What Medications Are Used to Treat Alcoholism?

Table of ContentsView AllTable of ContentsCOMBINE StudyAntabuse (Disulfiram)NaltrexoneCampral (Acamprosate)The Sinclair Method

Table of ContentsView All

View All

Table of Contents

COMBINE Study

Antabuse (Disulfiram)

Naltrexone

Campral (Acamprosate)

The Sinclair Method

Thanks to years of research, doctors and health professionals now have multiple options to treat alcohol use disorders.Building on this progress, scientists continue to work on the development of new medications and are discovering new ways to improve the effectiveness, accessibility, quality, and cost-effectiveness of treatment.

According to research, medications seem to be a positive part of the most effective combination for the treatment of alcohol use disorders—it’s also underused as a treatment method.

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“The most robust finding in the study is that those receiving any medication did much better than those who received no pills at all,” says ProfessorBarbara Mason, of Scripps Research Institute, and an author of the study. “This should be a wake-up call.”

“With less than one percent of those seeking help for alcohol dependence receiving a prescription, medication is underutilized. Medication for alcoholism can offer patients an advantage for their recovery, especially in a real-world setting,” says Mason.

A massive study published in 2006 followed more than 1,300 study participants at 11 academic locations over a three-year period to determine what combination of treatment, medication, and counseling was the most effective for treating alcohol use disorders.

The Combining Medications and Behavioral Interventions for Alcohol Dependence (COMBINE) study produced some surprising results when it revealed that one of the newer medications used for the treatment of alcoholism failed to improve treatment outcomes on its own.

As shown in COMBINE, no single medication or treatment strategy is effective in every case or in every person.

After 16 weeks, the COMBINE study showed overall positive outcomes for study participants.

Disulfiram was first developed in the 1920s for use in manufacturing processes. The alcohol-aversive effects of Antabuse were first recorded in the 1930s. Workers in the vulcanized rubber industry who were exposed to tetraethylthiuram disulfide became ill after drinking alcohol.

In 1948, Danish researchers trying to find treatments for parasitic stomach infections discovered the alcohol-related effects of disulfiram when they too became ill after drinking alcohol. The researchers began a new set of studies on using disulfiram to treat alcohol dependence.

In the 1980s, animal studies discovered that naltrexone also reduced alcohol consumption. Human clinical trials followed in the late 80s and early 90s. These showed that when combined with psychosocial therapy, naltrexone couldreduce alcohol cravingsand decrease relapse rates in alcoholics.

The FDA approved the use of naltrexone to treat alcohol use disorders in 1994. DuPont then renamed the drug Revia.

“These results demonstrate that either naltrexone or specialized alcohol counseling—with structured medical management—is an effective option for treating alcohol dependence,” said Mark L. Willenbring, MD, director, division of treatment and recovery research, National Institute of Alcohol Abuse and Alcoholism.

“Although medical management is somewhat more intensive than the alcohol dependence interventions offered in most of today’s health care settings, it is not unlike other patient care models such as initiating insulin therapy in patients with diabetes mellitus.”

The COMBINE study found that combining another alcohol-deterrent drug Campral (acamprosate) with the medical management program did not improve outcomes. Campral did not perform better than the placebo or dummy pill. This finding stumped researchers since previous studies performed in Europe using Campral had yielded positive treatment outcomes.

In 2001, David Sinclair, PhD, a researcher in Finland claimed an 80 percent cure rate for alcohol dependence when anti-alcohol drugs Revia or Vivitrol are prescribed according to hisSinclair Method. Dr. Sinclair’s research has been published in the peer-reviewed journalsAlcohol and Alcoholismand theJournal of Clinical Psychopharmacology.

The Sinclair Method is the standard treatment protocol for alcohol dependence in Finland, the method is also used in the U.K., but the method has yet to catch on in the United States.

With the Sinclair Method, people only take Revia or Vivitrol before drinking and never otherwise.Revia and Vivitrol are not like other anti-alcohol drugs that cause intense sickness and hangover sensations when taken with alcohol. The change in behavior only appears over time.

With the Sinclair Method, Revia or Vivitrol is taken one hour before drinking alcohol. At the end of four to six months of treatment with the Sinclair Method, 80 percent of people who had been overusing alcohol were either drinking moderately or abstaining entirely.

