Millions of people around the world face challenges associated with alcohol abuse and alcoholism. Fortunately, there is a wide range of treatment options available to overcome alcohol addiction and secure the long-term support needed to sustain recovery. Both inpatient and outpatient treatment programs may utilize pharmaceutical medications to minimize negative side effects during the course of treatment.
Clients may be prescribed different types of medications to manage withdrawal symptoms and to treat ongoing alcohol dependence. While some of the medications specifically treat alcohol use disorders, others help to manage adverse symptoms that are possible over the course of treatment. These medications may provide effective relief during the treatment process when combined with traditional therapy.
Medications Used for Alcohol Treatment
There are a variety of pharmaceutical medications used to treat alcoholism and alcohol withdrawal symptoms. These medications include:
- Disulfiram: Better known by its brand name Antabuse, disulfiram changes how the body processes alcohol. It causes negative effects for the person immediately after consuming alcohol that may include symptoms such as nausea, headache, and trouble breathing. These adverse side effects from alcohol are intended to make the person not want to drink alcohol to avoid these consequences. It is currently available for oral consumption or as a subdermal implant.
- Naltrexone: According to Progress in Brain Research, naltrexone is a mu opioid receptor antagonist that has been used in the United States since 1994. This means that the drug changes how the brain reacts to alcohol consumption. This medication is available orally under the brand names ReVia and Depade, and as an extended-release injection under the brand name Vivitrol. Naltrexone is recognized as one of the most effective medications prescribed to treat alcoholism and addiction to opioids. It works by blocking the positive sensations in the brain associated with drinking alcohol.
- Acamprosate: Campral is the brand name of acamprosate, a medication that helps to stabilize brain chemistry during alcohol withdrawal. As a result, the medication can reduce cravings for alcohol. It is most often taken orally in tablet form.
- Topiramate: Although topiramate (brand name: Topamax) is an anti-seizure medication that is also used to treat migraine headaches, it can effectively help to manage negative alcohol withdrawal symptoms. It is available to take orally.
- Baclofen: This pharmaceutical medication is used to treat spastic movement disorders such as multiple sclerosis. It is taken orally or topically, and sold under the brand name Lioresal. While baclofen is not currently recommended for alcoholism treatments, it is being researched for potential positive effects. According to Drug Safety, baclofen has already been approved temporarily in France for treatment of alcohol use disorders.
- Ondansetron: Marketed under the brand name Zofran, ondansetron is used to treat nausea. It is available in a wide range of delivery methods, including a rectal and an intravenous solution. While ondansetron is not specifically geared toward alcoholism, it can help to manage the negative symptoms associated with withdrawal.
- Anti-anxiety medications: For those undergoing treatment for alcoholism, anti-anxiety medications, including certain long-acting benzodiazepines, may be used to manage symptoms of alcohol withdrawal and early recovery, such as anxiety.
How Medications Work
The medications used for alcohol treatment fall into three categories: managing withdrawal symptoms, reducing alcohol consumption, or altering brain chemistry. These pharmaceutical medications work together to minimize possible negative side effects and increase success rates.
Medications such as Antabuse reduce alcohol consumption by introducing negative side effects, such as vomiting, in the presence of alcohol. Naltrexone and Campral work by changing brain chemistry and how alcohol affects the body. Other medications, such as anti-anxiety medications or antidepressants, work to address specific symptoms that may occur in the recovery process.
Medications for Long-term or Short-term Use
Many of the medications used during alcohol addiction treatment are intended for short-term use. Some, however, may be used on a longer-term basis. For instance, Antabuse can be prescribed over the long-term; however, it is typically prescribed in a larger dose during the first two weeks of treatment before a shorter dose is prescribed.
The supervising physician will determine the specific prescription length and dosages. Oftentimes, dosages will be adjusted throughout the treatment process.
Effectiveness of Medications
Some of the prescribed medications are considered more effective than others. For instance, Antabuse does not treat underlying issues with alcoholism, including brain chemistry. The prescription medication simply makes it more uncomfortable for the individual to drink alcohol. As with all medications, Antabuse is not an effective addiction treatment on its own; it must be used in conjunction with research-based therapies.
Other pharmaceutical medications are only moderately effective. According to American Family Physician, acamprosate and naltrexone can modestly reduce alcohol consumption and increase alcohol abstinence rates. They work best when combined with other types of treatment, including behavioral modification and supportive therapy.
The effectiveness of the pharmaceutical medication also largely depends on the individual, their unique medical history, their history with substance abuse and addiction recovery, and any co-occurring mental health issues. If the client has any co-occurring medical or mental health issues that require medication, any possible interactions must be considered before prescribing medication for alcohol withdrawal or addiction recovery.
All pharmaceutical medications come with some level of risks and potential side effects. The medications commonly used for alcohol treatment, however, appear to have fewer adverse side effects than those associated with alcoholism. According to Clinical Neuropharmacology, high-dose naltrexone seems to be well tolerated, safe, and effective in both men and women with alcohol dependence. The relatively low risks for these medications may make them ideal choices for alcohol treatment.
Adverse side effects for this class of medications include:
According to the Acta Poloniae Pharmaceutica, researchers are examining other types of pharmaceutical medications that can be used to treat alcoholism. Potential areas for research include other ways to reduce alcohol consumption. These range from controlling appetite to changing bodily reactions. The idea of most of this research is to make drinking less pleasant. These studies will likely increase the number of pharmaceutical medications used to manage alcohol addiction recovery.