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Medication-Assisted Treatment for Alcohol Use Disorder: Understanding the Benefits and Drawbacks

Understanding Medication to Stop Drinking

Are you struggling with alcohol? You’re not alone.

Alcohol use disorder (AUD) affects millions of people in the United States. AUD is a spectrum, ranging from mild to severe.

It can cause a significant impact on your life, from damaging relationships to affecting your performance at work. If you’re trying to stop drinking, evidence-based alcohol treatment combined with FDA-approved medication can help.

In this article, we’ll discuss the benefits of medication in treating AUD, factors to consider when determining medication, and the approved medication used to treat AUD.

Benefits of Medication as a Tool for Behavioral Change

AUD is a complex disorder that requires a multifaceted approach to treatment. Evidence-based alcohol treatment programs, such as cognitive-behavioral therapy (CBT), motivational interviewing (MI), and contingency management (CM), have been successful in treating AUD.

These programs aim to change the patient’s behavior through therapy sessions and counseling. However, some individuals may require additional support in the form of medication.

Alcohol has both psychological and biological influences on the body. The psychological component is the urge to drink due to triggers such as social gatherings or stress.

The biological component is alcohol’s effect on the brain’s chemistry, particularly with the release of dopamine, a “feel-good” hormone. A person with AUD experiences a heightened response to the release of dopamine, which creates a stronger association with alcohol and pleasure.

Medication can be used as a tool to address both these components. It can reduce the psychological urge to drink while also helping to alter the brain’s chemistry, making it easier to stop or moderate drinking.

In combination with evidence-based alcohol treatment programs, medication can be an effective way to make long-term behavioral changes.

Factors Considered When Determining Medication

When determining medication, several factors are considered, including the severity of AUD, drinking triggers, and individual treatment programs. The severity of AUD is categorized as mild, moderate, or severe.

The severity can determine the type of medication and dosage required. Drinking triggers vary, but some common ones include stress, social situations, or even specific sights and sounds.

Medication can help minimize cravings and reduce the trigger’s impact, making it easier to maintain long-term sobriety or moderation. Individual treatment programs are tailored for each patient, taking into account their AUD severity and drinking triggers.

The treatment program can influence the choice of medication, as not all medications are appropriate for all individuals. A medical professional should evaluate the individual’s health history, current medications, and treatment plan before prescribing any medication.

FDA-Approved Medications for Alcohol Use Disorder

Currently, there are three FDA-approved medications for treating alcohol use disorder.


Naltrexone is an oral medication that blocks the effects of alcohol on the brain’s reward centers. It reduces the urge to drink and can help reduce the quantity and frequency of drinking.

Naltrexone’s blocking effect is due to its ability to bind to opioid receptors in the brain. Alcohol increases the release of endorphins, which activate the opioid receptors and release dopamine.

Naltrexone blocks the opioid receptors, not allowing the release of dopamine- therefore, blocking the “feel-good” effects of alcohol.

Naltrexone can be used in combination with other evidence-based treatments, such as CBT, to reduce alcohol’s psychological effects. It is particularly useful in managing alcohol cravings, which can trigger relapses.


Acamprosate is an oral medication that works on the brain’s GABA and glutamate neurotransmitters, which are involved in regulating mood and reducing anxiety. It reduces the severity of post-acute withdrawal symptoms, such as anxiety, irritability, and insomnia, associated with stopping or reducing alcohol use.

Acamprosate is most effective when combined with evidence-based therapies, such as CBT and behavioral couples therapy.


Disulfiram is an oral medication that produces an unpleasant reaction when alcohol is consumed. It works by blocking an enzyme that breaks down alcohol, causing acetaldehyde to accumulate in the body.

Acetaldehyde produces unpleasant and sometimes severe physical symptoms, such as nausea, vomiting, and flushing.

Disulfiram can only be used when the patient is fully informed and agrees to the medication’s use. It is not suitable for all individuals and requires careful monitoring by a medical professional, as it can cause liver and cardiac problems in some individuals.


In summary, evidence-based alcohol treatment programs combined with FDA-approved medication can help individuals make long-term behavioral changes and achieve their sobriety or moderation goals.

Naltrexone, acamprosate, and disulfiram are currently the FDA-approved medications suitable for treating AUD.

