The US Food and Drug Administration (FDA) has approved three medicines for alcoholism. Unfortunately, they don’t “cure” alcoholism.
There are no medicines for alcoholism that can cause current drinkers to abstain.
Medicines for Alcoholism
Disulfiram
Alcoholics can take disulfiram (brand names Antabuse and Antabus). It causes severe negative reaction if alcohol is consumed . This can help people quit drinking. Of course, not taking the medication enables a person to drink alcohol without any ill effects.
Disulfiram works by stopping the body from completely breaking down alcohol. This causes a very high buildup of acetaldehyde. Disulfiram causes very unpleasant physical reactions. They include blurred vision, chest pain, nausea and vomiting, among others. Any side effects tend to disappear in about two weeks. They can include acne, mild drowsiness, headache, or a strange aftertaste.
The the discovery of disulfiram’s effects on drinking was an accident during the 1930s. Industrial workers became ill after contact with it and then drinking alcohol. Then much research followed. The FDA approved disulfiram in 1951.
Naltrexone
In 1994, naltrexone became the second drug approved by the FDA for alcoholism treatment. Decades of successful use in treating heroin addiction proved its safety. Then large studies proved its effectiveness in treating alcoholism.
Naltrexone (naltrexone hydrochloride) comes in pill form as Revia and Depade. It comes in injectable form as Vivitrol. The drug works by reducing the craving for alcohol.
Patients on naltrexone should not use any illicit drugs or take sedatives, tranquilizers, or other drugs. Naltrexone is not addictive and it doesn’t react adversely with alcohol.
Possible side effects include, upset stomach, vomiting, diarrhea, headache, or joint pain. Patients with any side effects can get a lower dosage. Naltrexone reduces cravings by stopping the brain from getting pleasure from the highs caused by drinking. Patients must always take it before drinking. It’s widely used in The Sinclair Method (TSM) of treating alcoholism. That method is used throughout Scandinavian countries and widely used in other regions.
Acamprosate
The FDA approved acamprosate in 2004. Countries in Europe used it safely and effectively for 20 years before that.
Campral is the brand name of acamprosate. It reduces the physical and emotional discomforts experienced by alcoholics after they stop drinking. These include anxiety, sweating and sleep problems.
The U.S. Department of Health and Human Services explains that
Chronic, heavy use of alcohol affects several neurotransmitter systems in the brain. These neuro transmitter systems adapt to the chronic presence of alcohol. Once they have adapted, these systems are only in equilibrium with alcohol. When alcohol use ceases, the systems become disregulated and enter a pathologic hyperexcitatory state.
It appears that acamprosate helps modulate and normalize brain activity. Its side effects tend to be minimal and it is not addictive. For this reason, patients can take it for as long as a year after drinking stops.
Medicines for Alcoholism Treatment: Summary
Disulfiram makes people sick if they drink alcohol. Naltrexone prevents them from experiencing pleasure (a “high”) from drinking. Acamprosate reduces the discomforts felt by alcoholics when they stop drinking.
Unfortunately, there are no “magic bullet” medicines for alcoholism treatment. But there are medicines that can help. Discuss these options with your doctor. That medical expert knows your specific medical history. Therefore your doctor can provide informed advice about medicines for alcoholism.
Readings
Acamprosate. React Weekly, 2016, 1591(1), 14.
Byrne, A. Naltrexone. Drug Alc Rev, 2000, 19(3), 347
Disulfiram. React Weekly, 2015, 1540(1), 119.