- Anti-addiction medications
- Drugs that reduce alcohol cravings, and treat alcohol dependency
- Naltrexone (ReVia, Vivitrol)
- Acamprosate (Campral): Its Ability to Treat Alcohol Dependency
- Disulfiram (Antabuse)*
- Topiramate (Topamax)
- Baclofen (Lioresal)
- Medication for Alcoholism, Withdrawal & Cravings
- Medications to Curb Alcohol Cravings
- Alcohol Detox & Withdrawal Medications
- Adrenergic Medications
- Which OTC Medications Will Help You to Stop Drinking? | Delphi
- Medications to Curb Alcohol Use
- OTC Options
- Additional Methods to Stop Drinking
- The Decision to Stop Drinking
- Symptoms Of Alcohol Withdrawal
- Alcohol misuse — Treatment
- Where detox is carried out
- Withdrawal symptoms
- 12-step facilitation therapy
- Cognitive behavioural therapy (CBT)
- Family therapy
Always treat alcohol dependency with professional guidance and support.
In lieu or in addition to counseling and rehabilitation therapy techniques, drugs are sometimes used for additional treatment in some of the more severe cases.
Some drugs are specifically designed to reduce the cravings for alcohol, while others cause one to experience symptoms of aversion if they have a drink; in essence, conditioning their body to reject alcohol.
Canada has legally approved three drugs that can be used for the treatment of alcoholism.
Drugs that reduce alcohol cravings, and treat alcohol dependency
Naltrexone and Acamprosate, classified as opioid antagonists, help to reduce the craving feeling for alcohol in a recovering alcoholic, and also serve to alleviate some effects of alcohol on a person’s system.
Naltrexone (ReVia, Vivitrol)
This anti-craving drug is a short-term use drug for individuals with serious alcoholism. There are two forms of this drug that can be administered: Vivitrol is injected once a month, and ReVia is a pill that is taken once daily.
There are some temporary side effects that can be associated with naltrexone, including nausea, headaches, feelings of fatigue, and pain in the stomach area. In rare cases, a high dosage of this drug can increase the risk of liver damage. It is not recommended that naltrexone be prescribed to a patient that has recently used other narcotic substances.
The injection Vivitrol is often prescribed in lieu of the pill form because many individuals find it hard to remember to take the pill each day. Sometimes there might be an infection or an abscess at the injection area, and patients are advised to report any bruising, swelling or pain to their doctors.
In some cases, this drug does not deliver the desired effect. Some research attributes this to specific genes found in some patients that may not be in others. Naltrexone is often used along with the drug acamprosate, which is another anti-craving drug. There is currently research being conducted to measure the results of using the two drugs in conjunction with each other.
Acamprosate (Campral): Its Ability to Treat Alcohol Dependency
This anti-craving drug causes the brain to inhibit a neurotransmitter called gamma-aminobutyric acid (GABA). This causes the brain to enter into a more relaxed state and also serves to reduce cravings for alcohol.
Several studies have been conducted with proven results that acamprosate successfully causes an individual to have the desire to drink less frequently. When prescribed along with psychotherapy, it has proven effectiveness to enable patients to take steps to better their lives.
It has proven effective even in individuals that have been diagnosed with severe alcoholism.
Common side effects associated with the use of acamprosate include headaches and diarrhea. More severe side effects include problems with memory functions.
It is recommended that people who have any problems with their kidneys take caution when on the drug.
Acamprosate is also often prescribed in conjunction with other drugs such as naltrexone, another anti-craving drug, and disulfiram, which is classified as an aversion drug.
Another type of drug that may be prescribed to inhibit alcohol use is Disulfiram, which is classified as an aversion drug. This drug causes the user to experience uncomfortable side effects when drinking, yet nothing that is ultimately harmful.
The drug is meant to condition the mind and body to develop an aversion to alcohol. Some side effects a patient might experience when using the drug and having a drink include feeling nausea, headaches, hot sweats, and vomiting.
As little as half a drink is all that is needed for the side effects to occur, and they may last up to two hours.
