Medication-Assisted Treatment for Alcohol Use Disorder

Medication-assisted treatment (MAT) programs combine prescription medications and counseling to help people overcome alcohol use disorder or alcohol addiction. This approach could be lifesaving for someone who wants to stop drinking and needs help. Unfortunately, despite its proven efficacy, fewer than 9 percent of people who treatment for alcohol addiction are offered MAT options, such as naltrexone, acamprosate, or disulfiram. [3]

Medication	Evidence Rating	How it Works	FDA-Approved?
Acamprosate	A	Decreases cravings and restores neurotransmitters in the brain	Yes
Disulfiram	B	Deters drinking by creating unpleasant effects when you consume alcohol	Yes
Naltrexone	A	Blocks rewarding effects of alcohol, deterring use	Yes
Vivitrol	A	Monthly injectable version of naltrexone that blocks pleasurable effects of alcohol	Yes
Topiramate	B	May reduce lingering anxiety and depression and curb cravings	No, off-label
Ondansetron	B	May block rewarding effects of alcohol	No, off-label

FDA-Approved Medications for Alcohol Use Disorder

Alcohol use disorder is characterized by compulsive alcohol use despite negative consequences. Many people with this condition find it difficult to quit drinking on their own. Fortunately, medications can help.

Some medications ease cravings and protracted withdrawal symptoms, 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 foster their recovery.

Several MAT options for alcohol use disorder exist. The right medication for you depends on your individual needs. But regardless of which medication you take for alcohol addiction, it’s essential that you attend therapy or counseling as well so that you can build coping skills and understand the underlying factors that caused your drinking in the first place.

Acamprosate (Brand Name: Campral)

The U.S. Food and Drug Administration (FDA) approved acamprosate (Campral) as an AUD treatment. While experts aren’t exactly sure how it works, the medication seems to interact with the brain’s reward pathway.[5]

Alcohol becomes less rewarding and intoxicating when someone is taking acamprosate. If someone slips into drinking while taking it, they might not progress into a full-blown relapse. Campral also reduces cravings and seems to rebalance neurotransmitter levels in the brain. [5]

Disulfiram (Brand Name: Antabuse)

What if every drink you took made you sick? That’s the concept behind FDA-approved disulfiram. Antabuse doesn’t block alcohol cravings, but if people drink while taking it, they feel unpleasant effects and experience flushing, rapid heart rate, and dizziness. In theory, this negative reaction should stop people from wanting another drink.

However, there are issues with treatment compliance because if someone wants to drink, they will simply not take this medication that day. [5]

Naltrexone (Brand Name: ReVia)

The FDA approved this drug for treating opioid use 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.[5]Additionally, there is a monthly injectable version of naltrexone available called Vivitrol, which can be administered in a doctor’s office and can help improve treatment compliance and recovery.

Medications Prescribed Off-Label for Alcohol Addiction

Topiramate (Brand Name: Topamax)

Anticonvulsant medications like topiramate aren’t FDA-approved 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.[5] It may also weaken the association between cravings cues and drinking.

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 helpful for alcohol use disorders. Experts think it can block pleasure signals in the brain, making drinking less rewarding. [5],[9]

This off-label use could be good for you if other drugs aren’t working.

What Medication is Most Effective for Alcohol Addiction?

Research shows that acamprosate may be the most effective medication in preventing relapse in those who have already achieved abstinence. Likewise, naltrexone is very effective at reducing drinking in people with alcoholism. It seems to be more helpful in those who have already stopped drinking when they start the medication.[5]

Disulfiram may be the least effective due to issues with treatment compliance. However, it has been shown to be more effective when taken under supervision, such as during an addiction treatment program.[5]

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 alcohol addiction treatment if:[6]

• 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. Counseling and medication give you the best chance at long-term recovery and abstinence. It’s also important to understand that there is no rush to stop taking your medication if it’s helping you stay sober. You can safely and effectively take AUD medications for years.

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: 

Individual Therapy

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. Many types of individual therapy are helpful for alcohol addiction, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), motivational enhancement therapy, and more.

Family Therapy

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.

Group Therapy

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.

Support Groups

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 drinking behaviors, 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, such as Boca Recovery Center.

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.