Alcohol Addiction Medication: Definition, Types, Benefits, Side Effects, Alternatives

Alcohol addiction medications are prescription drugs that reduce dependence on alcohol and support recovery from Alcohol Use Disorder (AUD). They target brain chemistry to decrease cravings, prevent relapse, and minimize withdrawal symptoms. Used during detox and ongoing treatment, these medications diminish alcohol’s pleasurable effects, stabilize neurotransmitter imbalances, or induce unpleasant reactions to alcohol, serving as deterrents.

FDA-approved medications for alcohol addiction are Naltrexone (ReVia, Vivitrol), Acamprosate (Campral), and Disulfiram (Antabuse). According to Kranzler, H. R.’s 2018 study, ‘Diagnosis and Pharmacotherapy of Alcohol Use Disorder: A Review’, alcohol consumption causes 88,000 U.S. deaths annually, and 14% of U.S. adults have Alcohol Use Disorder (AUD), though only 7% receive treatment at specialized facilities.

These medications are prescribed to less than 9% of patients who would benefit. Naltrexone reduces return to any drinking by 5% and binge drinking by 10%. In the most comprehensive study to date (COMBINE), patients achieving abstinence had better outcomes than those with reduced drinking. Screening is underutilized, with only 1 in 6 U.S. adults reporting they’ve been asked about their drinking behavior by healthcare providers.

Key benefits of using these medications include reduced cravings, improved relapse prevention, enhanced mental health, support for long-term recovery, and better management of withdrawal symptoms.

Common side effects vary by medication but include nausea, headaches, digestive problems, sleep disturbances, and mood changes. Disulfiram causes severe adverse reactions if alcohol is consumed.

Alternatives to medication include behavioral therapies such as Cognitive Behavioral Therapy (CBT) and Motivational Interviewing, peer support groups like Alcoholics Anonymous (AA), holistic approaches such as mindfulness and yoga, and nutritional support. Often, a combination of medication and these alternatives provides the most effective treatment.

What Is Alcohol Addiction Medication?

Alcohol addiction medications are prescription drugs specifically designed to help individuals reduce their dependency on alcohol and support recovery from Alcohol Use Disorder (AUD). These medications are a central component of Medication-Assisted Treatment (MAT) programs, which combine pharmacotherapy (the use of medications) with behavioral therapies to improve treatment outcomes and long-term sobriety.

Alcohol addiction medications work by targeting brain chemistry to reduce cravings, prevent relapse, and minimize withdrawal symptoms. They are used during medical detox to manage withdrawal safely and are continued as part of ongoing treatment to support abstinence. Common FDA-approved prescription medications for alcohol addiction include disulfiram, naltrexone, and acamprosate, each with distinct mechanisms to either deter drinking, reduce the pleasurable effects of alcohol, or stabilize neurotransmitter imbalances caused by chronic alcohol use.

How Do Alcohol Addiction Medications Work?

Alcohol addiction medications work by targeting specific mechanisms to reduce alcohol consumption and support recovery. Naltrexone blocks the brain’s opioid receptors, diminishing the pleasurable effects of alcohol and decreasing cravings. Acamprosate stabilizes the balance of neurotransmitters in the brain, reducing withdrawal symptoms and relapse risk. Disulfiram inhibits the enzyme aldehyde dehydrogenase, causing unpleasant reactions to alcohol, such as nausea and flushing, which deters drinking. These medications effectively address various aspects of alcohol addiction, enhancing treatment outcomes.

Who Needs Medication for Alcohol Addiction?

People with moderate to severe alcohol use disorder, those experiencing withdrawal symptoms, heavy daily drinkers, individuals with previous relapses, people with intense cravings, patients requiring additional recovery support, and those with co-occurring conditions need medication for alcohol addiction.

Those who benefit most from alcohol addiction medications include:

• Individuals with moderate to severe AUD who find it difficult to control or stop drinking
• Heavy or daily drinkers are at risk for withdrawal symptoms
• People who have relapsed after previous rehab or therapy attempts
• Individuals with strong cravings or persistent thoughts about alcohol
• Those who need additional support to maintain abstinence and focus on lifestyle changes
• Patients with co-occurring mental health or medical issues that complicate recovery

According to Huskamp, H.A.’s 2020 study, ‘Medication Utilization for Alcohol Use Disorder in a Commercially Insured Population’, medication-assisted treatment (MAT) for Alcohol Use Disorder (AUD) benefited 13.3% of the 151,128 individuals studied who had an index AUD visit. This means approximately 20,058 people filled an AUD prescription after their initial visit.

