Alcohol Abstinence Medications

Alcohol Abstinence Medications

Medicines to Treat Alcoholism and Prevent Relapse

Staying Sober Medications

Getting sober and staying sober are two completely different things. Each have their challenges.

Whilst it could be said that medical alcohol detox makes it pretty straightforward to stop drinking using pharmacological interventions to help ease the withdrawals, it’s not always the case for everyone. This is especially true if a medical detox is hard to come by and the person has stopped by cold turkey. The process of stopping drinking and detoxing should take roughly a week to achieve, whether using medications or going it alone (which is often dangerous).

How one stays sober after stopping drinking is another matter. While abstinence from alcohol is a main goal, maintaining sobriety can be a huge struggle due to varying factors such as cravings, triggers and environmental influences. In addition, not everyone who gets sober manages to enter sobriety with their life intact and rosy. Often, people have relationship issues, work issues, social and housing issues, as well as a whole host of negative feelings and self-flagellation thinking including guilt and shame. It’s all of this combined that often leads people to relapse. Sometimes, it takes times to sort through the mess that alcohol addiction brings and alcohol relapse prevention medications have been developed to do exactly that, provide support in the journey by helping to reduce the risk of returning to drinking.

Benefits of Using Alcohol Medications

Reduces relapse: Alcohol relapse prevention medications are designed to lower the risk of relapse for people. They work by targeting the neuro-biological pathways associated with addiction helping to mitigate cravings and making it easier for people to remain sober.

Improves outcomes: Medications combined with counselling and other good forms of support can significantly enhance the effectiveness of addiction treatment. By reducing the chances of relapse, people have a better opportunity to engage in the therapeutic process and work on addressing the issues contributing to their alcohol use.

Quality of life: Maintaining abstinence from alcohol leads to improved quality of life. Relapse prevention medications can help people regain control over their lives, mend relationships and regain physical and mental health.

Structured approach: Alcohol medications are usually safe when prescribed and monitored by medical professionals. They provide a structured and planned approach to recovery, reducing the chance of relapse.

Personalised: The choice of medication is tailored to specific needs and circumstances meaning treatment aligns with, and promotes, sober goals.

Long-term recovery: Alcohol relapse prevention medications can be particularly valuable for people who really need, and want, long-term recovery. They are intended to be used over extended periods, helping people establish and maintain a sober lifestyle.

Prevents consequences: Chronic relapses can be very dangerous as tolerance levels lower during sober spells meaning relapsing and old drinking patterns become dangerous for the brain and body to handle. Sobering up and relapsing in periodical batches can have severe health consequences. In addition, the consequences of drinking including accidents, legal issues, drink driving (DUI) and strained relationships can all be prevented using medication.

Medications offer an evidence-based approach to reducing the risk of relapse, supporting people in their journey toward sustained abstinence and, ultimately, improving overall well-being. When used in conjunction with counselling, therapy and strong support systems, the medications below and contribute to a holistic approach to addiction treatment and recovery.

Acamprosate (Campral)

Acamprosate is an anti-craving medication used in the treatment of alcoholism, particularly in post-detox alcohol recovery. It works by helping people who have stopped drinking alcohol to maintain abstinence by reducing cravings and withdrawal symptoms.

What is Acamprosate?

Acamprosate is also known under the brand name Campral. It’s a medication for the treatment of alcohol dependence. Acamprosate is thought to work by calming certain neurotransmitter systems in the brain that are affected by chronic alcohol use. In short, it works by reducing cravings for alcohol. It’s not a medication to help people stop drinking but rather to help them remain abstinent after they have stopped drinking.

Benefits of Acamprosate in Alcohol Recovery

Reduces Alcohol Cravings: Acamprosate is believed to help reduce the intensity and rate of alcohol cravings. This is particularly helpful during the early stages of recovery when cravings are at their strongest and difficult to deal with.

Withdrawal symptom management: While it’s not typically used during the acute detox phase, it may be introduced in the post-detox phase to help manage any lingering withdrawal symptoms or discomfort including anxiety and restlessness.

Helps sobriety: Acamprosate is designed to help people remain alcohol-free by reducing the urge to relapse. It supports long-term abstinence.

Few side effects: it is generally well tolerated and doesn’t have many side effects compared to some other medications used to help sobriety. It’s a great option for many people.

Not addictive: Acamprosate itself is not addictive and doesn’t lead to physical dependence, which is ideal for those with a propensity to addiction.

