Monday July 23rd 2018

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Does disulfiram help with alcohol cravings?

No. Disulfiram does not directly address alcohol cravings.

Disulfiram produces a sensitivity to alcohol which results in a highly unpleasant reaction if/when you drink even small amounts of alcohol. So, if disulfiram DOES NOT target cravings, how is disulfiram used in the treatment of alcoholism? We review here. Then, we invite your questions and comments in the section at the bottom of the page.

What is an alcohol craving?

As you change drinking patterns, it’s normal and common to have urges or a craving for alcohol. The words “urge” and “craving” refer to a broad range of thoughts, physical sensations, or emotions that tempt you to drink, even though you have at least some desire not to. You may feel an uncomfortable pull in two directions or sense a loss of control.

Fortunately, urges to drink are short-lived, predictable, and controllable. In fact, when you apply a recognize-avoid-cope approach commonly used in cognitive behavioral therapy, you can change unhelpful thinking patterns and reactions. It also helps to uncover the nature of your urges to drink and to make a plan for handling them. Learning to cope with alcohol cravings takes practice. So, how can disulfiram help you deal with alcohol cravings at the same time?

How can disulfiram help with alcohol cravings?

Disulfiram is used to help maintain sobriety in the treatment of chronic alcoholism as a deterrent to drinking. In fact, it’s one of the FDA approved medications used to stop drinking. When used in conjunction with supportive and psychotherapeutic measures, it can be successful in creating longer periods of sobriety or total abstinence. How does it work?

Disulfiram causes unpleasant effects when even small amounts of alcohol are consumed. Specifically, it blocks the oxidation of alcohol at the acetaldehyde stage. During alcohol metabolism following disulfiram intake, the concentration of acetaldehyde occurring in the blood may be 5 to 10 times higher than normal. This results in effects which can include:

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  • anxiety
  • blurred vision
  • breathing difficulty
  • chest pain
  • flushing of the face
  • headache
  • mental confusion
  • nausea
  • sweating
  • vomiting
  • weakness

These effects begin about 10 minutes after alcohol enters the body and last for 1 hour or more. Disulfiram stays in your system for about a couple of weeks after regular dosing…enough time to help you change behaviors and motivate you to stay sober. But to repeat, disulfiram is not a cure for alcoholism, but discourages drinking.

Disulfiram prescription for alcohol cravings

Disulfiram comes in tablets to take by mouth. It should be taken once a day. If you cannot swallow the tablets, crush them and mix the medication with water, coffee, tea, milk, soft drink, or fruit juice.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take disulfiram exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Disulfiram can help alcohol cravings (or it may not)

Disulfiram’s effects on craving have not been specifically evaluated in clinical trials. However, disulfiram has been shown to interfere with the metabolism of dopamine, potentially influencing the development of craving. Still, recent reviews of placebo-controlled clinical trials with disulfiram have failed to confirm the drug’s efficacy in alcoholism treatment. When used in combinations with psycho-social therapy, disulfiram may decrease
the quantity and frequency of drinking among recovering alcoholics, but the medication does not appear to increase the proportion of patients who maintain total abstinence.

Furthermore, disulfiram is contraindicated in persons who are currently intoxicated by alcohol, or who have been diagnosed with cardiovascular disease, or psychoses. Disulfiram is also contraindicated in individuals hypersensitive to the drug or other thiuram derivatives such as those used in pesticides or rubber vulcanization. People with a history of rubber contact dermatitis should be evaluated for hypersensitivity to thiuram derivatives prior to administration of disulfiram.

Disulfiram help with alcohol cravings questions

Did we answer all your questions related to alcohol cravings and the use of disulfiram? If you have any further questions you’d like to ask, please post them in the comments section at the end of the page. We try to answer each legitimate inquiry with a personal and prompt response.

Reference Sources: NIAAA: Medications and alcohol cravings
NIH: Handling urges to drink
NCBI: Efficacy of disulfiram for the treatment of alcohol dependence assessed with a multicenter randomized controlled trial
MedlinePlus: Disulfiram
Pubchem: Disulfiram
DailyMed: ANTABUSE- disulfiram tablet

Photo credit: Daily Med

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4 Responses to “Does disulfiram help with alcohol cravings?
8:04 am June 25th, 2015

I like most of your points. Nowadays alcohol addiction problem is increasing and becoming a big concern.

2:40 pm June 26th, 2015

That’s true Suresh. Also, we are lucky that our understanding for people’s needs in alcoholism recovery is also growing.

10:35 pm June 30th, 2015

Great post! I learned a few things I didn’t know about Disulfiram before.

8:55 pm August 7th, 2015

Great post. Many don’t really understand that there can be a craving with alcohol, they associate that with hard drugs so they don’t seek help. Thanks for posting.

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