When I quit drinking, I wanted to know if any medications for alcoholism had been demonstrated to help people cut down on alcohol or stay abstinent. My doctor informed me that no such things existed.
He was wrong, and this article will illuminate this issue in case you’ve found yourself in my former shoes.
Now, you might be wondering…
Why would I spend time writing about medications for alcoholism when I’m passionately opposed to the “pill for an ill” mentality?
Isn’t the purpose of Fit Recovery to elucidate strategies that empower individuals to rebuild their minds and bodies from scratch, such as repairing nutrient deficiencies and defying groupthink to reframe alcohol as a moot substance?
Yes, but alcoholism is such a brutal biochemical disorder that all options need to be on the table. With that said, everyone responds differently to medications. This list is not arranged in any particular order.
I did not use drugs to beat alcohol addiction, but I do wish my doctor had informed me about all of my options. Especially given the 90% relapse rates that plague the mainstream rehab industry!
While alcohol withdrawal medications (e.g., benzodiazepines) are widely prescribed for alcoholics, few people know about medication for alcohol cravings that might help them get past post-acute withdrawal syndrome (PAWS).
In most cases, people who take these drugs can wean off of them once they get safely past the worst of PAWS.
Medications for alcoholism are not necessary or suitable for everyone. This article will give an overview of some non-prescription alternatives, nutrient repair, and the importance of diet and lifestyle after quitting drinking.
Note: I’m not a doctor and I can’t recommend prescriptions. The root causes and symptoms of alcoholism vary between individuals. If you think you might benefit from any of the options below, ask your doctor for more information – and if he or she refuses to discuss the subject, get a better informed doctor!
Why Don’t We Hear About Medications For Alcoholism?
If you had diabetes, you’d probably be confused if your doctor failed to tell you about insulin and recommended a diabetes support group instead. There actually are diabetes support groups, and they probably help people – but you’d expect a medical expert to tell you about your medical options first.
So, why aren’t alcoholics informed by doctors about all of the medications above? A recent article lends some insight:
It is still rare for a person struggling with alcohol to hear that medication therapy exists. This partly reflects the tradition of treating addiction through 12-step programs. It’s also a byproduct of limited promotion by the drugs’ manufacturers and confusion among doctors about how to use them.
This is absolutely stunning.
Because our society sees alcoholism as a primarily spiritual matter, Big Pharma won’t allocate resources to promote medications that have been clinically proven to reduce relapse statistics. (I cite this research in the sections below.)
Even though a few older drugs have now been proven to help alcoholics, their patents have expired. Drug companies have no interest in promoting them for alcoholism.
There’s a lot more money in more socially acceptable pills for an ill – ADD medications for kids, statins for overeaters, and antidepressants for virtually everyone.
Since doctors receive most of their continuing education from pamphlets and seminars provided by drug companies, many of them have no idea how to prescribe medications for alcoholism. (source)
I could go on about the confluence of anti-science groupthink and our broken medical establishment. But my purpose here is to inform you about options for conquering alcoholism that you might not otherwise hear about.
Naltrexone hydrochloride is a medication that has been approved by the FDA to treat alcohol addiction since 1994.
Naltrexone is a opioid antagonist, meaning that it plugs the same brain receptors as opiates and endorphins (the brain’s natural pleasure chemicals). Instead of producing pleasurable effects, naltrexone sits in the receptor site and simply blocks pleasure chemicals from entering. Naltrexone therefore prevents drinkers from feeling pleasure when they drink.
Naltrexone taken along with abstinence shows only a small reduction in relapse rates. The mechanism through which naltrexone works requires both naltrexone and alcohol to be consumed, over the course of repeated episodes of drinking.
This process is called pharmacological extinction. Drinkers who use this method must take naltrexone before drinking for the rest of their lives to prevent rekindling their alcohol addiction. Many people who use this method voluntarily decide to quit drinking entirely.
Rehab centers in Norway and other parts of Europe have been known to use naltrexone with success rates of up to 80%.
Naltrexone for alcohol disorders is well-established in the scientific literature:
- A 1997 study found that when naltrexone was combined with therapy, only 35% relapsed, compared to the treatment industry standard of up to 90% relapse (source)
- In a 6 month double-blind, placebo-controlled study with 118 alcoholics, naltrexone was associated with significantly fewer heavy drinking days than the placebo (source)
- Out of 14 clinical trials conducted through 2001, only two failed to demonstrate the efficacy of naltrexone for alcohol disorders (source)
You can learn more in this article about naltrexone and pharmacological extinction.