Accompanies other therapies: Campral is often used as part of a comprehensive treatment program that includes counselling, support groups and other treatments.

Acamprosate is a valuable tool in post-detox alcohol treatment, but it works best when used as part of a better, more comprehensive recovery and treatment plan people should only use Acamprosate via a healthcare professional – usually a doctor or other addiction specialised who knows about other treatments the client may be undertaking.

Disulfiram (Antabuse)

Disulfiram, also known as Antabuse, is a medication used in the treatment of alcohol dependence and alcoholism.  It’s always used post-detox. It is pretty unique among medications used for alcohol dependence because it creates a strong aversion to alcohol drinking by causing rather unpleasant and harmful physical reactions when alcohol is consumed. Disulfiram can be obtained from the NHS – either from GPs or referral to local addiction teams – or by private Disulfiram (Antabuse) prescription in the UK.

What is Disulfiram?

Disulfiram is used to deter people from drinking alcohol. It comes in tablet form and is taken orally. When someone takes Disulfiram, it interferes with the body’s ability to metabolise alcohol. As a result, if a person drinks alcohol while on Disulfiram, they will experience unpleasant and often severe physical and psychological reactions. These range from feeling nauseous to sickness and vomiting, increased heart rate, diarrhoea, profuse sweating, blurred vision, flushing and skin redness. For people with heart conditions, drinking whilst on Antabuse can be very dangerous.

Benefits of Disulfiram in Alcohol Recovery

Alcohol deterrent: Disulfiram creates a strong aversion to drinking alcohol. When someone is aware of the consequences of drinking while on this medication, it provides a really strong deterrent against relapse.

Reinforces abstinence: Knowing that consuming alcohol will lead to uncomfortable and potentially dangerous reactions reinforces commitment to abstinence and promotes long-term sobriety.

Accountability: Disulfiram places the responsibility for maintaining abstinence directly on the person. It helps empower them to make good choices and not to drink. It backs up willpower.

Reduces Cravings: By the very nature of the unpleasant side effects of drinking on the drug, Disulfiram can help reduce the intensity and frequency of alcohol cravings, because alcohol just isn’t (or shouldn’t be) an option.

Generally safe: Disulfiram is usually rather safe to use under medical supervision, with relatively few side effects when taken as prescribed.

Not addictive: The medication is non-addictive and does not lead to any physical dependence on it, which isn’t aways the case with other abstinence meds.

Long-lasting effects: The deterrent persists when Disulfiram is in the system making it a good long-term tool in abstinence. Even if the person chooses to stop taking it, it remains in the system for a period of time. In tablet form, the drug is still in the system for around a week, whilst the implant form can last up to six months. This is great for avoiding sudden cravings and when people plan to stop taking it should they wish to drink any time soon due to the lasting effects.

People should be well-informed about the potential consequences of drinking while on the medication and it’s most effective when people are motivated to remain in recovery.

Disulfiram should only be used under the guidance and supervision of a healthcare professional. Like other medications for abstinence, when it’s used as part of wider recovery plan including counselling and support groups, there’s a higher chance of long-term sobriety.

Naltrexone

Naltrexone works by blocking the effects of alcohol on the brain and is proven to help people stay sober. Drinking alcohol activates the opioid receptors in the brain that produce feelings of pleasure and reward. By using this medication to block these opioid receptors, people don’t experience the same pleasurable effects from drinking alcohol.

What is Naltrexone?

Naltrexone is a medication that is used to help people reduce their drinking and stay sober. It’s also used to help people safely detox from alcohol as well as reducing cravings for alcohol. This is because it blocks the release of the neurotransmitter dopamine that’s involved in motivation and reward when it comes to substances.

Naltrexone is also a safe and effective drug for alcohol detox and withdrawal. It can help to reduce the severity and duration of withdrawal symptoms in addition to helping prevent relapse.

Benefits of Naltrexone for Alcohol Recovery

Reduces cravings: Naltrexone blocks the opioid receptors in the brain which are responsible for the pleasurable effects of alcohol. By reducing these pleasurable effects, naltrexone makes drinking less desirable and therefore reduces cravings.

Decreases the risk of relapse: Studies have shown that Naltrexone can significantly reduce the risk of relapse because it makes it less likely that a person will experience the rewards to the brain and body of drinking alcohol. This, naturally, leads to lowering triggers and relapse.

Promotes abstinence: Naltrexone can help people achieve and maintain abstinence from alcohol. As well as contributing to the reduction in the pleasures of drinking, it helps cravings and brings a sense of control to people helping them to choose not to drink.