Typically, patients only require one dose taken every 1-2 weeks.
There is a dangerous warning regarding an overdose of the drug, which could cause anything from chest pain and low blood pressure to the death of the patient.
While taking this drug, it is important for the patient to have a support system in place through friends and family, or buddies in support groups that can ensure the drug is being taken regularly.
*no longer available for treatment in Canada
Normally prescribed for the treatment of epilepsy, this anti-seizure drug can also be used to keep impulses in check, and has been studied as a possible drug for the treatment of alcoholism.
One study in which individuals with alcohol dependency had been prescribed topiramate resulted in longer periods of abstinence for the patients.
Side effects that were exhibited included a loss of concentration, a sensation of itching and burning skin, and no appetite.
This drug is currently being studied to see if it yields any benefit in helping patients stay abstinent. The drug is a muscle relaxant and anti-spasmodic and is currently being researched with patients that have alcoholic cirrhosis. It can be a very useful medication to treat alcohol dependency in the long term, some research says.
Medication for Alcoholism, Withdrawal & Cravings
Medications used to treat alcohol addiction work in different ways. Disulfiram causes unpleasant reactions when combined with alcohol. Naltrexone reduces cravings for alcohol and prevents pleasurable effects caused by drinking. Acamprosate curbs cravings for alcohol.
Each drug is approved by the Food and Drug Administration for the treatment of alcohol addiction, also known as alcoholism or alcohol use disorder, when used in combination with behavioral therapy and other support services. These three alcohol medications come in pill form, and naltrexone also comes in injectable form.
Other drugs, such as Topamax (topiramate) or Valium (diazepam), may be prescribed to relieve some symptoms of withdrawal.
Topamax and other anticonvulsants can relieve seizures associated with alcohol withdrawal.
Benzodiazepines such as Valium can treat a serious withdrawal symptom called delirium tremens, according to a guide on medications for alcohol use disorder created by the federal government.
Treatment facilities may provide medications during alcohol rehab to curb cravings and alleviate symptoms of withdrawal, which commonly occur during detox. People can take disulfiram and naltrexone after treatment and alongside continued therapy to aid alcohol recovery.
Marta Nelson of Advanced Recovery Systems explains how benzodiazepines such as Librium and Ativan can be used to relieve some withdrawal symptoms caused by alcohol cessation.
Medications to Curb Alcohol Cravings
When a person addicted to alcohol quits drinking, the brain craves the substance. Cravings can increase the risk of alcohol relapse, but many medications can reduce urges to drink.
In addition to blocking the pleasurable effects caused by alcohol, naltrexone can curb cravings for the substance.
A naltrexone pill is taken daily to relieve cravings, and the injectable form is taken monthly.
Naltrexone is most effective in patients who have shown an ability to quit drinking before they receive the medication, according to the U.S. Department of Health and Human Services.
Chronic alcohol use disrupts brain chemistry. Acamprosate helps normalize brain chemistry, which reduces cravings. Doctors prescribe acamprosate after a person is finished with withdrawal. The drug may not be effective if you take it while drinking alcohol, according to the Substance Abuse and Mental Health Services Administration.
Topiramate may reduce cravings for alcohol even if a patient is still drinking when he or she takes it. Numerous studies support its safety and effectiveness, according to a 2015 review published in the journal CNS Drugs. Doctors can legally prescribe the drug to reduce craving for alcohol, but the FDA has not approved it for alcoholism.
Alcohol Detox & Withdrawal Medications
Medications used while detoxing from alcohol treat symptoms of withdrawal, but they don’t prevent withdrawal. The only way to prevent alcohol withdrawal is to drink alcohol.
Some types of drug withdrawal can be prevented with medication. For example, heroin withdrawal occurs when parts of the brain called receptors don’t receive heroin. Buprenorphine is a medication that attaches to the same receptors that heroin attaches to, preventing withdrawal.
No known medication can prevent alcoholics from going into withdrawal when they don’t drink, but some medications can relieve symptoms of withdrawal to make it more comfortable.