Baclofen is a nervous system depressant and muscle relaxant that is widely prescribed for spasticity disorders, but which has proven to be one of the most effective medications for alcoholism. Specifically, it helps alcoholics who are deficient in GABA.
Baclofen stimulates GABA receptors in a similar way as benzodiazepines. In contrast to these powerful drugs, dosage tolerance to baclofen does not build up over time to any significant degree. The use of baclofen as a medication for alcoholism was pioneered by a brilliant French-American cardiologist named Olivier Ameisen.
There is no incentive for American drug companies to spend money on clinical trials for baclofen because it is an old generic drug that cannot be patented. By contrast, tens of thousands of Europeans – including 50,000 in France alone – take high-dose baclofen for alcohol use disorders.
The effectiveness of baclofen for alcohol withdrawal and alcohol cravings is now well-established in the scientific literature:
- In a two-year study of 100 patients, long-term baclofen treatment caused an effortless decrease of alcohol withdrawal and post-acute withdrawal symptoms (source)
- In a 12-week study of 56 alcoholic patients receiving either high dose baclofen or a placebo, 68% of those given baclofen remained abstinent, compared to 23% on the placebo (source)
You can learn more in this article about how to use baclofen for alcohol use disorders.
Gabapentin, sold under the brand name Neurontin, is an anticonvulsant medication that works by increasing the production of GABA in the brain. In alcoholics, brain cells are often too damaged to perform this crucial function.
Some people use gabapentin for alcohol withdrawal and then taper off to avoid dependence. Others take gabapentin over the long-term for alcohol cravings. Continuing to use gabapentin after alcohol detox has helped many alcoholics reduce the chance of relapse.
Gabapentin is not one of the FDA-approved medications for alcoholism, but it is often prescribed to alcoholics off-label.
A number of studies support the use of gabapentin for alcohol withdrawal and cravings:
- In a 12-day study of alcoholics detoxifying with either gabapentin or lorazepam, the gabapentin group was less likely to drink – and had less craving, anxiety, and sedation (source)
- In a 12-week study of 150 alcoholics receiving either gabapentin or a placebo, the gabapentin group had significantly less insomnia, dysphoria, and alcohol craving (source)
- Gabapentin reduced alcohol intake for alcoholic rats but not for non-alcoholic rats, demonstrating its effectiveness for alcohol cravings by acting as a substitute source of GABA (source)
You can learn more in this article about how to use gabapentin for alcoholism.
Acamprosate is FDA-approved to help alcoholics manage post-acute alcohol withdrawal syndrome. It is usually sold under the brand name Campral.
Acamprosate may help to ameliorate post-acute withdrawal syndrome, with a notable impact for some people on anxiety and alcohol cravings. It does this by stabilizing brain chemicals involved in alcohol withdrawal. Specifically, it is thought that acamprosate reduces glutamate activity in the brain.
Acamprosate is typically prescribed for 3-12 months following the cessation of acute withdrawal symptoms. In contrast to naltrexone, which blocks the pleasure that drinkers obtain from alcohol – or Antabuse, which causes nausea when alcohol is consumed – acamprosate relieves the intense sensation of stress that leads many alcoholics back to the bottle.
In Europe, acamprosate had been used with apparent success for decades before it was approved in the U.S.
- A critical review of acamprosate alcohol treatment studies found that acamprosate increases abstinence rates, reduces treatment costs, and produces superior results compared to group support alone. (source)
- A comprehensive meta-study of 17 trials consisting of 4,087 patients from 13 countries found that 36% of individuals receiving acamprosate alcohol treatment and 23.4% of individuals receiving placebo remained abstinence at 6 months. (source)
- In a one year study of alcoholics in real-world conditions, 540 individuals who received acamprosate alcohol treatment were found to have a 33.6% abstinence rate compared to 21.6% for 274 individuals who received only psychosocial support. (source)
You can learn more in this article about how to use acamprosate for alcoholism.
Topamax (topirimate) is an anticonvulsant and anti-epileptic medication that has powerful neuro-protective properties. It is not among the FDA-approved medications for alcoholism, but it has shown great promise for this purpose.
