Medication-Assisted Treatment For Alcohol Addiction

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Medication-Assisted Treatment For Alcohol Addiction

In a medication-assisted treatment (MAT), medications are paired with counseling, behavioral therapy, and support to help a person recover from addiction. Currently, three medications have been approved by the U.S. Food and Drug Administration to treat AUD.

None of these are considered a cure for alcoholism, but they’re the most effective medications in use in MAT:

  • disulfiram
  • acamprosate
  • naltrexone

In early recovery, most people are faced with temptations, cravings, and withdrawals that make them want to drink again. MAT provides a comprehensive and individualized program of medication and behavioral therapy, and has been clinically proven to help people overcome alcohol addiction, as well as opioid addiction.

MAT is a holistic approach to treatment, which means that it treats the whole problem. Medications may be utilized during or after a person detoxes from alcohol and to ease withdrawal symptoms. Most of the medications used in MAT can create an adverse reaction to alcohol, so it’s important to refrain from drinking any alcohol during treatment.

Understanding Alcohol Addiction

Alcohol is a legal central nervous system (CNS) depressant that’s fairly easy to make, and widely available to the public. Some may attempt to self-medicate with alcohol for anxiety, which may contribute to a co-occurring disorder. Many people suffering from an addiction to alcohol are unable to drink safely.

Alcohol addiction, also known as alcoholism, is a chronic disease marked by a person’s inability to control their drinking or preoccupation with drinking; even when it has a negative effect on them.

Not everyone who consumes alcohol or binge drinks will develop alcoholism. Everyone’s reaction to alcohol is different, and so are their drinking habits.

If a person’s drinking negatively impacts their life, it’s called an alcohol use disorder (AUD). Alcohol abuse and alcoholism are both considered alcohol use disorders. When alcohol abuse becomes more frequent, the issue may escalate into an addiction.

Some of the negative consequences of alcohol abuse are:

  • physical health problems
  • strained relationships
  • problems at work
  • mental health problems
  • financial difficulty
  • legal problems

There are nearly 18 million people in the United States dealing with an alcohol use disorder (AUD). Many of the people with an AUD want to stop drinking, yet they’re unable to quit by themselves. Alcohol is a potent drug, and recovering from addiction takes support, determination, and sometimes a medication.

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Alcohol Withdrawal Symptoms

Withdrawal symptoms may occur if a person regularly abuses alcohol, and then stops abruptly. A person can start experiencing withdrawals as soon as eight hours after they stop drinking—and symptoms may not peak until 24 to 72 hours.

Alcohol withdrawals can last up to several weeks, and they can be excruciating. Withdrawal symptoms have been known to cause a person to want to drink again. During the detox stage of recovery, people find that they’re unable to sleep and constantly irritable.

Other alcohol withdrawal symptoms may include:

  • anxiety
  • depression
  • fatigue
  • irritability
  • insomnia
  • shakiness
  • mood swings
  • nightmares
  • clammy skin
  • headache
  • problems sleeping
  • loss of appetite
  • nausea
  • pallor
  • rapid heart rate
  • tremor
  • delirium tremens (severe withdrawals)
  • agitation
  • fever
  • hallucinations
  • seizures
  • severe confusion

Withdrawal symptoms such as sleep changes, rapid changes in mood, and fatigue can last for months. Those who continue to drink heavily may develop health problems with their liver, heart, or nervous system.

Medical Detoxification For Alcohol Dependence

In a medically-supervised detoxification, patients receive the best possible treatment and support to get the alcohol out of their system. With the help of top healthcare professionals, patients are able to cleanse their bodies from the unwanted chemicals caused by addiction and maximize the chance of recovering from the physical addiction to alcohol.

Most people go into treatment malnourished, sleep-deprived, and dehydrated. These problems can make withdrawal symptoms worse. In a residential detoxification, patients will be able to cope with the withdrawal symptoms of early alcohol recovery.

In a medical detox program, each patient will be evaluated by a professional for the state of their AUD, and treated for vitamin, fluid, nutrition, and sleep deficiencies. In some cases, medications are administered during detox to prevent seizures, reduce cravings, and treat co-occurring disorders.

