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Types of Treatment

 

Medications

There are medications on the market approved to treat alcohol dependence. The newer types of these medications work by offsetting changes in the brain caused by alcoholism.

All approved medications are non-addictive and can be used alone or in combination with other forms of treatment. Three medications are currently approved in the United States to help people stop or reduce their drinking and prevent relapse. They are prescribed by a primary care physician or other health professional and may be used alone or in combination with counseling.

 

FDA-Approved Medications Available

Certain medications have been shown to effectively help people stop or reduce their drinking and avoid relapse.

Current Medications

The U.S. Food and Drug Administration (FDA) has approved three medications for treating alcohol dependence, and others are being tested to determine if they are effective.

  • Naltrexone can help people reduce heavy drinking.
  • Acamprosate makes it easier to maintain abstinence.
  • Disulfiram blocks the breakdown (metabolism) of alcohol by the body, causing unpleasant symptoms such as nausea and flushing of the skin. Those unpleasant effects can help some people avoid drinking while taking disulfiram.

It is important to remember that not all people will respond to medications, but for a subset of individuals, they can be an important tool in overcoming alcohol dependence.

Scientists are working to develop a larger menu of pharmaceutical treatments that could be tailored to individual needs. As more medications become available, people may be able to try multiple medications to find which they respond to best.

“Isn’t taking medications just trading one addiction for another?” This is not an uncommon concern, but the short answer is “no.” All medications approved for treating alcohol dependence are non-addictive. These medicines are designed to help manage a chronic disease, just as someone might take drugs to keep their asthma or diabetes in check.

 

Looking Ahead: The Future of Treatment

Progress continues to be made as researchers seek out new and better treatments for alcohol problems. By studying the underlying causes of alcoholism in the brain and body, NIAAA is working to identify key cellular or molecular structures — called “targets” — that could lead to the development of new medications.

Personalized Medicine

Ideally, health professionals would be able to identify which alcoholism treatment is most effective for each person. NIAAA and other organizations are conducting research to identify genes and other factors that can predict how well someone will respond to a particular treatment. These advances could optimize how treatment decisions are made in the future.

Certain medications already approved for other uses have shown promise for treating alcohol dependence and problem drinking:

  • The anti-smoking drug varenicline (marketed under the name Chantix) significantly reduced alcohol consumption and craving among people with alcoholism.
  • Gabapentin, a medication used to treat pain conditions and epilepsy, was shown to increase abstinence and reduce heavy drinking. Those taking the medication also reported fewer alcohol cravings and improved mood and sleep.
  • The anti-epileptic medication topiramate was shown to help people curb problem drinking, particularly among those with a certain genetic makeup that appears to be linked to the treatment’s effectiveness.

 

An Ongoing Process

Overcoming an alcohol use disorder is an ongoing process, one which can include setbacks.

The Importance of Persistence

Because an alcohol use disorder can be a chronic relapsing disease, persistence is key. It is rare that someone would go to treatment once and then never drink again. More often, people must repeatedly try to quit or cut back, experience recurrences, learn from them, and then keep trying. For many, continued followup with a treatment provider is critical to overcoming problem drinking.

Relapse Is Part of the Process

Relapse is common among people who overcome alcohol problems. People with drinking problems are most likely to relapse during periods of stress or when exposed to people or places associated with past drinking.

Just as some people with diabetes or asthma may have flare-ups of their disease, a relapse to drinking can be seen as a temporary set-back to full recovery and not a complete failure. Seeking professional help can prevent relapse — behavioral therapies can help people develop skills to avoid and overcome triggers, such as stress, that might lead to drinking. Most people benefit from regular checkups with a treatment provider. Medications also can deter drinking during times when individuals may be at greater risk of relapse (e.g., divorce, death of a family member).

Mental Health Issues and Alcohol Use Disorder

Depression and anxiety often go hand in hand with heavy drinking. Studies show that people who are alcohol dependent are two to three times as likely to suffer from major depression or anxiety over their lifetime. When addressing drinking problems, it’s important to also seek treatment for any accompanying medical and mental health issues.

Importance of Family/Friend Support

Caring for a person who has problems with alcohol can be very stressful. It may help to seek support from others, including friends, family, community, and support groups.

However, family/friend participation can make a big difference. Based on clinical experience, many health providers believe that support from friends and family members is important in overcoming alcohol problems. But friends and family may feel unsure about how best to provide the support needed.

Remember that changing deep habits is hard, takes time, and requires repeated efforts. Experiencing failures along the way, is expected; learn from them, and then keep going. Alcohol use disorders are no different. Be patient with your family member/friend. Overcoming this disorder is not easy or quick.

Pay attention to your family member/friend when he or she is doing better or simply making an effort. Too often there is so much anger or discouragement that good things and/or times are taken for granted. A word of appreciation or acknowledgement of a success can go a long way.