June 30, 2021 – Disulfiram, sold under the trade name Antabuse, is the longest-known one. Its anti-alcohol properties were discovered by accident between the ‘40s and ‘50s, Einstein says. “People came in contact with disulfiram, and then they consumed alcohol and got horribly sick,” she says. “It creates a physical reaction in your body that just makes the consumption of alcohol really aversive.’
Naltrexone, sold under brand names including Vivitrol, is used in treating opioid use disorder in addition to AUD. Naltrexone blocks the brain’s new opioid receptors—the very receptors that make opioid drugs, and likely alcohol, rewarding. “The thought behind naltrexone is that it makes consuming alcohol a less pleasurable experience,” Einstein says. Rather than making someone physically sick like disulfiram, naltrexone blocks the the alcohol-related highs and pleasures.
Acamprosate, formerly sold under the brand name Campral, can help remove the discomfort experienced during withdrawal. It normalizes the transmission of the neurotransmitter glutamate in the brain, which can become dysregulated when a long-time drinker stops drinking. “If they have been drinking alcohol problematically for a long time, then that discomfort can be a reason to relapse,” Einstein says.
These medications are in no way a cure-all, Einstein says. For example, disulfiram may require supervised dosing, because someone can just not take the pill the day they decide to drink. Still, AUD medications can help, and should be prescribed in conjunction with other treatments such as counseling.
Spreading more awareness, Einstein says, can help in assisting treatments and reducing stigma. Remember: Addiction is not someone’s fault.
“Reasons that someone’s circuitry causes them to develop alcoholism might vary from person to person,” Einstein says. “It’s better to have more medications that are possible for conditions like this.”
Einstein emphasizes that taking these medications is not a cop-out. “Lingering and outdated ideas that taking a medication is similar to taking a substance, or that you’re replacing one addiction with another, is not the case,” she says. “That really strong negative attitude around taking medication for addiction can impede people from seeking care.”
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