Benzodiazepines are prescription drugs used to treat anxiety, insomnia and seizures. The class of drugs, which includes Valium, Xanax (alprazolam) and Klonopin (clonazepam), is often considered the first approach to alcohol withdrawal treatment. Benzos can treat seizures and delirium tremens, the most serious alcohol withdrawal symptoms.
Adrenergic medications, such as Catapres (clonidine) and Precedex (dexmedetomidine), may relieve some symptoms of alcohol withdrawal, including elevated pulse and high blood pressure. The class of drugs is also referred to as alpha-2 agonists. They’re generally used to treat minor withdrawal symptoms, and they’re often prescribed alongside benzodiazepines.
Anticonvulsants, or anti-seizure medications, can be used as alternatives to benzodiazepines to treat or prevent seizures caused by alcohol withdrawal. However, they are less ly to prevent delirium tremens. Anticonvulsants used during alcohol withdrawal include Tegretol (carbamazepine) and Depakene (valproic acid).
Several types of medications are used during treatment for alcoholism. Medications for alcoholism, such as disulfiram and naltrexone, aid alcohol recovery when used alongside therapy. Other medications can relieve withdrawal symptoms during detox.
- Guglielmo, R. et al. (2015, April 22). Topiramate in Alcohol Use Disorders: Review and Update. Retrieved from https://link.springer.com/article/10.1007%2Fs40263-015-0244-0
- Johnson, B.A. & Ait-Daoud, N. (2011, March 24). Topiramate in the New Generation of Drugs: Efficacy in the Treatment of Alcoholic Patients. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063512/
- Myrick, H. & Anton, R.F. (1998). Treatment of Alcohol Withdrawal. Retrieved from https://pubs.niaaa.nih.gov/publications/arh22-1/38-43.pdf
- Substance Abuse and Mental Health Services Administration. (2005). Acamprosate: A New Medication for Alcohol Use Disorders. Retrieved from https://store.samhsa.gov/shin/content/MS974/MS974.pdf
- U.S. Department of Health and Human Services. (2015). Medication for the Treatment of Alcohol Use Disorder: A Brief Guide. Retrieved from https://store.samhsa.gov/shin/content/SMA15-4907/SMA15-4907.pdf
- U.S. National Library of Medicine. (2010, November 1). Disulfiram. Retrieved from https://medlineplus.gov/druginfo/meds/a682602.html
- U.S. National Library of Medicine. (2010, November 1). Naltrexone Injection. Retrieved from https://medlineplus.gov/druginfo/meds/a609007.html
- U.S. National Library of Medicine. (2016, May 15). Acamprosate. Retrieved from https://medlineplus.gov/druginfo/meds/a604028.html
- U.S. National Library of Medicine. (2017, October 15). Naltrexone. Retrieved from https://medlineplus.gov/druginfo/meds/a685041.html
Which OTC Medications Will Help You to Stop Drinking? | Delphi
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that in 2015, nearly three-quarters of all Americans adults reported drinking alcohol within the past year. Alcohol is the most commonly used addictive substance in the U.S.
While it is regularly consumed safely, the National Survey on Drug Use and Health (NSDUH) reports that in 2016, more than 15 million adults in the U.S. struggled with an alcohol use disorder (AUD).
Drinking alcohol regularly can become habit-forming. It can lead to problematic drinking and a range of other issues related to alcohol.
Medications to Curb Alcohol Use
The U.S. National Library of Medicine (NLM) reports that there are three medications approved to treat an AUD in the United States: acamprosate (Campral), disulfiram (Antabuse), and naltrexone (ReVia, Vivitrol). These are prescription medications that are used to help you stop drinking or sustain abstinence.
Naltrexone combats cravings while blocking the receptors in the brain that are activated by alcohol to stimulate the surge of dopamine and feelings of pleasure associated with drinking.
Disulfiram creates an adverse reaction if you introduce alcohol to the system again; it, therefore, works as a deterrent to return to drinking after stopping.
