medication for alcoholism to reduce cravings

Medication for Alcoholism

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Medically reviewed by Dr. Paul R. Linde, MD on February 18, 2021

Are There Really Medications To Stop Drinking Alcohol?

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 resource seeks to remedy that. Here you will find detailed information on how medication can be used to treat alcohol addiction, why it can help, and a comparison of some of the most common choices.

While we don’t advocate for the idea that any one solution works for everyone, it’s likely you’ll find options here that you didn’t think of before—perhaps even one that can help you change your drinking patterns for good.

Follow the links above for a complete guide to each medication option, continue reading for some commonly asked questions, or get in contact with us to learn more. For a direct comparison of the different medications, see our chart below:

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Learn more about Medication-Assisted Treatment

Medically reviewed by Dr. Paul R. Linde, MD on February 18, 2021

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Speak with a Ria Health team member about how medication-assisted treatment can help you. 

Who Can Benefit From Medication For Alcoholism?

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, coaching, 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.

Read more: 5 Ways Medication Can Make Quitting Alcohol Easier

Which Medications Help To Stop Craving Alcohol?

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.

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Which Medication Makes You Sick When You Drink?

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.

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.

Are There Medications For Detox From Alcoholism?

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.

How To Treat Alcoholism With Medication

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:

Medication Comparison

MedicationSummaryBest For:How It Works
NaltrexoneNaltrexone 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.
  • Limiting alcohol cravings
  • Treating physical addiction
  • Changing habits over time
  • Establishing moderation as an option

Naltrexone reduces your motivation to drink by blocking the reinforcement or reward of alcohol. Over time, this begins to change your brain’s reaction to alcohol, and many people find that they lose interest in drinking.

Read More

Disulfiram/AntabuseDisulfiram 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.
  • Maintaining abstinence
  • Establishing new habits
  • Drinking prevention

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

Rather than blocking the pleasurable effects of alcohol, 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

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

Gabapentin reduces anxiety for many people, and also controls the worst side effects of alcohol detox. This can make it a good substitute for people who don’t react well to naltrexone, and also help people adjust to other medications.

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BaclofenBaclofen 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.
  • Reducing withdrawal symptoms
  • Stopping alcohol cravings
  • Treating those who have liver disease

Baclofen seems to help people stop drinking by replacing the role that alcohol plays in the brain. As a result, some people stop feeling like they need alcohol when they take the medication.

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TopiramateTopiramate is another common off-label treatment for alcohol use disorder. It has shown strong all-around effectiveness in clinical trials and is available generically.
  • Limiting alcohol cravings
  • Improving anxiety-related drinking
  • Reducing overall consumption
  • Treating physical addiction symptoms

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.

Read More

Ready to get started with medication-assisted treatment?

Ria Health combines 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. You can also read up on our accreditations and learn about our confidentiality

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