The way this process works is when people normally drink alcohol, endorphins are released into the brain, and this reinforces the behavior of drinking alcohol. Revia and Vivitrol block the feel-good endorphins. Much like when Pavlov’s dogs were presented with food when a bell was rung, these dogs became conditioned to salivate at the sound of the bell alone. However, when these dogs continued to be presented with the ringing bell and no food, the salivating stopped.

If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

6 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Substance Abuse and Mental Health Services Administration.MAT Medications, Counseling, and Related Conditions.Agabio R, Pani PP, Preti A, Gessa GL, Franconi F.Efficacy of medications approved for the treatment of alcohol dependence and alcohol withdrawal syndrome in female patients: a descriptive review.Eur Addict Res. 2016;22(1):1-16. doi:10.1159/000433579Anton RF, O’malley SS, Ciraulo DA, et al.Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial.JAMA. 2006;295(17):2003-17. doi:10.1001/jama.295.17.2003Center for Substance Abuse Treatment.Incorporating Alcohol Pharmacotherapies into Medical Practice. Substance Abuse and Mental Health Services Administration (US); 2009.Winslow BT, Onysko M, Hebert M.Medications for alcohol use disorder.Am Fam Physician. 2016;93(6):457-465.Sinclair JD.Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism.Alcohol & Alcoholism. 2001;36(1):2-10. doi:10.1093/alcalc/36.1.2

6 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Substance Abuse and Mental Health Services Administration.MAT Medications, Counseling, and Related Conditions.Agabio R, Pani PP, Preti A, Gessa GL, Franconi F.Efficacy of medications approved for the treatment of alcohol dependence and alcohol withdrawal syndrome in female patients: a descriptive review.Eur Addict Res. 2016;22(1):1-16. doi:10.1159/000433579Anton RF, O’malley SS, Ciraulo DA, et al.Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial.JAMA. 2006;295(17):2003-17. doi:10.1001/jama.295.17.2003Center for Substance Abuse Treatment.Incorporating Alcohol Pharmacotherapies into Medical Practice. Substance Abuse and Mental Health Services Administration (US); 2009.Winslow BT, Onysko M, Hebert M.Medications for alcohol use disorder.Am Fam Physician. 2016;93(6):457-465.Sinclair JD.Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism.Alcohol & Alcoholism. 2001;36(1):2-10. doi:10.1093/alcalc/36.1.2

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Substance Abuse and Mental Health Services Administration.MAT Medications, Counseling, and Related Conditions.Agabio R, Pani PP, Preti A, Gessa GL, Franconi F.Efficacy of medications approved for the treatment of alcohol dependence and alcohol withdrawal syndrome in female patients: a descriptive review.Eur Addict Res. 2016;22(1):1-16. doi:10.1159/000433579Anton RF, O’malley SS, Ciraulo DA, et al.Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial.JAMA. 2006;295(17):2003-17. doi:10.1001/jama.295.17.2003Center for Substance Abuse Treatment.Incorporating Alcohol Pharmacotherapies into Medical Practice. Substance Abuse and Mental Health Services Administration (US); 2009.Winslow BT, Onysko M, Hebert M.Medications for alcohol use disorder.Am Fam Physician. 2016;93(6):457-465.Sinclair JD.Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism.Alcohol & Alcoholism. 2001;36(1):2-10. doi:10.1093/alcalc/36.1.2

Substance Abuse and Mental Health Services Administration.MAT Medications, Counseling, and Related Conditions.

Agabio R, Pani PP, Preti A, Gessa GL, Franconi F.Efficacy of medications approved for the treatment of alcohol dependence and alcohol withdrawal syndrome in female patients: a descriptive review.Eur Addict Res. 2016;22(1):1-16. doi:10.1159/000433579

Anton RF, O’malley SS, Ciraulo DA, et al.Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial.JAMA. 2006;295(17):2003-17. doi:10.1001/jama.295.17.2003

Center for Substance Abuse Treatment.Incorporating Alcohol Pharmacotherapies into Medical Practice. Substance Abuse and Mental Health Services Administration (US); 2009.

Winslow BT, Onysko M, Hebert M.Medications for alcohol use disorder.Am Fam Physician. 2016;93(6):457-465.

Sinclair JD.Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism.Alcohol & Alcoholism. 2001;36(1):2-10. doi:10.1093/alcalc/36.1.2

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