Improves general health: Indirectly, by helping people stay off alcohol, Naltrexone leads to improvement of health due to the negative effects drinking alcohol has on the brain and body.

Not Addictive: It’s not addictive so there’s no risk of developing a dependence on the medication.

Fewer side effects: Compared to a lot of other medications used for alcohol abstinence, Naltrexone has a lot fewer and less severe side effects. The most common side effects are mild and usually go away on their own.

Different Dosage: Naltrexone is available in both pill form and as in slow release injectable form. The pill is taken once a day while the injectable form is given once every four weeks, and sometimes 3 or 6 months. This flexibility allows people to choose the option that best suits their needs and preferences.

Overall, Naltrexone is a safe and effective medication that is a great tool for people who are trying to stop drinking and stay stopped too. Like many of alcohol medications, Naltrexone is at its most effective when used in conjunction with other therapeutic alcohol treatments.

Nalmefene

Nalmefene is a medication that is used to treat opioid overdose and alcohol dependence. It is an opioid antagonist, which means that it blocks the effects of opioids on the brain. Nalmefene can be taken by mouth, administered by injection, or delivered through nasal administration.

What Is Nalmefen?

Nalmefene is a medication that has been used to help people reduce or stop drinking alcohol. It is primarily indicated for the treatment of alcohol dependence, specifically in people who have high levels of alcohol consumption. Nalmefene is often used alongside psychological support as part of a wider treatment plan.

Benefits of Nalmefene For Alcohol Recovery

Reduces drinking pleasure: Nalmefene is an opioid receptor modulator that acts on the brain’s reward system. It reduces the effects of alcohol making it less pleasurable which, as a consequence, helps reduce alcohol consumption.

Reduces cravings: Although still yet to be fully understood, research proves that Nalmefene reduces cravings for alcohol and the desire to drink too much.

For abstinence and harm reduction: Nalmefene is used to help people either reduce their alcohol to safer levels as well as to help those who wish to maintain complete abstinence from alcohol.

Helps heavy drinkers: Nalmefene is usually only prescribed for people who are very heavy drinkers or who have difficulty controlling their drinking. It’s not normally prescribed for binge drinkers.

Complements other therapies: Like many other medical interventions in recovery, Nalmefene is most effective when used in combination with other forms of recovery, including counselling and improved self-care. It is generally not used as a stand alone solution to alcohol addiction.

Although it is used in harm reduction, it’s best to avoid alcohol completely while on this medication as taking Nalmefene and alcohol together can lead to severe side effects. Like any medication, Nalmefene may have side effects including nausea, dizziness and fatigue but these should disappear on their own. Nalmefene is available on prescription only, and should be supervised by a medical or addiction specialist.

Baclofen

Baclofen is a medication that has gained attention for its potential benefits in alcohol recovery, although it is not a common drug to be prescribed in the UK.

What Is Baclofen?

Baclofen is a medication that is primarily used as a muscle relaxant and antispasmodic treatment. It’s used to treat muscle spasticity from conditions such as multiple sclerosis, spinal cord injuries, cerebral palsy and other neurological disorders. Its use in alcohol recovery is based on its impact on the GABA (gamma-aminobutyric acid) system in the brain, which plays a role in addiction. It is believed to reduce cravings for alcohol and help increase abstinence rates by regulating GABA in a settling manner, resulting in a calming effect on neurotransmitters.

Benefits of Baclofen and Alcohol Recovery

Reduces cravings: Baclofen may help reduce cravings for alcohol making it easier for people to resist the temptation to drink.

Decreases consumption: Some people have reported a reduction in the amount of alcohol they consume while taking the drug.

Deters: Baclofen has been reported to create an aversive reaction to drinking alcohol. When combined with booze, it may cause unpleasant sensations such as nausea which can act as a deterrent.

Improves abstinence: In some research, Baclofen has been associated with increased rates of abstinence from alcohol due to reduced cravings and the aversion effect.

Harm reduction: For people who may not achieve complete abstinence, Baclofen can help reduce excessive alcohol consumption.

Reduces anxiety: Baclofen may help alleviate anxiety and stress-related cravings for alcohol making it easier to maintain sobriety.

Comprehensive treatment: It can be used as part of a comprehensive treatment plan for recovery complementing counselling, therapy and support groups.

Personalised: Baclofen dosages can be adjusted to suit individual biological and psychological needs creating a personalised approach to recovery treatment.