Topamax works primarily by balancing GABA and glutamate levels. It also removes excess dopamine that is released by alcohol. As a result, heavy drinkers who consume both Topamax and alcohol feel compelled to drink significantly less.
Like naltrexone, Topamax can help people who are still drinking. Like gabapentin, people can use Topamax for a short period to reduce alcohol withdrawal symptoms or for a longer period to deal with alcohol cravings and avoid relapse.
Since the patent for Topamax expired, there is no financial incentive for drug companies to pursue approval to market Topamax for alcohol addiction.
Still, a number of studies support the use of Topamax for alcohol withdrawal and cravings:
- Detoxing alcoholics who received up to 75 mg of Topamax had fewer alcohol withdrawal symptoms in the 7-10 days following drinking cessation, and significantly fewer relapses in the 4 weeks following treatment, than patients who received only therapy (source)
- In a 4-week study with 371 participants, half receiving placebo and the other half receiving Topamax, the Topamax group had significantly fewer drinking days (source)
- Low dose Topamax reduces alcohol cravings, anxiety, and depression during acute withdrawal (source)
You can learn more in this article about how to use Topamax for alcoholism.
Alcohol Abstinence Medication – Antabuse
Antabuse (disulfiram) became the first of the current three FDA-approved medications for alcoholism in 1951. This medication provides no symptom relief or normalization of brain chemistry. Instead, it produces severe side effects (nausea, vomiting, intense pain) when it is taken in conjunction with alcohol.
Antabuse works by blocking the enzyme in the liver that breaks down acetaldehyde, a toxic byproduct of alcohol. In recent years, Antabuse has often been either replaced by or prescribed in conjunction with the other two drugs that are FDA-approved for treating alcoholism: naltrexone and acamprosate.
Antabuse is a favorite of 12-step rehab centers because it has no potential for abuse. It basically serves as a severe biochemical punishment for failing to work The Program.
Scientific research on Antabuse is mixed:
- A study with 243 patients receiving either Antabuse, acamprosate or naltrexone found that the Antabuse group avoided alcohol for a longer duration and had fewer drinking days overall (source)
- A scientific review of studies performed on Antabuse concluded that the most significant reduction of relapse rates occurred for shorter duration studies, or those lasting less than 12 months (source)
- A 6-week study consisting of 605 US veterans found that Antabuse reduced drinking days compared to placebo, but that there was a very high rate of noncompliance (source)
Not surprisingly, Antabuse does tend to reduce relapse rates, but only over the course of short periods and/or in the presence of forced compliance. Because this medication is ineffective for longer durations without forced compliance, I have omitted this medication from the Top 5 list above.
You can read more about Antabuse in this article on the Antabuse-alcohol reaction.
Alcohol Withdrawal Medication – Benzodiazepines
Benzodiazepines are commonly used for alcohol withdrawal symptoms in hospitals, detox centers, and for patients who can be expected to safely detox at home.
Benzodiazepines powerfully stimulate GABA receptors and thereby reduce anxiety, prevent convulsions, and help with sleep. Because they vary in terms of strength and their length of effects, doctors choose between them depending on the patient’s symptoms. These drugs are usually prescribed only for a short duration to prevent tolerance, which builds quickly.
Despite the risk of addiction, some former alcoholics are able to use benzodiazepines for situational anxiety or occasional insomnia.
You can learn more about benzodiazepines in the articles below:
- How To Use Ativan For Alcohol Withdrawal
- How To Use Librium For Alcohol Withdrawal
- How To Use Valium For Alcohol Withdrawal
- How To Use Klonopin For Alcohol Withdrawal
- How To Use Xanax For Alcohol Withdrawal
Originally developed for Soviet astronauts in the 1960s, phenibut is an anxiolytic, meaning that it reduces anxiety, and also a nootropic, meaning that it boosts mental performance.
Phenibut activates GABA-B receptors in the brain, leading to a noticeable calming effect. It also slightly increases dopamine levels, leading to a sense of heightened pleasure.
Phenibut can be ordered online and used at home for alcohol withdrawal, with many people reporting a huge improvement of symptoms. Many people including myself are able to use it situationally.
The main risk with using phenibut for alcoholism is that tolerance and dependence can develop with daily use. Phenibut addiction is a real phenomenon, but I have used phenibut on numerous occasions for situational discomfort and insomnia. I always limit my dosage of phenibut to 100-200 mg – a very small amount!
