A highly addictive substance, alcohol recovery may include the use of pharmaceutical treatments. Medications can help reduce relapse rates by either satisfying or preventing the cravings of alcohol detox. Some pharmaceutical treatments for alcohol addiction have been used for many decades, but others are newer and still being researched for managing alcohol relapse. Disulfiram, Naltrexone, Acamprosate, and Topiramate are 4 options that may be considered for use in an alcohol rehab program.
A medication that has been utilized for alcohol treatment, disulfiram is possibly the oldest pharmaceutical treatment option available to manage cravings. By inhibiting aldehyde dehydrogenase (the enzyme that breaks down alcohol), an individual on disulfiram will experience a myriad of unpleasant symptoms if they consume alcohol. It works as a sort of negative reinforcement to prevent alcohol consumption. The symptoms that will present if alcohol is consumed include:
- facial flushing
- shortness of breath
Although disulfiram has been found to be effective in preventing the use of alcohol, it is only effective when the medication is taken as prescribed. Studies have shown that less than 20% of patients actually take the medication consistently. For this reason, disulfiram is most effective for patients who may have a severe physical dependence, but show a high motivation for getting sober.
Although Naltrexone was approved to treat opioid addiction back in the ‘80s, it was not until 1994 that the FDA approved it for use in treating alcohol addiction. It works by binding to the pleasure receptors in our brain and therefore preventing dopamine produced by alcohol from providing a pleasurable reward. By removing the pleasure aspect of drinking, it reduces the desire to drink. Evidence has shown that naltrexone can reduce how much and how often the individual will drink, reduce relapse rates, and reduce the percent of days abstinent.
The side effects of naltrexone are usually mild, such as nausea and headaches. However, getting patients to take the medication on a regular basis is often a struggle that physicians often observe with naltrexone as well. A once-monthly depot shot was recently developed and is a promising solution to improve outcomes when using naltrexone on an outpatient basis.
One of the newest pharmaceutical treatments for alcohol addiction, acamprosate was just approved by the FDA in 2004. Similar to the aforementioned medications, acamprosate helps in managing cravings to drink. However, it does via a different mechanism that disulfiram or naltrexone. As opposed to satisfying the cravings, this medication works by relieving or suppressing cravings. The most common side effect of acamprosate is diarrhea.
Studies on acamprosate for alcohol use disorders have shown mixed results on efficacy, but it is known that the medication works best when given close to the start of detox.
Previously approved by the FDA for use in treating epilepsy, topiramate studies have reported effectiveness in reducing the amount of alcohol a patient drinks and increase the percentage of abstinent days reported.
Low titration, or the gradual introduction of this medication, is required. This creates a barrier as it can take weeks to build up to an effective dose, but researchers are still optimistic about the effectiveness of topiramate. Human trials are being conducted in hopes of making this medication readily available to help individuals struggling with alcohol addiction.
Treating Alcohol Addiction
There is no shame in getting a helping hand when overcoming alcohol addiction. A severely physically addictive substance, alcohol can have a stronghold on an individual even if the desire to get sober is present. At Amethyst Recovery Center, we want to give our clients all of the resources possible to support their recovery, even medication. Call now to discuss pharmaceutical treatment options for overcoming addiction.