Relapse prevention: By helping to minimise cravings and reducing the rewarding effects of alcohol, Baclofen lowers the risk of relapse.

While baclofen shows promise for some individuals, its effectiveness can vary from person to person and not everyone will experience the same benefits. There can also be side effects associated with its use. In addition, some of its long-term safety and efficacies for alcohol recovery are still being researched.

NAD+

NAD+ is used as a therapy for general well-being but also to treat conditions such as depression, anxiety, long-Covid and alcohol misuse has grown in recent years with many reporting its benefits in giving an over boost to the body and brain.

What Is NAD+?

NAD+ (pronounced nad plus) or Nicotinamide adenine dinucleotide is a naturally occurring molecule in the body that plays a vital role in energy production and cellular function. NAD is involved in many biological processes including metabolism and DNA repair. NAD+ therapy involves receiving NAD+ through infusion (drip or injection) or pills and has been suggested as a potential treatment for alcohol recovery.

There is, however, limited evidence on the effectiveness of NAD+ therapy for alcohol recovery. NAD+ therapy is considered a dietary supplement and sometimes a nootrpic, not a medicine per se, and it can be expensive. More and more detox clinics and rehab centres are offering NAD+ therapy, so there is anecdotal if not empirical evidence it works.

Potential Benefits of NAD+ in Alcohol Recovery

Reduced Cravings & Withdrawals: NAD+ is involved in cellular metabolism, and in particular, the production of energy. Some research suggests that plays a role in reducing cravings and withdrawal symptoms associated with alcohol dependence.

Repairs physical damage: NAD+ therapy research suggests that it can support the brain and body’s cellular repair processes during alcohol recovery, meaning it can help repair any physical damage done through excess alcohol consumption, in effect, kick-starting the physical healing process.

Comprehensive plan: NAD+ therapy is often administered in specialised treatment centres under the supervision of medics (well, the infusions anyway). For alcohol recovery, it works best when used alongside counselling, behavioural therapy and other forms of support for people in recovery.

Tailored approach: The suitability of NAD+ therapy for alcohol recovery and abstinence varies from person to person. Even although it may not work for some or have limited effect, due to varying factors such as the person’s overall health, medical history and specific needs, there is evidence that when it does suit an individual, it works very well.

Safe: NAD+ is generally considered safe when administered appropriately. For the correct dosage, it’s a good idea to consult with a qualified medical or specialist NAD+ professional before considering any NAD+ therapy.

Choosing Medication

Alcohol relapse medications are generally considered a good idea for most people because they can help reduce cravings, manage withdrawal symptoms and support long-term sobriety.

Medications like acamprosate, naltrexone and disulfiram have been approved in the UK for treating alcohol dependence and alcoholism.. Acamprosate helps balance brain chemistry, reducing the desire to drink. Naltrexone blocks the pleasurable effects of alcohol and reduces cravings. Disulfiram creates unpleasant reactions when alcohol is consumed, discouraging relapse. These medications can be – and should be – used in combination with therapy and support programs to enhance the chances of successful recovery.

Please consult a medical professional or addiction specialist such as Detox Today to determine the most suitable medication and treatment plan for your individual needs.

Getting Help for Alcohol Addiction

Alcohol addiction, and especially alcohol withdrawal, should never be taken lightly, as it can be a severe and potentially life-threatening condition. If you or someone you know is struggling with alcohol dependence and experiencing withdrawal symptoms, please seek professional help.

Treatment providers and medical professionals can provide the necessary support and guidance to safely manage alcohol withdrawal and develop a comprehensive treatment plan for alcohol dependence.

The selection of treatment setting, whether inpatient, outpatient or at home should be determined based on the individual’s specific needs, severity of symptoms and presence of comorbid medical or psychiatric conditions.

Treatment for alcohol withdrawal should always be followed by further treatment for alcohol dependence to address the underlying addiction and promote long-term recovery.

Seeking help from support groups such as Alcoholics Anonymous (AA), engaging in comprehensive treatment programs or taking abstinence medications such as those above, can provide additional support and resources for people on their journey to recovery.

Remember, recovery is possible, and seeking help is the first step towards a healthier and happier life free from alcohol dependence. Contact us today for free advice on how to start getting well from alcohol addiction.

Written by James McInally

This article was written by James McInally,
James is an addiction specialist and counsellor, mindfulness teacher, NLP practitioner, fitness instructor and well-being coach. He has helped hundreds of people overcome alcohol misuse.
Last updated on 16 August 2023

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