 1% received MAUD within a month of discharge, which represents a missed effective opportunity for patientsโ treatment during hospital stays.
5 Best Anti-Alcohol Medication
If you’re considering incorporating medication into your alcohol addiction recovery, we explore five of the best medications for alcohol addiction, explaining how they work and what to expect. It’s important to discuss with your doctor to determine if these options are suitable for your individual needs:
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Naltrexone
Naltrexone is an opioid antagonist that works by blocking opioid receptors in the brain, which are part of the reward system involved in alcohol consumption. By inhibiting the effects of opioids, naltrexone reduces the pleasure associated with drinking. This helps to diminish cravings and decrease alcohol consumption.
If you are prescribed naltrexone, you would probably take it in oral tablets once daily, typically in a 50 mg dose, or via injection (Vivitrol), administered monthly by a healthcare provider. Patients with current prescribed or illicit opioid addiction canโt take naltrexone as it will induce acute opioid withdrawal.
Before starting naltrexone, ensure youโve been abstinent from alcohol for at least 7-10 days, as taking it too soon can cause withdrawal symptoms. Discuss any other medications or supplements you take with your doctor to avoid interactions.
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Acamprosate
Acamprosate is a structural analog of gamma-aminobutyric acid (GABA), a neurotransmitter that helps regulate brain activity. It helps stabilize chemical signaling in the brain disrupted by chronic alcohol use, reducing cravings and aiding in maintaining abstinence. Your doctor would instruct you to take it orally, typically as two 333 mg tablets.
- Take two tablets three times a day with meals to minimize stomach upset.
- Maintain a consistent dosing schedule to maximize effectiveness.
Acamprosate is most effective for individuals who have already achieved sobriety. Itโs important to continue taking the medication as prescribed, even if you experience side effects such as diarrhea or nausea. These effects often diminish over time.
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Disulfiram
Disulfiram (Antabuse) is an alcohol antagonist that induces unpleasant reactions when alcohol is consumed. Disulfiram works by inhibiting the enzyme acetaldehyde dehydrogenase, which metabolizes alcohol.
If you consume alcohol while taking disulfiram, acetaldehyde builds up in the body, leading to a severe and unpleasant reaction that includes nausea, vomiting, flushing, and headache. This reaction deters individuals from drinking. Disulfiram is taken orally, usually as a 250 mg or 500 mg tablet once daily.
- Take the tablet daily, ideally in the morning. If drowsiness occurs, you may take it in the evening.
- Abstain from alcohol for at least 12 hours before starting disulfiram.
Avoid any products containing alcohol, including certain mouthwashes, cough syrups, and foods cooked with alcohol, as even small amounts can trigger a reaction. Wear a medical alert bracelet or carry identification that states you are taking disulfiram.
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Baclofen
Baclofen (Lioresal) is a muscle relaxant and a GABA-B receptor agonist, not related to opioids or other typical alcohol treatments. It affects the GABA-B receptors in the brain, which helps reduce alcohol cravings and anxiety, making it easier to avoid drinking.
Baclofen is used off-label for alcohol treatment and typically started at a low dose (5-10 mg) three times a day, with gradual increases based on tolerance, potentially up to 80-120 mg daily. Take baclofen with or without food at the same time each day.
If you need to stop taking Baclofen to avoid withdrawal symptoms, you should taper off gradually under your doctorโs supervision. Baclofen side effects such as drowsiness or dizziness are common, so avoid driving or operating heavy machinery until you know how the medication affects you.
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Gabapentin
Gabapentin is an anticonvulsant medication. It is also used to treat neuropathic pain and seizures. Gabapentin affects GABA neurotransmitters, which help reduce alcohol cravings and manage withdrawal symptoms. It can also improve sleep and anxiety associated with alcohol cessation.
Gabapentin is also used off-label for alcohol addiction treatment and taken orally, starting at 300 mg once a day, with a typical range of 900-1800 mg per day, divided into three doses.
- Follow your doctor’s dosing instructions, starting with a low dose and gradually increasing.
- Take gabapentin consistently, with or without food.
Gabapentin side effects include drowsiness, so avoid activities that require full alertness until you know how the medication affects you. Itโs important to take the medication consistently and not to suddenly stop taking it without consulting your doctor, as this can lead to withdrawal symptoms.
Does Insurance Cover Anti-Alcohol Medication?
Some of these medications for alcohol addiction can be expensive. For example, Vivitrol can go up to $1,737.59 per month or more. This may be prohibitive for many individuals. Under the Affordable Care Act (ACA), treatment for substance use disorders, including alcohol use disorder, is considered an essential health benefit, which means these medications are generally covered.