When determining medication, the severity of AUD, drinking triggers, and individual treatment programs are considered. Consult with a medical professional to determine the appropriate medication and dosage for your individual treatment plan.

With the right approach and support, you can achieve your sobriety or moderation goals. Antabuse: How it Works Differently

Antabuse, also known as disulfiram, is an exclusive medication for alcohol abstinence.

Unlike other FDA-approved medications used for alcohol use disorder, Antabuse does not reduce cravings or urge to drink. Instead, it produces an unpleasant reaction when alcohol is consumed, strongly reinforcing the practice of alcohol abstinence.

Mechanism of Action for Inhibiting Alcohol Metabolization

Antabuse works by inhibiting the enzyme that breaks down alcohol in the liver. When someone drinks alcohol while taking Antabuse, it produces a reaction known as the disulfiram reaction.

During this reaction, accumulated ethanol is converted to acetaldehyde, which is then metabolized into acetic acid. This process takes much longer than usual, and the build-up of acetaldehyde causes a range of unpleasant physical symptoms.

Symptoms can include nausea and vomiting, pounding headaches, dizziness, flushing, and rapid heartbeat. This physical response to alcohol consumption is intense and can last several hours, effectively conditioning the user not to ingest alcohol again.

The conditioning process can take effect as soon as two weeks from the first Antabuse dose administered. Even if an individual takes Antabuse for a short period, the conditioning response can persist for years.

Benefits and Potential Drawbacks of Using Antabuse

Antabuse can be an effective tool in a long-term commitment to sobriety. It removes the possibility of “slipping” and drinking, which can cause a relapse for some individuals.

The strong biological reinforcement of the disulfiram reaction can provide an additional layer of motivation for some people in their sobriety journey. However, Antabuse is not a cure-all option for alcohol use disorder.

As mentioned, it does not reduce cravings or urge to drink but instead requires a high level of motivation to abstain from alcohol completely since no alcohol consumption is allowed. Furthermore, the disulfiram reaction can be intense and potentially dangerous for some individuals, such as those with a pre-existing heart condition.

It is essential to receive an evaluation to ensure its safety and effectiveness.

Determining the Right Medication

Various factors go into determining which medication is appropriate for a patient. First, personal goals, such as achieving long-term sobriety or moderate drinking, play a crucial role in deciding the right medication.

Previous alcohol consumption patterns and medical history also play an important factor. Patients should take time for personal reflection and discuss their goals with their therapist or physician.

Seeking the guidance of an alcohol therapy professional or participating in a therapist-moderated alcohol support group can be highly valuable in making the right decision. Once a medication is determined, the role of the physician in medication-assisted treatments is vital.

The physician ensures that the medication is effective and monitors changes in drinking habits and physical and mental health symptoms. The physician’s involvement can result in dosage or medication adjustments that can improve the treatment’s effectiveness.

In conclusion, medication-assisted treatments for alcohol use disorder, combined with therapy and support, can help achieve and maintain long-term sobriety or moderate drinking. Whether it’s


Acamprosate, or Antabuse, individuals need to carefully consider their goals, previous alcohol consumption patterns, and medical history.

Consulting with a physician, participating in alcohol therapy, and attending a therapist-moderated alcohol support group can help make an informed decision and guide the medication-assisted treatment plan.

Side Effects and Cost of Medication

Medication-assisted treatment can be an effective tool in helping individuals achieve sobriety or moderate drinking. However, like any medication, there can be side effects and costs to consider.

Side Effects of

Naltrexone and Antabuse

Naltrexone’s side effects are usually mild, commonly including nausea, headaches, drowsiness, and gastrointestinal distress. These symptoms may fade after the first few weeks of taking naltrexone.

However, some less common side effects can include liver damage and depression. Antabuse’s side effects are more intense and predictable.

When alcohol is consumed while taking Antabuse, the disulfiram reaction can occur, causing symptoms that could last several hours, such as dizziness, fatigue, headaches, nausea, and tachycardia. It can also create an unpleasant metallic taste in the mouth.

Because of the strength of the physical symptoms, medication adherence is extremely important with Antabuse. It’s critical to be aware of the possible side effects and to monitor them closely with your physician.

