How to Treat Alcohol Addiction with Medication

Alcohol addiction impacts millions of Americans, yet effective treatment exists. Medication-assisted treatment combines FDA-approved medications with therapy to minimize cravings and reduce relapse risk.

How Medication-Assisted Treatment Works

The Science Behind MAT

Medication-assisted treatment addresses the brain chemistry changes caused by chronic alcohol consumption. Despite evidence showing better outcomes with combined approaches, only 7.9% of individuals with alcohol use disorder obtain treatment.

Integration with Professional Therapy

MAT achieves optimal results when paired with:

• Behavioral counseling
• Support groups
• Individual therapy
• Holistic approaches

Research shows patients receiving combined medication and behavioral therapy maintain abstinence 40% longer than those receiving medication alone.

Evidence-Based Outcomes

Both the Department of Veterans Affairs and UK's National Institute for Health and Care Excellence recommend these medications as first-line treatments based on demonstrated effectiveness.

FDA-Approved Medications

Naltrexone: Blocking Alcohol's Effects

Naltrexone blocks opioid receptors that create alcohol's pleasurable effects, reducing cravings and the satisfaction from drinking.

Available forms:

• Daily 50mg pill
• Monthly injection (Vivitrol)

Effectiveness:

• Reduces heavy drinking days with a number needed to treat of 11
• Injectable form reduces drinking days by approximately 5 days monthly compared to placebo
• Users experience decreased satisfaction from alcohol

Best for: Individuals aiming to reduce rather than eliminate alcohol use, though it supports abstinence as well.

Acamprosate: Restoring Brain Chemistry

Acamprosate helps restore normal brain chemistry following alcohol withdrawal, reducing anxiety, insomnia, and restlessness that trigger relapse.

Dosing: Two tablets three times daily

Effectiveness: Prevents one person from returning to any drinking for every 11 people treated

Best for: Patients who have achieved initial abstinence and need support maintaining sobriety. Works optimally with complete abstinence.

Disulfiram: Creating Physical Deterrence

Disulfiram produces severe physical reactions when combined with alcohol by blocking aldehyde dehydrogenase, causing toxic acetaldehyde buildup.

Effects when drinking:

• Nausea and vomiting
• Rapid heartbeat
• Facial flushing
• Symptoms begin within 10-30 minutes

Best for: Highly motivated patients wanting a strong physical barrier against impulsive drinking. Requires medical supervision or family oversight.

What to Expect During Treatment

Initial Assessment

Treatment begins with a comprehensive 60-90 minute evaluation assessing:

• Consumption patterns and history
• Withdrawal history and severity
• Current medications and interactions
• Co-occurring mental health conditions
• Medical history including liver and kidney function

Blood tests examine liver function, kidney health, and nutritional deficiencies. This assessment determines appropriate medication selection—patients with liver damage typically receive naltrexone, while those seeking abstinence often start acamprosate.

Medical Monitoring and Adjustments

First month: Weekly appointments for monitoring and adjustment

Ongoing: Bi-weekly visits as stability improves

Expected timeline:

• Naltrexone: Reduced cravings within 7-14 days
• Acamprosate: Benefits emerge after 2-3 weeks

Medical staff monitor:

• Side effects
• Alcohol consumption through standardized questionnaires
• Treatment response
• Need for dosage adjustments

Combining with Behavioral Therapy

MAT functions optimally with:

• Weekly individual therapy: Identifies triggers and develops coping strategies through CBT
• Support groups: Typically twice weekly during early treatment
• Family involvement: Education and support for loved ones

Most patients see significant improvement within 30 days with consistent medication use and active therapy participation.

Managing Side Effects

Common Naltrexone Side Effects

• Nausea (15-20% of users)
• Headaches (10%)
• Fatigue (12%)

These typically diminish after initial weeks. Liver function monitoring is essential before and during treatment.

Common Acamprosate Side Effects

• Diarrhea
• Nausea
• Headaches

Side effects are generally mild and decrease over time.

Disulfiram Considerations

Requires complete alcohol avoidance including:

• Alcohol-containing foods and sauces
• Certain medications
• Some personal care products

Patients must understand the severe reaction that occurs with any alcohol consumption.

Final Thoughts

Medication-assisted treatment provides powerful tools for alcohol addiction recovery. Three FDA-approved options target different recovery aspects:

• Naltrexone: Reduces cravings and alcohol's rewarding effects
• Acamprosate: Maintains sobriety by restoring brain chemistry
• Disulfiram: Creates physical deterrence against drinking

The most effective approach combines medication with behavioral therapy and support systems. Medical professionals match treatment to individual needs and goals, creating personalized plans for sustainable recovery.

Amity Behavioral Health provides comprehensive medication-assisted treatment programs with board-certified physicians and licensed therapists. Contact us to learn how MAT can support your recovery journey.