Medication for Alcoholism

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.

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 reinforcement or reward from 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.

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.

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, while some drugs help you reduce cravings for alcohol like naltrexone; it 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: