AUD Medications: The Medications to Stop Drinking Alcohol

The FDA has approved three medications for use in treating alcohol use disorder (AUD). These medications are disulfiram, naltrexone and acamprosate. 

Through different mechanisms, all three of these drugs discourage a person from drinking alcohol. They don’t generally carry significant health risks, although naltrexone will cause opioid withdrawal in people dependent on opioids.

Understanding Alcohol Use Disorder 

AUD is a serious health condition characterized by uncontrolled, problematic drinking.[1] AUD ranges in severity, and it is commonly referred to as alcoholism or alcohol addiction, though these aren’t official medical terms. 

A person who has AUD doesn’t lack the willpower to stop drinking. This condition isn’t a moral failing. Alcohol misuse can cause lasting changes to the brain that essentially rewire it, making it much more difficult to stop drinking after the person has been chronically drinking.[2] 

A person who struggles to stop drinking alcohol should seek professional help. In severe cases, it can even be life-threatening to stop drinking alcohol on one’s own due to the intense symptoms that can accompany suddenly stopping one’s drinking. Regardless, seeking help to stop one’s drinking can help maximize your chances of successfully and safely staying drug abstinent long-term.[1] 

AUD is very common in the United States, with as many as 29.5 million Americans ages 12 and older (10.5% of this age group) having some level of past-year AUD, according to a 2022 survey. Additionally, 2.9% of youth ages 12 to 17 had past-year AUD, according to that same survey.[3] 

Common Medications for Treating AUD That May Help Stop the Urge to Drink

While medication can’t cure AUD—there is no cure for this chronic condition—a variety of medications have the potential to help a person reduce the likelihood that they engage in unhealthy drinking. Three medications have been approved by the FDA for this purpose:[4]

Naltrexone

Naltrexone is a medication that makes alcohol use feel less rewarding. It’s an opioid receptor antagonist, and it works by blocking receptors in the brain that make drinking alcohol pleasurable.[5] This can make alcohol less desirable and has been shown to decrease the rate at which a person engages in heavy drinking. 

While generally safe, naltrexone will cause opioid withdrawal in a person dependent on opioids.[6] 

Acamprosate

Acamprosate is a drug designed to help return a body to homeostasis after certain disruptions that heavy drinking and withdrawal can cause. It’s been shown to significantly help with alcohol abstinence.[7] Taking this drug can potentially reduce a person’s cravings to drink alcohol. It is noted as being especially helpful when a person first quits using alcohol.[8]

Disulfiram

Disulfiram is a drug that acts as a psychological deterrent to alcohol use.[9] A person with this drug in their system will experience negative symptoms if they consume alcohol, including the rapid onset of flushing, nausea and palpitations.[9] In effect, a person can take this drug to help discourage themselves from using alcohol. 

Note that some foods containing trace amounts of alcohol can also induce the negative symptoms caused by this drug, even if the user wasn’t attempting to get intoxicated. It’s also important to note that the evidence base for disulfiram being an effective AUD treatment is lower than that for naltrexone and acamprosate.[9] As a result, many doctors will often opt for prescribing naltrexone or acamprosate first. 

Vivitrol (Extended-Release Naltrexone)

Vivitrol is a brand name for extended-release naltrexone.[4] We mention this medication because it can be especially useful because it is an extended-release naltrexone injection, meaning a person can go a longer time without needing to retake their medication. Like generic naltrexone, it is generally safe, but it will cause opioid withdrawal in a person who is dependent on opioids.

Choosing the Right Medication to Help Stop Drinking Alcohol

Determining what medications might help you stop drinking is a decision best made by a medical professional. However, the following are some things that can help inform your choice:

The Importance of Therapy

Medication can help a person maintain abstinence from alcohol, but it shouldn’t be used to treat AUD on its own. A major part of combating AUD (especially moderate and severe AUD) is talk or behavioral therapy.[8] Therapy can help a person learn proven psychological techniques to better process their thoughts around alcohol and their cravings, so they can better avoid alcohol misuse. 

This is especially true for the medications often used to treat AUD, as compliance (the willingness of an individual to continue taking these medications) is often an issue.[10] If a person is taking medication that causes alcohol use to be less rewarding or causes them unwanted side effects, but they still want to drink and don’t have the tools to manage those feelings in a healthy way, they’ll just stop taking the medication. 

Part of a Comprehensive Treatment Plan

If you struggle with alcohol use, talk with an addiction treatment professional. They can help you form a comprehensive treatment plan that addresses all your treatment needs and maximizes your chances of a successful, long-term recovery. 

The ideal treatment for AUD varies by the individual but will typically involve some combination of the medications discussed in this article and behavioral treatments, such as cognitive behavioral therapy (CBT). Other helpful behavioral treatments can include motivational enhancement therapy and marital or family counseling, depending on a person’s unique circumstances.[8]

Continued Care

AUD is usually considered a chronic condition, but that doesn’t mean a person struggling with AUD can’t gain control over their cravings and stay free of alcohol misuse. With proper treatment, sustaining long-term abstinence becomes much easier. If a relapse does occur, a person may be able to regain control and seek help to better deal with the relapse faster than if they hadn’t built the skills developed in treatment.[11] 

It’s important to address problems with alcohol use. The drug has significant misuse potential, and people often underestimate its ability to do damage due to the fact that it’s widely available and legal for most adults to purchase. Chronic alcohol use can destroy lives, significantly affecting physical and mental health and causing important relationships to deteriorate. 

Thankfully, recovery is possible. The first step is to talk to a professional who understands the nature of AUD.

Precautions & Warnings

The medications discussed in this article are prescription medications you should only use as a doctor intends. Naltrexone, including Vivitrol, will cause opioid withdrawal if a person is dependent on opioids. Disulfiram will cause potentially severe nausea if consumed with alcohol, especially in significant quantities. 

FAQs: Common User Questions About AUD Medications

The following are some frequently asked questions about this topic:

A Path to Recovery

AUD is an unfortunately common type of substance use disorder, but it’s treatable. It’s important to seek help if you struggle with alcohol use, as an addiction professional can help you form the best treatment plan that works for your needs. 

Recovery isn’t easy, but it’s always possible. If you want to start the path to recovery, explore the effective treatment options available and talk to experts about your first steps.