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Are there really medications for alcoholism?

Yes, there are, and many can be very effective

While big advances have been made in treating alcoholism (or alcohol use disorder), many people still don’t know that these options exist, or how they work.

This page seeks to remedy that. Here you will find detailed information on each of the most common medications for alcohol use disorder, and how they may be able to help.

We don’t advocate for the idea that any one solution works for everyone. However, it is likely that you will find options here that you didn’t think of before, and some may be very useful. Skip to below to begin reading about individual medications, and feel free to contact us here if you have any questions.

First, some basic numbers, and some commonly asked questions.

The Statistics:

6.2%

6.2 percent of American adults suffer from alcohol use disorder

6.7%

Only 6.7 percent of people with alcohol use disorder are likely to get treatment this year

#3

Alcohol is the 3rd leading cause of preventable death in the U.S.

$1/4 T

Each year, alcohol abuse costs the U.S. roughly a quarter trillion dollars

Clearly, alcohol misuse is a widespread issue, and clearly not enough people are getting help.

Medication for alcoholism is underutilized, but it has a strong track record. In fact, medication assisted treatment (medication combined with other forms of therapy) often has a higher success rate than Alcoholics Anonymous and many traditional rehab programs.

With such a health crisis on our hands as a nation, we need all of the tools we can get. Broader knowledge of these options, and broader use, could make a big difference.

And on an individual level, the more choices are available, the more possible it will feel to confront and defeat a dependence on alcohol.

While no single option will work for everyone, it is likely that one of the below solutions can help you, or someone you care about.

Skip To Medications

The short answer is, anybody who is ready to make a change in their relationship with alcohol.

While one medication may not suit all people, there are many options for each situation. These include medicines that are safer for people with advanced liver disease, choices for people who want to cut back gradually, and options that help people reinforce abstinence.

The main factor is what kind of support system a person needs. Prescriptions for alcohol abuse tend to target physical addiction symptoms, cravings, brain chemistry, and common drinking triggers such as anxiety and insomnia. Medication can therefore solve much of the biological aspect of addiction.

However, for many people drinking is also a coping mechanism. This is why medication is especially effective when combined with therapy, or other forms of counseling/group support.

But even for those who benefit primarily from support groups and therapy, medication can boost their overall success rate—especially over the long term. No matter your situation, medication assisted treatment is worth looking into.

Naltrexone, acamprosate, baclofen, topiramate, and gabapentin can all help reduce cravings for alcohol.

  • Naltrexone helps reduce cravings over time by limiting the pleasurable effects of alcohol.
  • Acamprosate can keep cravings under control once you’ve already quit, helping to prevent relapse.
  • Baclofen, topiramate, and gabapentin are all off-label medications for alcoholism that can make you less interested in alcohol. They can also control common drinking triggers, such as anxiety.
View All Medication options

The only medication that intentionally makes you feel ill from drinking alcohol is disulfiram, also known as antabuse.

This treatment for alcoholism was discovered in the mid-20th century. Until the 1990s it was the only approved option for treating alcohol use disorder. Because of this, many people still associate medication assisted treatment with the effects of disulfiram, which basically causes a severe hangover whenever you have even a small amount of alcohol.

Disulfiram can be a powerful deterrent to help you stay abstinent, but it’s also a pretty severe way to keep yourself sober. In the past 20 to 30 years, other medication options—including naltrexone and acamprosate—have emerged. Both of these drugs are FDA approved, and neither works by making you ill when you drink. Read more about each of them below.

Other medications may have side effects that make you feel ill, but this is not intentional. If you feel sick after taking any other drug to quit drinking, ask your doctor about alternatives.

None can prevent detox, but there are many that can help manage it. The most popular include:

  • Benzodiazepines – including Librium and Valium. These medications are sedative, assist with anxiety, and can mute many of the worst withdrawal symptoms. The drawback is that they, too, are addictive, and need to be tapered off. However, they are among the most commonly used in rehab facilities to ease people off of alcohol.
  • Baclofen – This drug can be used to gradually reduce alcohol consumption, or make withdrawal less severe. It can also help you maintain abstinence long-term, and has been shown to reduce people’s interest in alcohol overall. While not addictive, baclofen does have its own withdrawal effects and needs to be tapered off.
  • Gabapentin – This drug is primarily used to treat epilepsy and nerve pain, so it can prevent seizures, and other nervous-system related consequences of alcohol withdrawal. It may also have its own withdrawal symptoms. Like baclofen, it can help some people avoid relapse over the long term.

None of these medications can block the effects of detox completely, and none should be taken without supervision. Alcohol withdrawal can be dangerous, even fatal in some extreme cases. If you experience any physical addiction symptoms, talk to a doctor, and don’t go it alone.

Skip To Medications

Begin by talking to a doctor or an addiction specialist, and discuss your individual situation.

Each medication has different pros and cons, and different protocol. But the basics are the same as with any medicine: take it regularly and follow the instructions as best you can.