At this dosage, life seems slightly easier than it normally would be. Relaxation is effortless and sleep comes quickly if desired.
If you are interested in trying phenibut for yourself, be sure to choose a reputable brand like Absorb Health Phenibut.
You can learn more in this article about phenibut for alcohol withdrawal.
Kratom is a member of the coffee family from Southeast Asia. Its leaves contain mitragynine, which is a partial opioid agonist. This means that it binds partially to some of the opioid receptors in the brain, providing pain relief and pleasure.
Kratom provides less stimulation and is less addictive than prescription opiates because it binds to different receptors. As it turns out, alcoholics are addicted to endorphins released by alcohol. When made into a tea, this plant can help stimulate opioid receptors that scream for endorphins (the brain’s natural opiates) that are released by consuming alcohol.
People who switch from alcohol to kratom often report a total cessation of alcohol cravings. Unlike alcohol, kratom is not toxic, and it is much easier to quit than alcohol – especially in low to moderate doses of 2-5 grams.
I use kratom occasionally in social settings. I’ve tried many vendors and found that Top Extracts Kratom is consistently the freshest and best quality.
You can learn more about kratom in this article about kratom for alcohol withdrawal.
Kava is a ground root from the Western Pacific that stimulates GABA receptors, creating a sense of focused relaxation. It also increases dopamine levels, leading to enhanced sociability. Kava is not physically addictive.
Kava can be used for mild to moderate alcohol withdrawal or for social occasions as an alternative to alcohol. I have consumed kava with friends several times and had a blast each time, before drifting off into a very deep sleep.
I have tried 5 kava vendors, and my current favorite is Top Extracts Kava for its potency and freshness.
You can learn more about this fascinating plant in this article about kava for alcohol withdrawal.
Diet & Lifestyle Matter!
Medications can save lives by improving quality of life and serving as a temporary crutch while other adjustments are made.
But they do not enable people to understand, address, and prevent the root causes of disease.
The root causes of alcoholism are complex, but it is always a biochemical disorder. Genetic factors and environmental triggers make some people’s brains more susceptible to becoming dependent on alcohol. Once dependence occurs, excessive alcohol consumption creates deficiencies in nutrients and neurotransmitters that we need to feel good.
And more – alcohol doesn’t merely create deficiencies; it exacerbates already-existing deficiencies that served as catalysts for alcohol use disorder in the first place.
Addressing the root cause of alcoholism requires supplementation with vitamins, minerals, amino acids and other nutrients that are vital for the normal functioning of the brain-body system.
One of the best ways to get started on nutrient repair without ordering 15 supplements on Amazon is to order a bottle of Calm Support. I discuss this supplement in many articles because it contains many of the same nutrients that I used to get past post-acute withdrawal.
Biochemical restoration also requires maintenance of this system through healthy lifestyle habits, such as sufficient sleep, stress management, and regular exercise.
The following articles can help you learn more about how to get started building your brain-body system from scratch:
- Top 20 Supplements For Detox And Recovery
- Body Repair After Quitting Drinking
- Top 10 Ways Exercise Rewires Your Brain
- How To Sleep Better After Quitting Drinking
- Top 20 Liver Detox Foods
- Alcoholism And Hypoglycemia
- How To Use Magnesium For Alcohol Withdrawal
In case you’ve been told that nutritional supplementation simply makes your pee yellow (I once thought this), I’ll share my favorite reaction to an anti-vitamin editorial influenced by Big Pharma. Dr. Rhonda Patrick has a PhD in biomedical science.
Functional medicine is a growing domain of expertise that addresses the underlying causes of chronic disease. For nearly every disease including chronically relapsing alcoholism, root causes usually include lifestyle maladies, diet problems, and nutrient deficiencies.
Chris Kresser is a functional medicine expert and you might enjoy listening to his conversation with Joe Rogan in the video below.
Medications for alcoholism may not work for everyone, but the failure to beat alcoholism can be fatal. I believe that you deserve to know about every option out there.
If you’re suffering from severe alcoholism (as I did), it’s VERY important to find a doctor who can advise you about the full range of possible treatment options. Send this article to him or her, and then ask to schedule a conversation.
If you’re lucky enough to be stuck with mild to moderate alcohol dependence, rest assured that the articles on here Fit Recovery can make your life MUCH easier going forward!
If you have any questions about medications for alcoholism, feel free to post them in the comment box below.