Acamprosate serves to regulate brain chemistry to alleviate cravings for alcohol; this makes it easier to refrain from drinking alcohol after you have stopped for a period, the journal CNS & Neurological Disorders Drug Targets explains.
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Another medication, topiramate (Topamax) is an anticonvulsant that is sometimes used off-label to help people stop drinking.
Studies published in Psychiatric Times show that it is effective at lowering the number of days a person drinks heavily, and it increases the number of days they remain abstinent.
Over-the-counter, or OTC, products may also be useful as aids to stop drinking. Supplements such as B-vitamins and L-glutamine may be helpful in managing cravings for alcohol.
L-glutamine is an amino acid that the body naturally produces.
Excessive amounts of alcohol can inhibit how l-glutamine is synthesized and absorbed in the body. Adding it back in while trying to stop drinking can help to regulate body chemistry. This can aid in managing cravings as well as lifting moods.
Regular bouts of heavy drinking can deplete the body of thiamine, a B-vitamin, which can result in anemia and leave a person feeling fatigued, weak, depressed, and unfocused. Taking a B-vitamin complex can aid in diminishing cravings, increasing energy and focus, and restoring the body’s natural composition.
An herbal remedy that may be useful for minimizing alcohol cravings is kudzu extract, which comes from the root of a Japanese plant. The journal Drug and Alcohol Dependence reports on studies showing that kudzu extract can help to reduce binge drinking episodes and, therefore, minimize excessive drinking.
“Prescription and OTC medications and supplements are meant to be used as adjunctive treatment methods for alcohol abuse, dependence, and addiction. These methods can help you to stop drinking, but they should be combined with therapeutic and supportive methods to sustain long-term sobriety.”
Additional Methods to Stop Drinking
Since alcohol withdrawal symptoms have the potential for being dangerous, you shouldn’t just stop drinking cold turkey if you’ve been drinking excessively on a regular basis for a long time.
A medical detox program can help to safely wean the alcohol the body, often by replacing it with other central nervous system depressant substances, such as benzodiazepines, which can then be tapered off slowly over time and under direct medical supervision.
Supplementary medications can be helpful in managing specific side effects of alcohol withdrawal during detox as well.
To stop drinking and remain sober during recovery, you will need to address the cravings and emotional aspects of alcohol abuse and addiction as well.
Therapeutic methods, such as cognitive behavioral therapy (CBT), teach relapse prevention tactics, coping mechanisms, and stress reduction tools that can help to sustain abstinence and promote healthy life choices and behaviors.
Support groups, including 12-step programs Alcoholics Anonymous, can be extremely beneficial in providing you with a sober environment. You will be surrounded by peers who also wish to remain sober, and they can offer tips on how to do so.
An alcohol abuse treatment program is the best choice for people who want to stop drinking and remain abstinent on a long-term basis.
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The Decision to Stop Drinking
If you decide to stop drinking after developing a dependence on alcohol, you need professional assistance. Regular alcohol use can cause physical and psychological dependence and significant cravings.
Potentially life-threatening withdrawal symptoms can even occur when alcohol processes the body.
Most people who drink excessively and regularly will suffer from some level of alcohol withdrawal symptoms when they try to stop drinking.
Alcohol withdrawal can range from mild to severe and include various side effects such as:
Symptoms Of Alcohol Withdrawal
- Trouble concentrating
- Mood swings
- Irregular heart rate
The journal NICE Clinical Guidelines warns that about 5 percent of the time, acute alcohol withdrawal includes fever, delusions, extreme mental confusion, and seizures that can be life-threatening — a condition called delirium tremens (DTs).
Alcohol is, therefore, not a substance that is recommended to stop suddenly without professional help. Alcohol is often weaned the body slowly or replaced with a substitute medication during medical detox.
Medications are beneficial in managing symptoms of alcohol withdrawal as well as helping to control cravings. To stop drinking safely and effectively, therapeutic, supportive, and pharmacological methods are combined as part of a comprehensive alcohol abuse treatment program.