What Types Of Medications Are Used For Alcohol Addiction?

The medications used to treat alcohol addiction are U.S. Food and Drug Administration (FDA) approved medications such as Naltrexone (brand names: ReVia, Vivitrol), Acamprosate (brand name: Campral), and Disulfiram (brand name: Antabuse).

The three FDA medications used to treat alcohol addiction include:

1. Naltrexone (ReVia, Vivitrol)
2. Acamprosate (Campral)
3. Disulfiram (Antabuse)

Naltrexone

Naltrexone is an opioid receptor antagonist commonly marketed under brand names such as Revia and Vivitrol. It is typically administered orally in tablet form or by intramuscular injection, depending on the treatment indication. Naltrexone works by blocking opioid receptors in the brain, which reduces the euphoric and sedative effects of opioids and alcohol, thereby helping to prevent relapse in individuals with opioid or alcohol dependence. Its mechanism also involves modulating the reward pathways associated with substance use.

Naltrexone reduces the risk of heavy drinking by 17% compared to placebo. 

According to Kirchoff, R. W.’s 2021 study, ‘Naltrexone Initiation in the Inpatient Setting for Alcohol Use Disorder: A Systematic Review of Clinical Outcomes’, Hospital readmission rates decreased significantly when naltrexone protocols were implemented, dropping from 23.4% to 8.2% in one study and from 26.2% to 2.8% in another. Emergency department revisits within 30 days fell from 18.8% to 6.1%. The odds of returning to the emergency department decreased by 79% for patients counseled about naltrexone. Naltrexone prescribing rates increased dramatically after educational interventions, rising from 0% to 64% in one hospital and from 1.6% to 28.1% in another.

Acamprosate

Acamprosate, marketed under the brand name Campral, is taken orally in tablet form to help maintain abstinence in individuals recovering from alcohol dependence. Acamprosate effectively reduces alcohol cravings and consumption in patients with Alcohol Use Disorder by targeting glutamate neurotransmission. Acamprosate has been shown to reduce the risk of relapse and support sustained sobriety when combined with counseling or psychosocial support.

According to Sharma, A.K.’s 2024 study, ‘Role of Acamprosate and Baclofen as Anti-craving Agents in Alcohol Use Disorder: A 12-Week Prospective Study’, Acamprosate showed a 72% retention rate with 38.89% of patients maintaining complete abstinence throughout the study period. Patients on Acamprosate had significantly lower alcohol cravings with a mean PACS score of 7.10 (p < 0.01). For those who relapsed, Acamprosate-treated patients waited an average of 29.91 days before first alcohol consumption and 37.64 days before returning to previous drinking patterns. When they did drink, these patients consumed 5.45 drinks per occasion on average. Acamprosate demonstrated statistically significant effectiveness in reducing both craving intensity and alcohol consumption amount compared to alternative treatments.

Disulfiram

Disulfiram, commonly known by the brand name Antabuse, is taken orally as a tablet to support the treatment of chronic alcoholism. It works by inhibiting the enzyme acetaldehyde dehydrogenase, leading to an accumulation of acetaldehyde when alcohol is consumed, which causes unpleasant symptoms such as nausea, vomiting, and headache. This reaction serves as a deterrent to drinking alcohol. Disulfiram is effective in promoting abstinence by conditioning individuals to avoid alcohol intake, though its success depends heavily on patient compliance and motivation.

According to Schallenberg, M.’s 2025 study, ‘Effectiveness of Disulfiram as Adjunct to Addiction-Focused Treatment for Persons With Severe Alcohol Use Disorder’, disulfiram shows clear effectiveness for treating severe Alcohol Use Disorder. 50% of patients remained abstinent for at least 1 year when disulfiram was used as an adjunct therapy. The study analyzed 45 patients in an outpatient program from 2011 to 2023. Without treatment, alcohol intake returns in 90% of AUD cases, and only 15% of those needing treatment receive it. The medication helps patients resist cravings and avoid impulsive drinking. No differences existed in outcomes based on patient sex, craving levels, or presence of other health conditions.

