Disulfiram is not a cure for alcoholism, but rather a deterrent utilized to discourage alcohol consumption. It also cut the number of heavy drinking sober house days and increased the number of days they didn’t drink at all. People with AUD who quit drinking abruptly may go into alcohol withdrawal.
Naltrexone may help reduce the urge to drink and prevent excessive alcohol consumption. Without the satisfying feeling, people with alcohol use disorder may be less likely to drink alcohol. As a result, these medications only serve as a portion of the alcohol rehab process. In fact, the most important part of medication-assisted treatment is behavioral therapy and peer support. The risk of alcohol dependence begins at low levels of drinking and increases directly with both the volume of alcohol consumed and a pattern of drinking larger amounts on an occasion, to the point of intoxication, which is sometimes called binge drinking.
Management and Treatment
Data from these specialty care settings indicate that adoption of medication for the treatment of alcohol disorders is uncommon in both the public and private sector (Ducharme et al. 2006). An examination of public reimbursement as reported by the National Conference of State Legislatures (2008) indicates that Medicaid coverage of substance abuse medications is not common among States and that it is an option not a requirement (Gelber 2008). There has been considerable enthusiasm about the potential of rimonabant, a cannabinoid receptor 1 antagonist, based on preclinical research showing that it reduced alcohol drinking. Researchers funded by the Agency for Healthcare Research and Quality, a Federal Government research agency, reviewed studies on medicines to treat alcohol dependence and alcohol use disorder published between January 1970 and October 2013. The report included 135 studies and was reviewed by health care professionals, researchers, experts, and the public.
Research is needed to address the optimal use of medication therapy for the treatment of alcohol use disorders and for treating the broader spectrum of unhealthy alcohol use, from non-dependent risky drinking to alcohol dependence. This is especially true given the major scientific advances in pharmacotherapy that have been made over the past 60 years. To improve access to effective medication therapy, research also should explore the use of these medications in a range of health care settings. To optimize medication treatment outcomes, practitioners need to assess both the appropriate level of counseling (from minimal to more intensive) and the appropriate methods to enhance medication adherence for individual patients.
Studies of Medication Use in Primary Care
Because benzodiazepines work on the same receptors of the brain as alcohol, these drugs are often administered during the acute detoxification phase. Oftentimes, the individual is immediately given the drug to mitigate the dangerous withdrawal symptoms of alcoholism and then slowly tapered off. Typically, benzodiazepines are only administered during the initial alcohol detoxification phase. Approximately 5 days after their last drink, the individual will often be administered a safer alternative that is FDA approved from alcohol abuse. Women who have alcohol-use disorders often have a co-occurring psychiatric diagnosis such as major depression, anxiety, panic disorder, bulimia, post-traumatic stress disorder (PTSD), or borderline personality disorder. Campral (acamprosate) is the most recent medication approved for the treatment of alcohol dependence or alcoholism in the U.S.