Alcohol misuse — Treatment
The treatment options for alcohol misuse depend on the extent of your drinking and whether you're trying to drink less (moderation) or give up drinking completely (abstinence).
If you are worried about your drinking or have had an alcohol-related accident or injury, you may be offered a short counselling session known as a brief intervention.
A brief intervention lasts about 5 to 10 minutes, and covers risks associated with your pattern of drinking, advice about reducing the amount you drink, alcohol support networks available to you, and any emotional issues around your drinking.
Keeping a «drinking diary» may be recommended so you can record how many units of alcohol you drink a week. You may also be given tips about social drinking, such as alternating soft drinks with alcoholic drinks when you're out with friends.
Moderation or abstinence are treatment options if you're:
- regularly drinking more than 14 units a week
- experiencing health problems directly related to alcohol
- unable to function without alcohol (alcohol dependency)
Cutting alcohol out completely will have a greater health benefit. However, moderation is often a more realistic goal, or at least a first step on the way to abstinence.
Ultimately, the choice is yours, but there are circumstances where abstinence is strongly recommended, including if you:
- have liver damage, such as liver disease or cirrhosis
- have other medical problems, such as heart disease, that can be made worse by drinking
- are taking medication that can react badly with alcohol, such as antipsychotics
- are pregnant or planning to become pregnant
Abstinence may also be recommended if you've previously been unsuccessful with moderation.
If you choose moderation, you'll probably be asked to attend further counselling sessions so your progress can be assessed, and further treatment and advice can be provided if needed.
You may also have regular blood tests so the health of your liver can be carefully monitored.
If you're dependent on alcohol to function, it's recommended you seek medical advice to manage your withdrawal.
Some people may be prescribed medication to help achieve abstinence. You may also choose to attend self-help groups, receive extended counselling, or use a talking therapy such as cognitive behavioural therapy (CBT).
Where detox is carried out
How and where you attempt detoxification will be determined by your level of alcohol dependency. In mild cases, you should be able to detox at home without the use of medication as your withdrawal symptoms should also be mild.
If your consumption of alcohol is high (more than 20 units a day) or you've previously experienced withdrawal symptoms, you may also be able to detox at home with medication to help ease withdrawal symptoms. A tranquiliser called chlordiazepoxide is usually used for this purpose.
If your dependency is severe, you may need to go to a hospital or clinic to detox. This is because the withdrawal symptoms will also be severe and are ly to need specialist treatment.
Your withdrawal symptoms will be at their worst for the first 48 hours. They should gradually start to improve as your body begins to adjust to being without alcohol. This usually takes 3 to 7 days from the time of your last drink.
You'll also find your sleep is disturbed. You may wake up several times during the night or have problems getting to sleep. This is to be expected, and your sleep patterns should return to normal within a month.
During detox, make sure you drink plenty of fluids (about 3 litres a day). However, avoid drinking large amounts of caffeinated drinks, including tea and coffee, because they can make your sleep problems worse and cause feelings of anxiety. Water, squash or fruit juice are better choices.
Try to eat regular meals, even if you're not feeling hungry. Your appetite will return gradually.
You must not drive if you're taking medication to help ease your withdrawal symptoms. You should also get advice about operating heavy machinery at work. You need to tell the DVLA if you have an alcohol problem – failure to do so could result in a fine of up to £1,000.
It's ly the medication will make you feel drowsy. Only take your medication as directed.
Detox can be a stressful time. Ways you can try to relieve stress include reading, listening to music, going for a walk, and taking a bath. Read more about stress management.
If you're detoxing at home, you'll regularly see a nurse or another healthcare professional. This might be at home, your GP practice, or a specialist NHS service. You'll also be given the relevant contact details for other support services should you need additional support.
Withdrawal from alcohol is an important first step to overcoming your alcohol-related problems. However, withdrawal isn't an effective treatment by itself. You'll need further treatment and support to help you in the long term.