What Are the Benefits of Alcohol Addiction Medication?

The benefits of alcohol addiction medication include reducing cravings, preventing relapse, stabilizing mental health, and supporting long-term recovery. Medications like naltrexone work by targeting brain chemistry to suppress drinking urges, while others help manage withdrawal symptoms and create deterrents to alcohol consumption.

Here are the key benefits of alcohol addiction medication:

• Reduce Cravings: Medications such as naltrexone and acamprosate suppress the urge to drink by targeting brain chemistry, making it easier for individuals to abstain from alcohol.
• Improve Relapse Prevention: These medications decrease the risk of returning to heavy drinking. According to Jung, Y. C.’s 2006 study, ‘Pharmacotherapy for Alcohol Dependence: Anticraving Medications for Relapse Prevention’, Naltrexone reduces relapse risk by 36% compared to placebo treatments. Acamprosate doubles abstinence rates in most clinical trials. The combination of naltrexone and acamprosate yields the strongest outcomes, studies reporting 73% abstinence with this dual-medication approach compared to just 25% with placebo after 12 weeks of treatment. This combination therapy maintains its effectiveness over time, with 66% of patients remaining abstinent following a 3-month follow-up period versus only 20% in the placebo group. These pharmacotherapy options provide significantly improved outcomes for alcohol-dependent patients seeking sustained recovery.
• Enhance Mental Health: By stabilizing neurotransmitter imbalances caused by chronic alcohol use, medications like acamprosate ease withdrawal symptoms such as anxiety, insomnia, and mood swings, supporting better mental health during recovery.
• Support Long-Term Recovery: Medications improve treatment adherence and long-term outcomes, helping individuals maintain sobriety and improve their quality of life.
• Better Withdrawal Management: Certain medications make the detoxification process safer and more comfortable by reducing the severity of withdrawal symptoms, increasing the likelihood of successful recovery.
• Decrease Alcohol’s Pleasurable Effects: Naltrexone blocks opioid receptors in the brain, reducing the rewarding sensations of alcohol consumption, which discourages drinking.
• Create Negative Associations with Alcohol: Disulfiram causes unpleasant physical reactions when alcohol is consumed, promoting avoidance of drinking through aversion therapy. According to Lanz, J.’s 2023 study, ‘Disulfiram: Mechanisms, Applications, and Challenges’, disulfiram causes several unpleasant physical reactions when combined with alcohol consumption. The drug works by inhibiting the enzyme acetaldehyde dehydrogenase (ALDH), which normally converts toxic acetaldehyde to acetic acid during alcohol metabolism. This inhibition leads to a buildup of acetaldehyde in the body, resulting in an aversive reaction that includes flushing, headache, and nausea, essentially creating an immediate “hangover” effect. At the higher doses historically used (1000-3000 mg daily), the drug became notorious for causing serious side effects and even death from severe disulfiram-ethanol reactions, though current standard doses (250-500 mg daily) are lower but still effective.
• Enhance Engagement in Therapy: By reducing cravings and withdrawal discomfort, medications enable individuals to participate more fully in counseling and support programs, strengthening overall recovery efforts.

Can Alcohol Addiction Medications Reduce Withdrawal Cravings?

Yes, alcohol addiction medications reduce withdrawal cravings. Naltrexone and acamprosate are two FDA-approved medications that specifically target cravings. Naltrexone works by blocking opioid receptors in the brain, thereby reducing the rewarding effects of alcohol and lowering the urge to drink. Acamprosate helps restore the chemical balance in the brain disrupted by chronic alcohol use, which alleviates cravings and supports abstinence.

According to Marin, M. C. D.’s 2023 study, ‘Pharmacological Treatment of Alcohol Cravings’, Naltrexone shows superior effectiveness in reducing alcohol cravings, with 7 out of 11 studies (64%) demonstrating significant reductions compared to placebo. Acamprosate demonstrates less consistent results, with only 2 out of 5 studies (40%) showing craving reduction benefits. The research spans 37 years (1983-2020) and includes 60 randomized controlled trials with an average of 109 participants per study. Most studies (41.2%) implemented 12-week follow-up periods, with dropout rates averaging 27.5% across all trials. The OCDS measurement tool was used in 31.7% of studies, making it the most common assessment method for alcohol cravings.

