Medication for Alcohol Use Disorder

Interestingly, this study reported that serum glutamate levels of responders were normalized after acamprosate treatment, whereas there was no significant glutamate change in nonresponders; this provides further support for the hypothesis that acamprosate works to restore homeostasis in the brain glutamate system. By developing such predictors, it may be possible to improve patient treatment matching and the overall success rate of acamprosate—and, to that end, any pharmacotherapy used in the treatment of AUD. “Although medical management is somewhat more intensive than the alcohol dependence interventions offered in most of today’s health care settings, it is not unlike other patient care models such as initiating insulin therapy in patients with diabetes mellitus.” The COMBINE study found that, when combined with a structured outpatient medical management intervention consisting of nine brief sessions conducted by a healthcare professional, the alcohol-deterrent medications Revia and Vivitrol (naltrexone)  and up to 20 sessions of alcohol counseling were equally effective treatments for alcoholism.

  1. When assessing patients for StUD, the first clinical priority should be to identify any urgent or emergent biomedical or psychiatric signs or symptoms that may be present and make appropriate referrals.
  2. You may also choose to attend self-help groups, receive extended counselling, or use a talking therapy such as cognitive behavioural therapy (CBT).
  3. Dr. Sinclair’s research has been published in the peer-reviewed journals Alcohol and Alcoholism and the Journal of Clinical Psychopharmacology.
  4. Medications also can deter drinking during times when individuals may be at greater risk of relapse (e.g., divorce, death of a family member).
  5. This will give you a good idea of how much alcohol you’re drinking, the situations in which you drink, and how you could start to cut down.

Non-Psychostimulant Medications

Nalmefene should only be taken if you’re receiving support to help you reduce your alcohol intake and continue treatment. You’ll continue to experience unpleasant reactions if you come into contact with alcohol for a week after you finish taking disulfiram, so it’s important to maintain your abstinence during this time. Acamprosate (brand name Campral) is used to help prevent a relapse in people who have successfully achieved abstinence from alcohol. If you’re detoxing at home, you’ll regularly see a nurse or another healthcare professional. You’ll also be given the relevant contact details for other support services should you need additional support. How and where you attempt detoxification will be determined by your level of alcohol dependency.


Medications can help restore normal brain functioning, reduce relapse risk, and decrease symptoms of protracted withdrawal (e.g., craving, mood, sleep disturbance), thereby facilitating better engagement in behavioral treatment. Behavioral therapies, in turn, enhance pharmacotherapy response by modifying attitudes and behaviors related to alcohol, increasing healthy life skills, and helping people to stay engaged in recovery. If you feel that you sometimes drink too much alcohol, or your drinking is causing problems, or if your family is concerned about your drinking, talk with your health care provider.

More on Substance Abuse and Addiction

Due to the anonymous nature of mutual-support groups, it is difficult for researchers to determine their success rates compared with those led by health professionals. Alcohol-related problems—which result from drinking too much, too fast, or too often—are among the most significant public health issues in the United States. Group therapy, led by a therapist, can give you the benefits of therapy along with the support of other members. Drugs used for other conditions — like smoking, pain, or epilepsy — also may help with alcohol use disorder.

StUD is primarily diagnosed based on the history provided by the patient and a comprehensive assessment that may include collection of information from collateral sources, such as family or friends, when available and with patient consent. Subsequent workup (eg, ordering indicated clinical testing and/or imaging) should be based on the history and clinical exam findings. The Guideline document includes the recommendations approved by the CGC, each with its recommendation strength rating and evidence quality assessment.

Parental/guardian consent is not required for treatment of young adults; however, clinicians should initiate a conversation with young adult patients about whether their treatment plan might be enhanced by involving a parent/guardian or other trusted older adult. The CGC underscored the superiority of CM as a primary component of treatment for StUD. Where CM is not available, several other behavioral interventions—notably, CRA, CBT, and the Matrix Model—should be considered as other effective treatment options.

Research on the science of addiction and the treatment of substance use disorders has led to the development of research-based methods that help people to stop using drugs and resume productive lives, also known as being in recovery. Any form of naltrexone treatment for AUD is contraindicated in individuals who have current physiologic dependence on opioids, who are in opioid withdrawal, who have used prescribed or illicit forms of opioids within the past 7 to 10 days, or who have a urine drug drug addiction blog screen positive for opioids. This avoids unintended precipitation of opioid withdrawal through administration of an opioid antagonist. Of note, naltrexone can cause hepatocellular injury when used in higher than recommended doses and is contraindicated in individuals with acute hepatitis or liver failure. In 1948, Danish researchers trying to find treatments for parasitic stomach infections discovered the alcohol-related effects of disulfiram when they too became ill after drinking alcohol.

Some published protocols exist for voucher- and prize-based interventions,59,60 as well as some introductory trainings.§ Effective CM interventions are attentive to the schedule, magnitude, timing, and type of reinforcement; this can be cumbersome in busy treatment settings, but technology may ease the burden (see Technology-Based Interventions). The recommendation statements were informed by the literature review, EtD tables, and clinical new life house expertise of the CGC members. This was an iterative process where CGC subcommittees drafted recommendations, and a review and discussion of the evidence profile and clinical considerations might have led the CGC to revise the recommendation. In the absence of relevant evidence, several recommendations were developed based on clinical consensus. Recommendations may be made even when there is low-certainty or insufficient evidence.

For serious alcohol use disorder, you may need a stay at a residential treatment facility. Most residential treatment programs include individual and group therapy, support groups, educational lectures, family involvement, and activity therapy. Some of the medications used as part of a treatment protocol older adults national institute on alcohol abuse and alcoholism niaaa are controlled substances due to their potential for misuse. Drugs, substances, and certain chemicals used to make drugs are classified by the Drug Enforcement Administration (DEA) into five distinct categories, or schedules, depending upon a drug’s acceptable medical use and potential for misuse.


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