Medications for alcohol treatment

1) Naltrexone is one of three medications that are FDA-approved for  treatment of alcohol use disorder (AUD) and alcohol dependence or overuse.  Not everyone who drinks alcohol at unhealthy levels has AUD, but the medicine can help anyone wanting to cut down.

Naltrexone is not the medication that makes you sick when you drink -- that medication is called disulfiram (Antabuse) [and is discussed separately below].

Naltrexone, when used "as needed" (on drinking days), allows you to still drink but makes it less likely that you will go overboard.

The best time to take the naltrexone pill is one hour before you think you will take your first drink of alcohol for that day.  That's because your blood level of the medicine is highest one hour later. You generally won't take more than one 50 mg pill per day. On a day when you are not likely to drink you don't need to take the pill at all. 

2) Disulfiram is another FDA-approved treatment for alcohol dependence or overuse. It is the medicine that nearly everyone has heard of that makes you feel sick if you drink at any point (for that day) after taking the pill. By the way, the "sickness" it causes is not dangerous, it is just unpleasant.

You might say, "That's crazy, why would anyone voluntarily do that?" In fact, that is part of the problem:  most people who are prescribed this medicine don't consistently take the medicine because they suspect (usually correctly) that they will drink if they don't take it. 

But, it turns out that this medicine CAN be helpful in certain specific situations. It works best for people whose goal really is total abstinence (not drinking at all) AND who have a partner or family member who will make sure they take the pill each day, or at least each day where they might drink.

Not all patients, partners or family members are able to cooperate on this goal. When they can, this might be the right medicine.

Some heavy drinkers who all of a sudden stop or cut way down get alcohol withdrawal, which can be mild or severe.

When alcohol withdrawal is severe it can be dangerous. Dr Andrews will discuss all this with you during your virtual telemedicine appointment, which you can schedule by calling, texting or emailing Dr Andrews.

3) Acamprosate this is another FDA-approved medication for use in helping people cut down or stop drinking. It works in a way that is similar to naltrexone.

            Call/text to 713-444-4018     Email to richard@sinclairdoctor.com

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What is naltrexone?   

[Note:  if you can't take naltrexone I will prescribe a different medicine]

Naltrexone is a prescription medication designed to help people reduce or stop drinking alcohol. Unlike some medications that cause unpleasant reactions when you drink, naltrexone won’t make you sick. Instead, it just reduces the “buzz,” helping reduce your urge to drink. and break the cycle of alcohol dependence.

What are the benefits of naltrexone?

If you’re trying to reduce or control your drinking, naltrexone offers several key benefits:

->  Reduced alcohol cravings

->  Helps reduce heavy drinking

Studies have shown that people who take naltrexone drink less frequently and do less binge drinking, even if they don’t quit completely.

Not everyone wants to quit drinking, and unlike some medications that require complete abstinence, naltrexone can be used by people who just want to cut down, instead of quitting completely. 

Because naltrexone doesn’t produce any “high” or mood-altering effects, it isn’t addictive. You don’t have to worry about becoming physically dependent.

What can I expect from naltrexone treatment?

Dr. Andrews prescribes naltrexone in pill form, and some people take it daily. But we might recommend that you take it only on the days that you will drink. This process is called the Sinclair Method:  you take your naltrexone pill about an hour before your first drink of the day, which is safe to do.  The idea is that you drink with it active in your system. It does not make you sick like some medicines do.

The Sinclair Method may work best if you’re not ready or willing to quit entirely.

Over time, because alcohol no longer produces the same rewarding effects, the brain “unlearns” the alcohol-reward association. You still can enjoy alcohol, but now you are in control of it. 

Naltrexone is a powerful, flexible medication that can help you abstain from drinking, or help you only drink moderately. As the positive reinforcement disappears, most people naturally start to drink less. Whether you take it every day or use the Sinclair Method, it disrupts the cravings that drive addiction.

To learn more about naltrexone and whether it might help you, schedule a telehealth appointment by calling, texting or emailing Dr Andrews today.