A number of medications are recommended by the National Institute for Health and Care Excellence (NICE) to treat alcohol misuse. These include:
Disulfiram (brand name Antabuse) can be used if you're trying to achieve abstinence but are concerned you may relapse, or if you've had previous relapses.
Disulfiram works by deterring you from drinking by causing unpleasant physical reactions if you drink alcohol. These can include:
- chest pain
In addition to alcoholic drinks, it's important to avoid all sources of alcohol as they could also induce an unpleasant reaction. Products that may contain alcohol include:
- some types of vinegar
You should also try to avoid substances that give off alcoholic fumes, such as paint thinners and solvents.
You'll continue to experience unpleasant reactions if you come into contact with alcohol for a week after you finish taking disulfiram, so it's important to maintain your abstinence during this time.
When taking disulfiram, you'll be seen by your healthcare team about once every 2 weeks for the first 2 months, and then every month for the following 4 months.
Nalmefene (brand name Selincro) may be used to prevent a relapse or limit the amount of alcohol someone drinks.
It works by blocking opioid receptors in the brain, which reduces cravings for alcohol.
Nalmefene may be recommended as a possible treatment for alcohol dependence if you've had an initial assessment and:
- you're still drinking more than 7.5 units a day (for men) or more than 5 units a day (for women)
- you don't have any physical withdrawal symptoms
- you don't need to stop drinking immediately or achieve total abstinence
Nalmefene should only be taken if you're receiving support to help you reduce your alcohol intake and continue treatment.
Many people who have alcohol dependency problems find it useful to attend self-help groups, such as Alcoholics Anonymous (AA).
One of the main beliefs behind AA is that alcoholic dependence is a long-term, progressive illness and total abstinence is the only solution.
The treatment plan promoted by AA is a 12-step programme designed to help you overcome your addiction.
The steps include admitting you're powerless over alcohol and your life has become unmanageable, admitting you've acted wrongly and, where possible, making amends with people you've harmed.
Read more about the 12 steps of Alcoholics Anonymous and alcohol support.
12-step facilitation therapy
12-step facilitation therapy is the programme devised by AA. The difference is you work through the stages on a one-to-one basis with a counsellor, rather than in a group.
The therapy may be your preferred treatment option if you feel uneasy or unwilling to discuss your problems in a group setting.
Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy (CBT) is a talking therapy that uses a problem-solving approach to alcohol dependence.
The approach involves identifying unhelpful, unrealistic thoughts and beliefs that may be contributing towards your alcohol dependence, such as:
- «I can't relax without alcohol.»
- «My friends would find me boring if I was sober.»
- «Just drinking one pint can't hurt.»
Once these thoughts and beliefs are identified, you'll be encouraged to base your behaviour on more realistic and helpful thoughts, such as:
- «Lots of people have a good time without alcohol, and I can be one of them.»
- «My friends me for my personality, not for my drinking.»
- «I know I can't stop drinking once I start.»
CBT also helps you identify triggers that can cause you to drink, such as:
- social anxiety
- being in «high-risk» environments, such as pubs, clubs and restaurants
Your CBT therapist will teach you how to avoid certain triggers and cope effectively with those that are unavoidable.
Alcohol dependence doesn't just impact on an individual – it can also affect a whole family. Family therapy provides family members with the opportunity to:
- learn about the nature of alcohol dependence
- support the member of the family who is trying to abstain from alcohol
Support is also available for family members in their own right. Living with someone who misuses alcohol can be stressful, so receiving support can often be very helpful.
There are a number of specialist alcohol services that provide help and support for the relatives and friends of people with a dependence on alcohol.
For example, Al-Anon is an organisation affiliated with AA that provides relatives and friends with help and support. Its confidential helpline number is 020 7403 0888 (10am to 10pm, 365 days a year).
Read more about the different types of talking therapies.
If you're aiming to moderate your drinking, you may be asked to keep a «drinking diary».
On a daily basis, make a note of:
This will give you a good idea of how much alcohol you're drinking, the situations in which you drink, and how you could start to cut down.
Page last reviewed: 21 August 2018
Next review due: 21 August 2021