Cost of

Naltrexone and Antabuse With and Without Insurance Coverage

Naltrexone and Antabuse’s cost can vary with and without insurance coverage. The price can range from $80 to $200 per month for naltrexone and $100 to $300 per month for Antabuse.

However, depending on your insurance coverage, the cost can be significantly less, ranging from $10 to $50 per month. It’s always essential to evaluate insurance coverage options and understand the out-of-pocket cost when considering medication-assisted treatment.

Importance of Monitoring Possible Side Effects With a Physician

As with any medication, there are possible risks and side effects that must be closely monitored. For example, Antabuse comes with a risk of hepatocellular injury that can occur in some patients.

Therefore, physicians who prescribe medication for alcohol use disorder usually evaluate such risks cautiously and monitor patients closely. Also, side effects can occur at different times in patients’ medication history, sometimes after the first few weeks or months.

Hence, a physician must evaluate the patients consistently and adjust the dosage or medication accordingly, if necessary. Monument’s Approach to Medication-Assisted Treatment

If you or someone you know needs help with alcohol use disorder, Monument’s online alcohol treatment program provides medication-assisted treatment options.

Monument’s treatment program centers on personalized attention and delivering top quality addiction treatment plans tailored to each patient’s needs. Monument provides accessible and affordable alcohol treatment options with licensed medical professionals.

Patients receive a personalized treatment plan, medication-assisted treatment, and continuous mental and behavioral support by independent licensed practitioners who partner with Monument on the platform.

Importance of Additional Support Beyond Medication

Medication-assisted treatment can provide much-needed support to help achieve sobriety or moderate drinking. However, rehabilitation and recovery from alcohol use disorder beyond medication require behavioral change.

Therefore, Monument’s online treatment programs go beyond medication to provide additional support to foster long-term recovery. Monument’s platform offers online alcohol therapy that includes one-on-one sessions with licensed therapists to help patients explore the underlying reasons for their alcohol use disorder, generate new behaviors, and learn coping mechanisms.

Partnership with Independent Medical and Clinical Practices

Monument partners with independent medical and clinical practices to provide quality and personalized care. The independent practices provide the medication, the medical professionals, and the therapies, while Monument provides administrative and business support services.

These services can help build a fruitful collaboration between licensed medical and clinical practices who provide the medical and therapeutic care, and Monument who provides support in streamlining the business operations and optimization of patient outcomes. In conclusion, medication-assisted treatment can provide much-needed support for individuals struggling with alcohol use disorder.

However, awareness of costs, side effects, and the importance of monitoring with a physician are necessary. Monument’s online treatment programs provide personalized attention and partnerships with independent medical and clinical practices to provide affordable treatment options.

In combination with medication, therapy, and behavioral support, Monument provides a flexible approach for each patient’s unique needs. In conclusion, medication-assisted treatment combined with evidence-based alcohol treatments can be a successful approach to achieving and maintaining sobriety or moderate drinking.

The FDA-approved medications,


Acamprosate, and Antabuse, have different mechanisms of action and possible side effects. Individuals should evaluate their personal goals, medical history, and insurance coverage when determining medication, and always consult a doctor when experiencing side effects.

Monument’s online alcohol treatment platform provides excellent support through personalized treatment plans, licensed physicians, online alcohol therapy, and partnerships with independent medical and clinical practices. Along with the medication assistance, additional therapy and behavioral support is crucial in maintaining long-term recovery.


1. Are the FDA-approved medications for alcohol use disorder safe?

Yes, the FDA has approved the medication after conducting rigorous research and reviewing the safety and efficacy data. 2.

Can I drink alcohol while on medication for alcohol use disorder?

It depends on the medication; some, such as Antabuse, do not allow drinking at all, while others like

Naltrexone reduce the cravings and urge to drink but still allow for moderate drinking.

3. Do the medications have any side-effects?

Yes, as with any medication, there can be side effects.

Naltrexone side effects are usually mild, such as headaches and gastrointestinal distress.

Antabuse side effects can be more intense, including nausea, dizziness, fatigue, and tachycardia. 4.

How much does medication-assisted treatment cost?

The costs vary depending on insurance coverage and the medication prescribed, ranging from $80 to $300 per month.

5. Can I stop medication once I achieve sobriety?

It depends on your goals and individual treatment plan. Some individuals may continue with medication for an extended period, while others can gradually taper off the medication under medical supervision.

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