What Are the Side Effects of Alcohol Addiction Medication?

The side effects of alcohol addiction medication are nausea, headaches, digestive problems, sleep disturbances, and mood changes, with some medications causing specific reactions.

According to Stokłosa, I.’s 2023 study, ‘Medications for the Treatment of Alcohol Dependence—Current State of Knowledge and Future Perspectives from a Public Health Perspective’, naltrexone commonly causes gastroenterological disturbances, joint/muscle pain, sleep disturbances, headaches, and anxiety at 50-100mg doses. Acamprosate side effects include accidental injury, anxiety, depression, asthenia, pain, anorexia, stomach upset, dizziness, dry mouth, insomnia, itching, and sweating. Disulfiram produces unpleasant reactions when combined with alcohol: tachycardia, shortness of breath, tachypnea, heat sensation, anxiety, panic, headache, nausea, and vomiting due to increased acetaldehyde levels.

Here are the common side effects of alcohol addiction medications:

• Naltrexone (ReVia, Vivitrol): Common side effects include nausea, headache, dizziness, nervousness, fatigue, trouble sleeping, vomiting, and anxiety. Some patients experience depression or mood changes, so monitoring mental health is important during treatment.
• Acamprosate (Campral): Side effects often involve gastrointestinal issues such as diarrhea, along with nausea, headache, and itching. It is generally well tolerated but requires dose adjustment in patients with kidney impairment.
• Disulfiram (Antabuse): Side effects include drowsiness, headache, metallic or garlic-like taste in the mouth, and peripheral neuropathy. When alcohol is consumed with disulfiram, severe reactions such as flushing, nausea, vomiting, and palpitations occur, which is the intended deterrent effect.

Side Effects of Naltrexone

Common side effects of naltrexone are given below:

• Nausea: A common gastrointestinal reaction causing discomfort and the urge to vomit.
• Headache: Persistent or recurrent pain in the head, often reported during treatment.
• Dizziness: Feelings of lightheadedness or unsteadiness, potentially affecting balance.
• Nervousness: Increased anxiety or restlessness, linked to the drug’s impact on neurotransmitters.
• Fatigue: Unusual tiredness or lack of energy, possibly due to metabolic adjustments.
• Vomiting: Severe nausea leading to involuntary expulsion of stomach contents.
• Abdominal cramps: Spasmodic pain in the stomach or intestines, a frequent digestive side effect.

Side Effects of Acamprosate

Common side effects of acamprosate are given below:

• Weakness: A pervasive feeling of reduced strength and persistent physical fatigue that impairs daily activities.
• Decreased appetite: A significant reduction in the desire to eat, which leads to unintended weight loss and nutritional deficiencies.
• Diarrhea: The occurrence of frequent, loose, or watery bowel movements that disrupt normal digestion and hydration.
• Gas: Excessive intestinal gas causing bloating, abdominal discomfort, and a sensation of fullness.
• Nausea: A persistent feeling of queasiness that often accompanies an urge to vomit and affects overall well-being.
• Anxiety: Elevated feelings of worry, tension, and unease that interfere with concentration and emotional stability.
• Depression: A prolonged state of low mood characterized by loss of interest in activities and feelings of hopelessness.
• Dizziness: A sensation of lightheadedness or imbalance that worsens with movement and affects coordination.
• Dry mouth: Reduced saliva production resulting in oral dryness, difficulty swallowing, and discomfort.
• Trouble sleeping: Challenges in falling asleep or maintaining sleep, leading to insomnia and daytime fatigue.
• Itching: An uncomfortable skin sensation that prompts scratching and is caused by allergic reactions or skin conditions.
• Sweating: Excessive perspiration that occurs independently of physical activity or environmental heat, often signaling underlying issues.
• Numbness or tingling: Pins-and-needles sensations typically in the extremities, indicating nerve involvement or circulation problems.

