Medication Assisted Treatment (MAT) for Alcoholism

There are two drugs approved for medication assisted treatment  (MAT) of alcoholism: disulfiram and naltrexone.

Antabuse is the commercial name for the drug disulfiram. It has long been used to scare alcoholics into abstinence.

Antabuse causes a dramatic physical reaction — a form of alcohol poisoning best dealt with in an emergency room — even if only a small amount is ingested. It does this by interfering with an enzyme that breaks down a toxic byproduct of alcohol metabolism (acetylaldehyde, whose build-up is associated with some symptoms of hangover), resulting in severe nausea, vomiting; headache and increased heart rate, among other uncomfortable symptoms.

For more, click on AntabuseThe Challenges of Taking Antabuse, and emotional acceptance.


The second drug approved for alcoholism treatment is naltrexone, sold under the brand names Revia (in pill form) and Vivitrol (a once-a-month injection). It was originally found to be useful in helping opiate addicts. Subsequently, it was found to be effective for alcoholics as well.

According to SAMSHA:

Naltrexone blocks opioid receptors in the brain, stemming the endorphin-mediated reinforcing effects of drinking alcohol.

There is strong evidence that naltrexone significantly reduces alcohol relapses to heavy drinking, the frequency and quantity of alcohol consumption in those who do drink, and alcohol craving. In brief, naltrexone is significantly beneficial in helping those patients who cannot remain abstinent to reduce their drinking behaviors, breaking the vicious, self-destructive cycle in alcoholics whereby one drink leads to another, and allowing more quality time for psychosocial therapy to be productive. Naltrexone has demonstrated effectiveness in a variety of alcohol-treatment settings using adjunctive psychosocial therapies that provide motivation to stay in treatment, avoid relapses, and take medications.

Individualized, flexible naltrexone dosing can be of benefit. Longer-term naltrexone therapy extending beyond three months may be most effective, and naltrexone might be used on an asneeded, “targeted,” basis indefinitely. It is expected that the information in this report will help healthcare providers to better use this effective medication.1

Naltrexone should only be taken after detox from alcohol and opiates has been fully completed (7-10 days after stopping): it can cause or worsen withdrawal symptoms in people who are under the influence. Most patients take naltrexone for 12 weeks or longer.

 Click here for the next article in the MAT series, Medication Assisted Treatment for Opiate Addiction.




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