If you ask yourself, “Why can’t I stop drinking?” and are ready to quit alcohol, there is good news. Medications can help you reduce drinking, avoid relapse, or abstain from alcohol … even if you’ve already tried 12 step meetings or psychotherapy.
FDA approved medications such as acamprosate, disulfiram and naltrexone can both reduce your desire to drink and promote abstinence. Here, we review how well these medications work and evaluate whether or not more is needed from you. Can you really stop drinking just by taking pills? We explore here.
Medications to stop drinking
Alcohol use disorder is a medical term for problem drinking. Check out the Alcohol Use Disorders Identification Test on page 17 of the WHO guidelines for alcohol screening to learn more about how doctors diagnose problem drinking. If you think that you have a drinking problem (or have been diagnosed with one) and want to cut back or stop drinking totally, there are medications which can help you.
The medication you use will depend on your doctor’s judgment and your personal preferences and goals. Be prepared to try the medicine for at least 3 months, although your doctor may recommend that you stay on the medication for a year or longer if the treatment is working. Why so long? Well, because relapse to heavy drinking is very common within the first year of sobriety. But as each medicine has a different mechanism of action and your response may be better to one type of medication than another, be flexible and work with your doctor to achieve your goals. The main pills used to help you stop drinking include:
Acamprosate – Acamprosate acts on the GABA and glutamate neurotransmitter systems and is believed to reduce insomnia, anxiety, restlessness, and unpleasant mood which is usually characteristic of intermediate term abstinence from alcohol. Although the effectiveness of Acamprosate is still not proven, Acamprosate has been helpful to people who have determined a goal of abstinence.
Disulfiram – Commonly known as Antabuse, this medication inhibits the intermediate metabolism of alcohol. The idea is that taking Antabuse will motivate you to stay away from drinking in order to prevent the symptoms that drinking will cause. In other words, if you take a Disulfiram tablet and THEN drink, you will get sick. The result is a buildup of acetaldehyde and common reactions include flushing, sweating, nausea, and increased heart rate.
Naltrexone – Naltrexone works by blocking opioid receptors, which results in reduced alcohol craving and reduced reward in response to drinking. Naltrexone particularly helps reduce relapses and is often used for people who experience occasional slips in the first months of sobriety. Naltrexone is less effective in maintaining abstinence.
Can pills help you stop drinking?
Given the evidence from clinical trials, and anecdotal experience…yes, medications such naltrexone, acamprosate, and disulfiram as can help you stop drinking. In fact, people who do not respond to psychosocial approaches alone are particularly strong and responsive candidates for medication treatment. But you must have a willingness to be and stay sober in order to stay off the booze. And furthermore, no single approach is universally successful or appealing to everyone. So, experts recommend that you COMBINE alcohol dependence medications with the full range of effective treatments to increase your chances of staying sober. These include:
- Behavioral therapy for alcoholism
- Behavioral support from your prescribing doctor
- Professional medical counseling
- Professional psychological counseling
- Peer support groups (plus 12 step alternatives)
In sum, no matter which alcohol dependence medication you use, if you have a goal of abstinence, or if you can abstain from drinking even for a few days prior to starting the medication, you are more likely to have better outcomes. And you cannot rely on medications alone. You will need to identify other treatment options that can work for you in the long run, if you want to stay sober.
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