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 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 is because your blood level of the medicine is highest at about one hour. Unless it has been discussed with the doctor 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 seems crazy, why would someone 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 do not 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. But not all patients, partners or family members are able to cooperate on this goal. When they can, this might be the right medicine.

Anyone who is drinking a lot and then all of a sudden stops or cuts way down might develp 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 right from this website.

3) Acamprosate this is another FDA-approved medication for use in helping people cut down or stop drinking. 

What is naltrexone?

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 blocks the “buzz,” helping reduce your urge to drink and break the cycle of alcohol dependence.

Dr. Andrews can prescribe naltrexone in pill form as a part of addiction medicine treatment or to help patients practice effective harm reduction.

What are the benefits of naltrexone?

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

Reduced alcohol cravings

Because naltrexone dulls alcohol’s rewarding “high” or euphoria, it teaches your brain to look elsewhere for fulfillment, helping to significantly reduce the urge to drink.

Helps reduce heavy drinking

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

Supports harm reduction and moderation

Not everyone wants to quit drinking, and unlike some medications that require complete abstinence, naltrexone can be used by people who want to cut down, not just quit. This makes it ideal for harm reduction approaches.

Low risk of addiction

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 may recommend you take it daily or just before drinking. This process is called the Sinclair Method, where you take your naltrexone pill about an hour beforehand and drink with it active in your system.

Over time, because alcohol no longer produces the same rewarding effects, the brain “unlearns” the alcohol-reward association — a process called pharmacological extinction. The Sinclair Method may work best if you’re not ready or willing to quit entirely.

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 benefit you, schedule a telehealth appointment by booking online today.