Medications for Alcohol Use Disorder: What Are They? Do They Work?

When it comes to substance use disorder medications, the most well-known are the ones that treat addictions to opioids. But did you know that medications can be used to effectively treat and manage alcohol use disorders as well? Here are some key facts.

There are three safe, effective, FDA-approved medications that can treat alcohol use disorders.

• Disulfiram, also known as Antabuse. This medication functions as an incentive not to drink, because it makes the experience of consuming alcohol very unpleasant. This strong physical reaction can help disincentivize drinking for patients. It’s been around for a long time and has generic versions available.
• Naltrexone. This medication blocks the opioid receptors in the brain. That’s the area that can make consuming substances like alcohol feel rewarding. So instead of making a patient physically sick when drinking, it simply blocks the pleasurable effects. Naltrexone is available as a pill: a brand-name formulation, Revia, as well as a generic. Naltrexone is also available as a once-per-month injectable, known by the brand name Vivitrol. This version of naltrexone is often more expensive.
• Acamprosate, also known by the brand name Campral. This medication can ease withdrawal symptoms and makes the experience of consuming alcohol feel less rewarding. Acamprosate is available in generic formulations.

What’s it like to use these medications? We asked someone in recovery for her perspective.

We spoke with one Shatterproof supporter, who asked to remain unnamed, about her experience using Antabuse as well as Vivitrol. She said that, like all medications, there were elements that worked for her and elements that didn’t.

“While Antabuse helped me stop drinking, it didn’t change the circumstances in my life that led to my drinking,” she said. “I needed more support to deal with the underlying issues that fueled my addiction.” Still, she reported that her husband found Antabuse very helpful. “He took it religiously for a year and it made all the difference for him. He has now been in recovery for almost 10 years and credits Antabuse for paving the way.”

Her experience with Vivitrol had similar ups and downs. She said the medication gave her “peace of mind” in the early days of recovery, but access was an issue. “Vivitrol was not covered by my insurance, so I had to pay around $1,400 out of pocket each month to get a single shot. None of the doctors where I lived were approved to administer it, so I had to drive over an hour each way to see a doctor who could.”

Addiction medications are underused due to a lack of awareness and access, plus stigma and misinformation.

Though all medications for substance use disorders are safe and effective, they remain underused and difficult to access. This is especially true for alcohol use disorder medications. According to 2019’s National Survey on Drug Use and Health, just 1.6% of people with alcohol use disorders reported using medications to treat their condition.

Alcohol use disorders are serious but treatable.

Though alcohol is normalized in our culture, an addiction to this substance can be just as dangerous as any other. It’s not something you should try to quit using alone or abruptly. In fact, depending on the severity of illness, quitting alcohol “cold turkey” can be harmful and even deadly.

When beginning treatment for alcohol use, it’s very important to seek the guidance and supervision of qualified health care professionals. Together, patients and doctors can decide if medications could help maintain health and comfort along the recovery journey.