Medication-Assisted Treatment for Alcohol Use Disorder
Last Updated Dec 2, 2021
Medication-assisted treatment programs combine prescriptions and counseling to help people overcome an alcohol use disorder. This approach could be lifesaving for someone who wants to stop drinking and can’t.
Alcohol abuse is a leading cause of preventable death among Americans. People with an alcohol use disorder (AUD) often can’t stop drinking even though they know the habit harms their health, their families, and their community.
An estimated 11.5 percent of men and 5.1 percent of women in the United States have an AUD, and many of them want to stop drinking now. Medication could help, but despite its proven efficacy, fewer than 9 percent of people who get AUD therapy are offered prescriptions.
Medication Options for AUD
An alcohol use disorder is characterized by the continued use of alcohol, even when it’s harming a person’s health, community, and future. Someone like this can be physically and emotionally incapable of turning down the opportunity to drink.
Medications can help. Some medications ease cravings, others make alcohol less rewarding, and others lessen psychological distress that leads to drinking.
Experts say medications could help to defer drinking during times of high relapse risk. But some people could use them every day to avoid real risks they weren’t aware of when they woke up this morning.
Several MAT options for alcohol use disorder exist.
Acamprosate (Brand Name: Campral)
The U.S. Food and Drug Administration (FDA) approved acamprosate as an AUD treatment. While chemists aren’t exactly sure how it works, the medication seems to interact with the brain’s reward pathway.
Alcohol becomes less interesting and intoxicating when someone is taking acamprosate. If someone slips into drinking while taking it, they might not progress into a full-blown relapse.
Disulfiram (Brand Name: Antabuse)
What if every drink you took made you sick? That’s the concept behind FDA-approved disulfiram.
This prescription medication doesn’t block alcohol cravings, but if people drink, they feel incredibly ill. In theory, this illness should stop people from wanting another drink.
Naltrexone (Brand Name: ReVia)
The FDA approved this drug for treating opioid disorders. But when researchers discovered it helped with alcoholism too, doctors started using it in AUD programs.
Naltrexone blocks the pleasurable feelings associated with drinking. People may also have fewer alcohol cravings, so they’re less likely to relapse.
Topiramate (Brand Name: Topamax)
Anticonvulsant medications like topiramate aren’t designed to help AUDs. But some people find that this medication can ease feelings of depression and anxiety, and that could help them to stop drinking as a form of self-medication.
If the FDA-approved drugs don’t help curb drinking, your doctor might try this option.
Ondansetron (Brand Name: Zofran)
Pharmacists developed this medication to curb nausea, but some people find it’s helpful for alcohol use disorders. Experts think it can block pleasure signals in the brain, making drinking less rewarding.
This off-label use could be good for you if other drugs aren’t working.
Is Medication Enough on Its Own?
Some pharmaceutical solutions can block cravings and make your next slip less dangerous. But your doctor may not recommend medications right away. And even if you’re using medications, you’ll need other forms of help.
Your doctor might use medications in treatment if:
- You have cravings. Your thoughts about alcohol distract you, keeping you from working on recovery. If your cravings are managed, you can better focus on the work you’re doing in therapy.
- You relapse often. You want to stop drinking, but you’re overcome with the urge. You return to drinking as a result.
- You’re not making progress. You’re in an alcohol treatment program, but you don’t feel like you’re getting better.
Think of medications as an option that could help you participate in therapy. When pharmaceuticals and therapy combine, you could get the results you long for.
What Therapy Can I Use?
An AUD treatment program is designed to help you stop drinking and build a healthier life. There is no one-size-fits-all program for people who can’t stop drinking. Your team will create a program that fits you, your lifestyle, and your future.
Your treatment program might include some or all of these approaches:
You work one-on-one with a therapist in private sessions. You discuss how your alcohol abuse began, what keeps it going, and how you might change your life. You also talk through your triggers and develop skills to help you stay sober.
You bring close family members with you to your therapy sessions. Together, you discuss issues within the home that could keep your alcohol abuse alive. You also work through difficult, longstanding problems you’ve avoided by drinking.
Some therapists combine individual and family approaches in alternating sessions. Your family will learn how to support you in recovery.
You work with other people who also have alcohol abuse problems in small group sessions. You might role-play in these meetings, or you might discuss how your alcohol issues are different or similar.
You have just one therapist, but each member can help someone else to stop drinking too. Group members learn from and support each other in these sessions.
You meet with other people with alcohol use disorders in informal settings. No counselor or mental health expert is present, so these aren’t formal therapy sessions.
In these groups, you can study how other people have overcome addiction issues. And you could get support to help you through a critical or difficult time. Many people attend these meetings for years or even the rest of their lives.
Where Can I Find MAT?
Start with a conversation at your next doctor’s appointment. Explain your alcohol habit, and listen to your doctor’s advice. Some insurance plans require doctors to refer their patients to treatment, so this chat is a good place to start the healing process.
When you’re ready to join a treatment program, your doctor could help you find a reputable option. Or you could use a tool from the Substance Abuse and Mental Health Services Administration, such as the National Helpline or the online treatment finder.
No matter what method you use to find the care you need, keep searching until you get it. With treatment, you can recover.
Though it’s tempting to just attempt to stop drinking on your own, you need medical assistance if you have an alcohol use disorder. Quitting on your own could be dangerous, and it’s not likely to be successful. Get guidance to ensure the process is safe and you are supported.
Excessive Alcohol Use. (April 2022). Centers for Disease Control and Prevention.
Harmful Use of Alcohol Kills More Than 3 Million People Each Year, Most of Them Men. (September 2018). World Health Organization.
Evidence-Based Pharmacotherapies for Alcohol Use Disorder: Clinical Pearls. (September 2020). Mayo Clinical Proceedings.
Understanding Alcohol Use Disorder. (April 2021). National Institute on Alcohol Abuse and Alcoholism.
Medications for Alcohol Use Disorder. (March 2016). American Family Physician.
Medication for the Treatment of Alcohol Use Disorder: A Brief Guide. (2015). Substance Abuse and Mental Health Services Administration.
Treatment for Alcohol Problems: Finding and Getting Help. (August 2021). National Institute on Alcohol Abuse and Alcoholism.
Diagnosis and Pharmacotherapy of Alcohol Use Disorder: A Review. (July 2020). Journal of the American Medical Association.
SAMHSA’s National Helpline. (March 2022). Substance Abuse and Mental Health Services Administration.