Some medicines require that you stop drinking completely. Others, like naltrexone, may even harness your drinking habits to help retrain your brain. It all depends on which medication you choose, and what your goals are.

And, once again, medication often works best when combined with a larger support system. Whether that means group meetings, coaching via a telemedicine app, or regular therapy sessions, the right combination can help you establish a lasting change.

Below are some of the most commonly used medicines to treat alcohol use disorder, or alcoholism:

Naltrexone

Naltrexone is one of the most common medications for alcohol use disorder. It boasts a high success rate and is ideal for people who want to cut back, or change their drinking behaviors.

Naltrexone is best for:

  • Limiting alcohol cravings
  • Treating physical addiction
  • Changing habits over time
  • Establishing moderation as an option

How Does Naltrexone Work?

Naltrexone reduces your motivation to drink by blocking the pleasure effects of alcohol. It does this by limiting the endorphin rush many people get from drinking. Naltrexone was originally developed to treat opioid addiction, and although alcohol is not an opiate, the effect of naltrexone is similar.

Read More

Disulfiram/Antabuse

Disulfiram is the original medication to treat alcoholism. It causes you to feel ill when you drink, motivating you to stay abstinent. Gentler medications are now available, but antabuse can still work for some people.

Disulfiram is best for:

  • Maintaining abstinence
  • Establishing new habits
  • Drinking prevention

How Does Disulfiram Work?

Disulfiram causes severe, hangover-like symptoms to appear when you drink even a small amount of alcohol. Essentially, it stops your liver from breaking down alcohol completely.

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Acamprosate/Campral

Acamprosate is the most recent of three FDA approved medications for treating alcohol use disorder. Also known by the brand name Campral, it is often used to help people maintain abstinence once they’ve stopped drinking.

Acamprosate is best for:

  • Establishing abstinence
  • Controlling drinking urges and cravings
  • Preventing relapse
  • Long-term maintenance

How Does Acamprosate Work?

Rather than blocking the pleasurable effects of alcohol, as naltrexone does, acamprosate appears to work by restoring a chemical imbalance in your brain caused by chronic drinking. This can make it easier for you to avoid alcohol, and eliminates a lot of common drinking triggers.

Read More

Gabapentin

Gabapentin is an off-label medication for alcohol use disorder, originally developed to treat epilepsy. If you struggle with anxiety or insomnia, this medication may help you quit alcohol more easily.

Gabapentin is best for:

  • Easing withdrawal symptoms
  • Relieving anxiety and insomnia
  • Reducing alcohol consumption
  • Transitioning to other medications

How Does Gabapentin Work?

Gabapentin reduces anxiety in many people who take it, and also controls the worst side effects of alcohol detox. It is especially useful for people for whom anxiety is a drinking trigger, or who are likely to experience acute withdrawal symptoms. It can make it easier to get started on other medications by smoothing out the transition period, and can be a good substitute for people who don’t react well to naltrexone.

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Baclofen

Baclofen is a medication often used to treat muscle spasms, which has gained some popularity as a treatment for alcohol addiction. In the cases where it works, it can achieve powerful results.

Baclofen is best for:

  • Reducing withdrawal symptoms
  • Stopping alcohol cravings
  • People with liver disease

How Does Baclofen Work?

Baclofen seems to help people stop drinking by replacing the role that alcohol plays in the brain. The result is that some people stop feeling like they need alcohol when they take the medication. Here’s how it works:

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Topiramate

Topiramate is another common off-label treatment for alcohol use disorder. It has shown strong all-around effectiveness in clinical trials and is available generically.

Topiramate is best for:

  • Limiting alcohol cravings
  • Improving anxiety-related drinking
  • Reducing overall consumption
  • Treating physical addiction symptoms

How Does Topiramate Work?

Topiramate is generally prescribed to treat seizures and migraines, but also seems to help with alcohol use disorder. People who take it appear to have fewer cravings. They also report less pleasure from alcohol, and have fewer anxiety-related drinking urges. Topiramate even seems to work better than naltrexone in some studies.

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Kudzu

Kudzu is a climbing vine native to Eastern Asia, which has gotten attention as a natural remedy for reducing alcohol use. Studies are ongoing, but the results look promising so far.

Kudzu is best for:

  • Limiting binge drinking
  • Reducing cravings
  • Lowering your interest in alcohol

How Does Kudzu Work?

Kudzu appears to affect how fast you drink, and how much. There is little evidence yet that it can help you quit alcohol completely. However, researchers at Harvard Medical School are looking further into kudzu extract, and there is a chance it will be marketed as a mainstream medication in the future.

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Ria Health offers treatment for alcohol use disorder via telemedicine

We combine prescription medication, recovery coaching, and digital tracking tools to create custom plans for each member's needs. The program is covered by many insurance plans, and can be done 100 percent from your smartphone or personal device.