The detox process lasts anywhere from seven to 10 days. Duration of detox can vary, and according to the National Library of Medicine, “how well a person does depends on the amount of organ damage and whether the person can stop drinking completely. Alcohol withdrawal may range from a mild and uncomfortable disorder to a serious, life-threatening condition.”

After detox, patients will be ready to start recovering from the mental addiction to alcohol. This may be achieved through counseling sessions, homework, meditation, exercise, support groups, medications, and/or behavioral therapy. Fundamentally, an inpatient alcohol rehab can be a place to learn how to live without alcohol.

How Does Disulfiram Help Treat Alcohol Addiction?

Disulfiram (Antabuse) is a medication that has been used to treat chronic alcoholism by creating an unpleasant reaction to alcohol. Its most effective application will be for those who have already completed detoxification, but are still in early recovery.

Antabuse is a brand of disulfiram that’s taken as a tablet once a day in the morning or night. Antabuse should never be taken within 12 hours after drinking alcohol.

Patients have experienced an adverse reaction to alcohol for up to two weeks after they stopped taking Antabuse. Drinking while taking Antabuse can make a person very sick, and may trigger any number of these side effects:

  • throbbing pain in the head and neck
  • trouble breathing
  • nausea and vomiting
  • sweating
  • flushing
  • thirst
  • chest pain
  • rapid heartbeat
  • lightheadedness
  • fainting
  • weakness
  • blurred vision
  • confusion
  • dizziness

How Does Acamprosate Help Treat Alcohol Addiction?

Acamprosate (Campral) is used to help a person in recovery who has already stopped drinking, but wants to avoid alcohol use. Campral works by reducing a person’s desire to drink alcohol. “The use of acamprosate typically begins on the fifth day of abstinence, reaching full effectiveness in five to eight days,” (Substance Abuse and Mental Health Services Administration—SAMHSA).

Campral is a brand name of acamprosate, and works best when it’s taken three times a day (preferably at the same time each day), and paired with behavioral therapy. Acamprosate can take up to five days to completely work, and treatment can range from three to 12 months. The manufacturer recommends a year-long acamprosate regimen for the best results.

Mixing Campral with alcohol may cause a severe interaction, and should be avoided. It should also be noted that misuse of any prescription drug can cause a negative reaction to acamprosate, which may include diarrhea, nausea, anxiety, and insomnia.

How Does Naltrexone Help Treat Alcohol Addiction?

Naltrexone (Revia or Vivitrol) is an opiate antagonist that works by reducing the euphoric effects of alcohol. Naltrexone allows a person with an alcohol addiction to stay sober and motivated to remain in treatment.

Revia is a tablet version of naltrexone that needs to be taken once every one to three days. Vivitrol is a liquid version of naltrexone that’s administered by a healthcare professional once a month, as an intramuscular gluteal (buttocks) injection.

Neither brand of naltrexone is considered a cure for alcohol addiction. Opiate-agonists need to be paired with counseling, support group meetings, and behavioral therapy for utmost effectiveness. Naltrexone should only be used by people who are unable to stop drinking alone.

Naltrexone will not produce any narcotic-like effects or cause mental or physical dependence. It simply blocks the high feeling that makes people want to use alcohol. People who have liver problems such as liver disease, hepatitis, or cirrhosis should avoid taking naltrexone, because it may cause liver injury.

Is Medication Alone Enough To Stop Drinking?

It isn’t recommended that a person merely uses a medication to quit drinking. These medications can be helpful for cravings, withdrawals, or side effects of alcohol addiction, but they’re designed to work with behavioral therapy. Recovery is more than just refraining from substance abuse—it’s about making abstinence a top priority in all areas of life.

Recovery doesn’t end as soon as treatment is over, so patients may continue taking medications such as naltrexone and disulfiram as long they need it. In the words of SAMHSA, the ultimate goal of medication-assisted treatment is full recovery, including the ability to live a self-directed life. No matter how bad someone’s addiction, or how powerless they feel—with the right help, people can recover from alcohol abuse and addiction. Contact today to learn more.

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