Alcohol addiction is a disease that goes far beyond willpower. Chronic alcohol abuse can rewire your brain not only to crave a substance but physically require it in order to function. This dependence is why kicking a drinking habit is so difficult. Fortunately, there are several types of drugs used to treat alcoholism that target specific alcohol addiction side effects and help contribute to both short and long-term recovery efforts.
Disulfiram (Brand names: Antabuse)
This drug was the first of its kind to be FDA-approved for use as part of alcohol addiction treatment. Rather than treating symptoms of alcoholism, Disulfiram uses negative reinforcement to discourage alcohol consumption. Drinking alcohol after taking this medication will induce unpleasant side effects like that of a bad hangover: nausea and vomiting, headaches, and sweating. When alcohol is introduced to the body with disulfiram already in the system, it produces a byproduct called acetaldehyde that is responsible for the previously listed effects.
Unfortunately, this aversion approach to alcohol abstinence can backfire, leaving little motivation for alcoholics to actually take this medication. As such, it’s often helpful to monitor individuals to ensure it’s taken. Disulfiram doesn’t necessarily need to be an ongoing medication and instead, can be reserved for use at times when temptation is at its strongest. This could be during extra-stressful events (example: holidays or losing a job) or at specific times of the day as part of a routine (example: after-work happy hour)
Naltrexone (Brand names: Revia, Depade, Vivitrol)
Initially approved for use in opioid addiction treatment, scientists stumbled upon Naltrexone’s ability to curb alcohol cravings. It does so by blocking opioid receptors which are responsible for causing feelings of pleasure. This prevents the pleasurable feelings that alcohol consumption might otherwise generate. Severing the reward pathway previously associated with drinking can help unravel alcohol’s hold on the brain which has been shown to be an effective means of reducing the likelihood of relapse. It is available in both pill form or as a monthly injectable.
Acamprosate (Brand names: Campral)
The third of the three FDA-approved alcoholism medications, Acamprosate helps minimize the discomfort of the psychological-based alcohol withdrawal symptoms, which can include anxiety, depression, restlessness, and insomnia. It does this by interacting with GABA and glutamate transmitters – both of which levels get thrown off by the neurochemical changes caused by ongoing substance abuse. Otherwise, the discomfort caused by these imbalances can be a cause for newly recovering alcoholics to relapse.
One potential obstacle of this medication is that it requires a lot of pills: two of them three times a day. This can be especially difficult to keep track of if you are taking other medications at the same time.
Its principal use is as an antiepileptic drug intended to treat and prevent seizures. The same mechanisms that make it effective for treating epilepsy can also counter some of the neurological consequences of alcohol addiction. It works similarly to acamprosate by affecting GABA and glutamate receptors (although the exact mechanism is unknown). Gabapentin increases the levels of GABA within the brain, which overall helps to normalize GABA activity.
Studies have shown that gabapentin can ease anxiety and insomnia (a side effect of alcohol withdrawal) and help reduce cravings. The long-term benefits of which can reduce instances of heavy drinking and encourage alcohol abstinence. Findings are promising as a potential new alcoholism treatment medication. It is not yet approved by the FDA but is currently used in other countries.
Similar to gabapentin, this medication is primarily used to treat epilepsy and migraines. It has been found to be effective for treating alcohol dependence (although it is not FDA approved specifically for this purpose). Also like gabapentin, topiramate affects GABA and glutamate neurotransmission.
The exact mechanism in which topiramate is able to achieve this is unclear, but it is believed to reduce dopamine release – a key aspect in the formation of addiction. This essentially works to deprogram the alcoholic to associating drinking with pleasure and to rely on this substance as their primary dopamine source.
Can a Pill Cure Alcoholism?
The benefits of drugs used to treat alcoholism cannot be overstated, however, they can only do so much on their own. These medications can help deter releasing, but do not guarantee alcohol abstinence. It is always recommended that these drugs are used in conjunction with some form of counseling or therapy to promote long-term recovery from alcohol addiction.