MEDICATIONS  

Many people and primary care physicians are unaware that there are any medical treatments available to assist people in controlling their addictions.  All of the following medications have been approved by the FDA for treating alcohol dependence, and have been proven to be helpful to patients by reducing drinking, reducing relapse rates to heavy drinking, and achieving and maintaining abstinence. 

Disulfiram (Antabuse) is the most commonly known of medications for treating alcoholism.  It produces an unpleasant flushing effect, nausea, headache, chest pains and sweating whenever the patient drinks while taking the medication.  This typically leads to excessive vomiting and a desire to avoid these unpleasant effects.  This medication is most effective when given in a monitored fashion in order for the individual to comply with taking it, and works best for individuals who want to achieve complete abstinence.

Naltrexone (ReVia or generic) blocks opiate receptors that are involved in the rewarding effects of drinking alcohol and in the craving for alcohol.  This medication is successful in breaking the cycle of one drink leading to another.  This medication does not cause sickness when the individual drinks, it simply reduces the euphoric effects associated with the drinking.  Naltrexone’s efficacy is in reducing relapse to heavy drinking, reducing overall alcohol consumption and reducing cravings has been demonstrated by numerous clinical trials.  Naltrexone is most effective as an adjunct to psychosocial treatments such as the BRENDA approach or cognitive-behavioral therapies.  Naltrexone can be taken daily in a pill form or can be taken as an injection to provide a 30 day coverage (Vivitrol)

Acamprosate (Campral)-is the most recently approved medication for treating alcohol dependence.  This medication reduces the physical and emotional discomfort such as insomnia, anxiety, and restlessness that result from abstinence, making it easier to resist drinking.  Acamprosate works best for maintaining abstinence.  This medication’s efficacy has also been proven in clinical trials, with an increasing number of studies being conducted to date.  Acamprosate is also most effective when combined with psychosocial treatment.

Future trials  There are several other medications that are already FDA approved that show promising scientific support in reducing the discomfort of short and long term withdrawal and in reducing the negative effects on memory, concentration, learning, and decision-making.  An awareness and appreciation of these new scientific developments is key in being able to educate people who are trying to control their addiction and to delivering the most effective treatment available.