Medication-assisted treatment is the use of medications, in combination with therapy, to help an individual end a substance use disorder. Medication-assisted treatment for alcohol addiction is effective and available.
Medication alone has been shown to be ineffective in addressing addiction.1 But when used in combination with therapy, it can help successfully treat substance use disorders, including alcohol addiction.
Understanding Alcohol Addiction and Dependence
Alcohol addiction and dependence aren’t the same thing. Understanding addiction and dependence is essential for understanding how medication-assisted treatment for alcohol addiction works. “Addiction” is classified as alcohol abuse, addiction and dependence.
Addiction occurs due to changes in the brain regions associated with learning, memory and reward or pleasure. Heavy, chronic alcohol abuse can lead the brain to form ironclad associations between alcohol use and the pleasure it produces. Over time, this can lead to powerful alcohol cravings and changes in thought and behavior patterns. Addiction is characterized by compulsive alcohol use despite negative consequences.
Dependence is a physical reliance on alcohol. Initially, alcohol enhances the effects of GABA, a neurotransmitter that produces feelings of calm and well-being, and reduces the activity of glutamate, a neurotransmitter associated with feelings of excitability.
When alcohol use becomes chronic, the brain attempts to compensate for the presence of alcohol by suppressing GABA (calm) activity and increasing glutamate (excitability) activity. As a result, it takes increasingly larger amounts of alcohol to produce the desired effects. This is known as tolerance, and it’s the primary sign that you may be developing a dependence.
At some point, brain function may shift so that the brain begins to operate more comfortably when alcohol is present than when it’s not. Then, when you stop drinking, normal brain function rebounds, and this causes the onset of withdrawal symptoms. Alcohol dependence is characterized by these symptoms, which include nausea, tremors, insomnia, headaches, hallucinations and seizures.
Four Types of Medication-Assisted Treatment for Alcohol Addiction
The FDA has approved three medications to help treat alcohol addiction and dependence. Which type of medication-assisted treatment for alcohol addiction is right for you depends on the severity of your addiction and your unique needs.
- Disulfiram (Antabuse)
Disulfiram was approved by the FDA in 1951 to help keep people off alcohol once detox is complete. This medication works by inhibiting the enzyme aldehyde dehydrogenase, which is responsible for metabolizing acetaldehyde, a toxic product of alcohol metabolism.
When you drink alcohol while taking disulfiram, acetaldehyde builds up in the body and causes a severe physical reaction that includes nausea, vomiting, headache and weakness. This medication doesn’t affect cravings or help to normalize brain function. Rather, its effectiveness lies in making an individual reluctant to use alcohol for fear of the adverse effects.
- Acamprosate (Campral)
Acamprosate was approved by the FDA in 2004 for treating alcohol dependence. After detox is complete and the individual is abstinent, acamprosate is administered to help normalize the glutamate and GABA systems to reduce long-term symptoms of withdrawal, which often include insomnia, anxiety and restlessness. Treating these symptoms is effective for helping to reduce the risk of relapse.
- Naltrexone (ReVia)
Naltrexone was approved by the FDA in 1994 and works by blocking the brain’s opioid receptors to prevent the euphoric effects of alcohol, making drinking it less rewarding. It also reduces cravings for alcohol, which can be intense and often lead to a relapse.
- Naltrexone (Vivitrol)
Naltrexone is also available in a long-lasting injection known as Vivitrol, administered in a physician’s office once a month. Taking the medication in this format decreases the likelihood of relapse, as clients are unable to skip a dose.
Medication-Assisted Treatment for Alcohol Addiction Works
Some people are reluctant to choose medication-assisted treatment for alcohol addiction because they mistakenly assume that you can’t be truly “clean” if you’re taking a “drug.” But, as the Association for Addiction Professionals points out, medications are used to treat numerous diseases and conditions. Using it to treat addiction is no different.2
If you’re struggling with your alcohol use, medication-assisted treatment is an option that can help improve your chances of successful recovery for the long haul.