Side Effects of Disulfiram

Common side effects of disulfiram are given below:

• Drowsiness: An unusual feeling of sleepiness or decreased alertness that impairs focus and activity levels.
• Tiredness: Persistent fatigue or lack of energy that occurs independently of physical exertion and affects daily functioning.
• Impotence: Difficulty achieving or maintaining an erection in males, impacting sexual performance and confidence.
• Acne: Sudden appearance of pimples or skin breakouts that affect facial or body skin.
• Skin rash: Red, itchy, or irritated patches on the skin that cause discomfort and indicate an allergic reaction.
• Headache: Mild to moderate headache that recurs and disrupts concentration and daily tasks.
• Metallic taste: A bitter or garlicky flavor sensation in the mouth that persists and affects taste perception.
• Nausea: Ongoing queasiness or an urge to vomit that diminishes appetite and causes discomfort.

What Are the Alternative Treatments to Alcohol Addiction Medication?

The alternative treatments to alcohol addiction medication are behavioral therapy approaches, peer support communities, holistic recovery methods, and dietary wellness strategies. These non-pharmacological interventions are effective alcohol addiction treatment options either alone or as a complement to medication.

Here are the common alternative treatments to alcohol addiction medication:

• Behavioral Therapies: Behavioral therapies are structured psychological treatments that focus on changing drinking behaviors and thought patterns associated with alcohol use. These therapies include approaches such as Cognitive Behavioral Therapy (CBT), which helps individuals identify and replace negative thinking and behaviors; Motivational Interviewing, which builds motivation for change; Contingency Management, which uses rewards to reinforce sobriety; and Dialectical Behavior Therapy (DBT), which teaches emotional regulation and coping skills. Behavioral therapies are delivered by trained professionals in individual or group settings and are proven to reduce alcohol consumption, support long-term recovery, and address co-occurring mental health issues.
• Support Groups: Support groups are peer-led gatherings where individuals share experiences, challenges, and successes related to alcohol recovery. The most well-known example is Alcoholics Anonymous (AA), which follows a 12-step program focused on mutual support, personal accountability, and spiritual growth. Other options include SMART Recovery, which uses cognitive and behavioral techniques, and secular groups like LifeRing. Support groups foster a sense of community, reduce isolation, and provide ongoing encouragement, making them a valuable resource for maintaining sobriety and preventing relapse.
• Holistic Approaches: Holistic approaches address the whole person—mind, body, and spirit—rather than focusing solely on alcohol use. These treatments include practices such as mindfulness meditation, yoga, acupuncture, art therapy, and exercise programs. Holistic methods aim to reduce stress, improve emotional well-being, and support healthy lifestyle changes. Exercise, for example, has been shown to promote neural adaptations that help reduce alcohol cravings and improve mood, while mindfulness practices enhance self-awareness and coping skills.
• Nutritional Support: Nutritional support involves dietary counseling and supplementation to correct deficiencies commonly found in individuals with alcohol addiction. Treatment includes balanced meal planning, vitamin and mineral supplementation, and education on healthy eating habits. Nutritional support helps restore physical health, improve energy levels, and support brain function, all of which contribute to better treatment outcomes and sustained recovery.

Can Medication Alone Cure Alcohol Addiction?

No, medication alone does not cure alcohol addiction. While pharmacotherapy is effective in treating alcohol use disorders (AUDs), a comprehensive approach appears most beneficial.

According to van Amsterdam, J.’s 2022 study, ‘The Added Value of Pharmacotherapy to Cognitive Behavior Therapy And Vice Versa in the Treatment of Alcohol Use Disorders: A Systematic Review’, only 33% of studies (3 out of 9 randomized controlled trials) showed a potential added value when comparing combined therapy (psychotherapy + pharmacotherapy) to pharmacotherapy alone. This suggests that in 67% of studies, medication alone was not significantly improved by adding psychotherapy, indicating medication is effective but does not provide complete treatment for alcohol use disorders.

How Effective Are Medications In Treating Alcohol Addiction?

Alcohol addiction medications are effective tools in treating alcohol use disorder, especially when combined with counseling and support.

According to Bahji, A., Bach, P.’s 2022 study, ‘Pharmacotherapies for Adults With Alcohol Use Disorders: A Systematic Review and Network Meta-analysis’, oral naltrexone (50 mg/d) improved total abstinence by 15% and reduced heavy drinking by 19% compared to placebo. Acamprosate (2-3 g/d) showed a 33% improvement in total abstinence and a 22% reduction in heavy drinking over placebo. Disulfiram (250-500 mg/d) demonstrated the strongest effects with a 71% improvement in total abstinence and an 81% reduction in heavy drinking compared to placebo. These medications, along with baclofen (30 mg/d), have the strongest evidence for effectiveness in treating alcohol addiction.

