The Physician’s Perspective | Medication to Control Drinking

 

So, you’ve decided to cut down on your drinking. Great! There’s medication to help with that! Now, I’m not saying that you can take a pill and magically make your drinking habits completely go away. There are, however, medications that can help reduce the amount of drinking you do, as an aid to achieving your goals.

If you think you’d like to cut back on your drinking, it’s not a bad idea to see if medications could help you.

There are 3 FDA-approved medications to treat alcohol abuse

Disulfiram (Antabuse)

First, there’s Disulfiram (Antabuse), which has been around since the 1920’s. It works by blocking some of the enzymes involved in the breakdown of alcohol and its metabolites. The result of taking this drug, when combined with even the smallest amount of alcohol, is essentially almost instantaneous hangover: flushing, nausea, vomiting, pounding headache, trouble breathing, and more. Its application focuses on more of a classical conditioning method in which you begin to associate drinking with a not-so-good time.

Acamprosate (Camprol)

Next, there’s Acamprosate (Camprol). How this drug works is not fully understood, but it’s thought to stabilize processes in the brain that are otherwise disrupted in alcohol abuse. Unlike Disulfiram, it doesn’t cause all the terrible hangover effects when taken with alcohol, but it does have a pretty significant list of side effects, such as chest pains, hypertension, insomnia, anxiety, and weakness, just to name a few. On top of that, Acamprosate needs to be taken 3 times a day, which can be less than convenient for those of us who forget things. Acamprosate also only works for people who have stopped drinking completely.

Naltrexone (Revia or Vivitrol)

The third medication is Naltrexone (Revia in pill form or Vivitrol, an injection), which is an opioid-receptor blocker. Naltrexone blocks the effects of opiates—drugs like morphine, oxycodone and heroin. It turns out that some of the pleasure of drinking comes from increased levels of opiates in the brain. Naltrexone works by blocking this link between having a drink and the brain’s pleasure stimulation, thereby decreasing reinforcement of the addictive behavior. Also, like Acamprosate, there are no unpleasant effects when taken with alcohol. Dosing is once daily, and the most common side effects reported are nausea, diarrhea, and headaches.

There are several other medications that are nearing FDA-approval for decreasing drinking. At Ria Health we also use Gabapentin. We will discuss these medications in future blog posts.

Which of these is right for me?

If you think you’d like to cut back on your drinking, it’s not a bad idea to see if medications could help you. Not every medication is perfect for every person, and it’s important to take into account your overall treatment goals, lifestyle, and budget. Ultimately the decision to start a medication is best made between you and a doctor, and I would encourage you to start that conversation.

And it goes without saying, if you’re having difficulties managing your drinking, I’m here to help you.

START NOW

Leave a Reply

Your email address will not be published. Required fields are marked *