However, cost-sharing and prior authorization may apply. Medicare Part D generally covers anti-alcohol medications like Vivitrol. However, out-of-pocket costs depend on your plan and can be high if you havenโt met your deductible or if the drug is in a higher tier. Medicare Part B may also cover Vivitrol if administered in a doctor’s office, as it falls under medical benefits in this setting.
If your insurance coverage doesnโt fully cover the cost or you face high out-of-pocket expenses, consider discussing alternative medications with your healthcare provider that may be more affordable or better covered by your insurance plan.
Tips for Successful Alcohol Rehab
Alcohol rehab involves multiple steps, and medication is just one part of the journey. Successful recovery from alcohol addiction requires a comprehensive approach that includes professional support, lifestyle changes, and strong personal commitment.
Whether you’re just starting your recovery or looking to reinforce your progress, here are some essential tips to guide you toward sobriety.
- Get a personalized treatment plan that may include counseling, medication, or a combination of both.
- Consider inpatient or outpatient rehab depending on the severity of your condition.
- Establish short-term and long-term goals for your recovery.
- Recovery is gradual; setbacks can happen, but stay focused on your progress.
- Engage with groups like Alcoholics Anonymous (AA) for peer support and shared experiences.
- Consider therapy to address underlying issues like anxiety or depression that may contribute to alcohol use.
- Identify warning signs and create a strategy for handling potential triggers.
- Take time for self-care and recognize the courage it takes to pursue recovery.
Anti Alcohol Medication โ Final Thoughts
Medication for alcohol addiction can be a powerful tool in the journey to recovery from alcohol use disorder. These medications target the neurobiological mechanisms that drive alcohol cravings, making it easier to reduce consumption and prevent relapse.
While these medications offer significant benefits, they are most effective when combined with other treatment methods, such as counseling, support groups, and lifestyle changes. If you’re considering integrating medication into your recovery plan, consult your healthcare provider to determine the best action for your needs.
People Also Ask
Is there medication for alcohol addiction?
Yes, medications like Naltrexone, Acamprosate, and Disulfiram are FDA-approved to help treat alcohol use disorder by reducing cravings, preventing relapse, and discouraging alcohol consumption.
What drug is commonly used to treat alcoholics?
Naltrexone is commonly used to treat alcohol addiction by blocking the euphoric effects of alcohol and reducing cravings.
Which is better, acamprosate or naltrexone?
Acamprosate is better for maintaining abstinence, while Naltrexone is more effective in reducing heavy drinking and cravings. The best choice depends on individual treatment goals.
Page Sources
- Yaseen, W., Mong, J., & Zipursky, J. (2024). Sobering perspectives on the treatment of alcohol use disorder. JAMA Network Open, 7(3), e243340. https://doi.org/10.1001/jamanetworkopen.2024.3340
- Swift, R. M. (1999). Medications and Alcohol Craving. Alcohol Research & Health, 23(3), 207-214. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6760374/
- Mason, B.J. What Medications Are Used to Treat Alcohol Use Disorder? https://www.niaaa.nih.gov/sites/default/files/publications/video-RSA2017/Mason_508.pdf
- Stokลosa, I., et al. (2023). Medications for the Treatment of Alcohol DependenceโCurrent State of Knowledge and Future Perspectives from a Public Health Perspective. International Journal of Environmental Research and Public Health, 20(3). https://doi.org/10.3390/ijerph20031870
- Volpicelli, J. R., et al. (1994). Naltrexone and the Treatment of Alcohol Dependence. Alcohol Health and Research World, 18(4), 272-278. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6876440/
- Mason, B. J., & Heyser, C. J. (2010). Acamprosate: A prototypic neuromodulator in the treatment of alcohol dependence. CNS & Neurological Disorders Drug Targets, 9(1), 23. https://doi.org/10.2174/187152710790966641
- Stokes, M., Patel, P., & Abdijadid, S. (2024, March 21). Disulfiram. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK459340/
- De Beaurepaire, R. (2018). A Review of the Potential Mechanisms of Action of Baclofen in Alcohol Use Disorder. Frontiers in Psychiatry, 9. https://doi.org/10.3389/fpsyt.2018.00506
- Mason, B. J., Quello, S., & Shadan, F. (2018). Gabapentin for the treatment of alcohol use disorder. Expert Opinion on Investigational Drugs, 27(1), 113. https://doi.org/10.1080/13543784.2018.1417383
- Isola, S., & Reddivari, A. K. R. (2023, July 10). Affordable Care Act. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK549767/
- Maisel, N. C., et al. (2013). Meta-analysis of naltrexone and acamprosate for treating alcohol use disorders: When are these medications most helpful? Addiction (Abingdon, England), 108(2), 275. https://doi.org/10.1111/j.1360-0443.2012.04054.x