Are There Any Off-Label Medications Used For Alcohol Addiction?

Yes, several off-label medications are used to treat alcohol addiction, including Topiramate and Baclofen, and Gabapentin. 

Topiramate, an antiepileptic drug, reduces alcohol cravings and consumption by modulating neurotransmitter activity, particularly enhancing GABA and inhibiting glutamate, which helps stabilize brain chemistry disrupted by alcohol use. 

Baclofen, a GABA-B receptor agonist originally approved for muscle spasticity, decreases alcohol craving and withdrawal symptoms by calming overactive neural pathways; it is approved for alcohol use disorder in France but remains off-label elsewhere due to mixed evidence and safety concerns at higher doses. 

According to Jose, N. A.’s 2019 study, ‘Comparison between baclofen and topiramate in alcohol dependence: A prospective study’, baclofen outperformed topiramate in treating alcohol dependence. Baclofen achieved a 61.22% complete abstinence rate compared to topiramate’s 37.78%. The dropout rate for baclofen was lower at 24.49% versus 33.33% for topiramate. Baclofen showed faster results, with 48.98% of patients reaching complete abstinence within 2 weeks, while topiramate achieved this in only 17.78% of patients. Baclofen demonstrated significant craving reduction at week 1, whereas topiramate required 2 weeks to show similar improvements.

Gabapentin, another anticonvulsant, reduces withdrawal symptoms and cravings by affecting calcium channels and GABA neurotransmission, showing promising results in reducing heavy drinking. These medications lack FDA approval for alcohol addiction because of limited large-scale clinical trials, inconsistent results, and concerns about side effects or long-term safety, but they are increasingly prescribed based on emerging evidence and clinical judgment.

Do You Need A Prescription For Alcohol Addiction Medications?

Yes, you need a prescription for alcohol addiction medications. These medications, including naltrexone, acamprosate, and disulfiram, are approved by the U.S. Food and Drug Administration for the treatment of alcohol use disorder and must be prescribed by a licensed healthcare provider. Access to these medications without a prescription is not permitted, ensuring safe and effective management of alcohol addiction based on individual medical history and needs

According to Kranzler, H. R.’s 2018 study, ‘Diagnosis and Pharmacotherapy of Alcohol Use Disorder: A Review’, despite evidence of their effectiveness, these medications are underutilized, with less than 9% of patients who could benefit from medication receiving prescriptions, while most patients with AUD receive counseling instead of medication.

Are Alcohol Addiction Medications Safe?

Yes, alcohol addiction medications are safe when used under medical supervision. Medications such as naltrexone, acamprosate, and disulfiram have well-established safety profiles and are effective for treating alcohol use disorder (AUD) in patients without advanced liver disease or other contraindications.

According to Ehrie, J.’s 2020 study, ‘Survey of Addiction Specialists’ Use of Medications to Treat Alcohol Use Disorder, ’ naltrexone is considered the safest medication for treating Alcohol Use Disorder (AUD). For oral naltrexone, 69.1% of prescribers reported few side effects, and only 0.6% reported very severe effects. Long-acting naltrexone showed a similar safety profile, with 65.0% reporting few effects.

Disulfiram had the most concerning safety profile, with 38.7% of specialists reporting severe or very severe side effects. Acamprosate demonstrated good tolerability, with 59.0% reporting few effects and 9.6% reporting no side effects at all. Topiramate had moderate concerns, with 48.0% reporting some side effects that limit prescribing. Specialists were most uncertain about baclofen, with 31.4% unable to rate its safety profile.

Can You Take Alcohol Addiction Medication While Pregnant?

No, you should not take alcohol addiction medications during pregnancy without medical supervision due to limited safety data and potential risks to the developing fetus. According to Kelty, E.’s 2021 study, ‘Pharmacotherapies for the Treatment of Alcohol Use Disorders During Pregnancy: Time to Reconsider?’, disulfiram causes serious fetal harm, while acamprosate and naltrexone present no substantial risks of congenital malformations or serious consequences. The authors recommend acamprosate and naltrexone for pregnant women with alcohol use disorder, weighing these medications’ safety profiles against the established dangers of continued alcohol consumption during pregnancy.