Are There Medications for Alcoholism? - Pharmacological Treatment of Alcoholism

Update: March 21, 2025, 09:30 Alcoholism as a chronic disease requires comprehensive treatment in which, in addition to psychotherapy, medications play an important role. The medications used can help alleviate withdrawal symptoms, reduce alcohol cravings, and support the process of maintaining sobriety. Although pharmacotherapy is not a standalone solution, when combined with other therapeutic methods, it can significantly improve treatment effectiveness and patients' quality of life.

TL;DR

Pharmacological treatment of alcoholism supports psychological therapy by reducing alcohol cravings, alleviating withdrawal symptoms, and preventing relapses. The most commonly used medications are disulfiram (Esperal), which causes unpleasant reactions after alcohol consumption, acamprosate, which reduces alcohol hunger, and naltrexone, which decreases the pleasure from drinking. Alcohol detoxification often requires the use of benzodiazepines and anticonvulsants under strict medical supervision to prevent complications. There are no effective over-the-counter medications for alcoholism; all effective treatments require medical supervision. The effectiveness of pharmacotherapy depends on patient motivation, degree of dependence, individual body response, and cooperation with a psychotherapist.

Are There Effective Pills for Alcoholics?

Pills can be an effective part of therapy in treating alcoholism, but it should be remembered that pharmacological treatment alone is rarely sufficient. Medications can help fight addiction through various mechanisms:

• Blocking alcohol effects – medications such as disulfiram cause unwanted reactions after consumption (e.g., nausea, vomiting, headaches), which discourages the person from drinking.

• Reducing alcohol cravings – preparations (e.g., acamprosate) help reduce alcohol cravings by restoring the balance of neurotransmitters in the brain.

Pharmacological Treatment of Alcoholism as Therapy Support

Medications for alcoholism are typically used as a supplement to therapy. This form of support can help the addicted person reduce withdrawal symptoms, control alcohol cravings, and minimize the risk of relapse. Treatment is usually effective when used in combination with psychotherapy, support programs (e.g., support groups, 12-step programs), and lifestyle changes. However, it's important to remember that pharmacological treatment does not completely replace psychological therapies. Patient engagement and cooperation with the therapist are necessary for treatment to bring long-term effects.

Key Mechanisms of Action of Medications for Alcoholism

Changing the Body's Response to Alcohol

Some therapeutic substances work by blocking the enzyme aldehyde dehydrogenase, which is responsible for breaking down acetaldehyde formed after alcohol metabolism. The purpose of this action is to discourage the patient from drinking by causing very unpleasant symptoms.

Medications to Reduce Alcohol Hunger

Appropriate medications can affect the nervous system, restoring balance to neurotransmitters (e.g., glutamate and GABA), which are naturally disrupted by chronic drinking. This action aims to reduce alcohol hunger and facilitate abstinence. The therapeutic substance does not trigger reactions after alcohol consumption but rather works subtly, helping the body cope with the neurochemical consequences of addiction.

Reducing Pleasure from Alcohol Consumption

It's possible to block receptors in the brain that are responsible for the feeling of pleasure from alcohol consumption. This reduces the feeling of euphoria that many addicted people associate with drinking, which can help control habits related to addiction.

Most Commonly Used Medications in Alcohol Treatment

Disulfiram (Esperal) – is one of the most commonly used medications in treating alcoholism. Its main action consists of causing unpleasant physical reactions after alcohol consumption, such as:

• headaches

• nausea

• vomiting

• accelerated heartbeat

• shortness of breath

Thanks to these symptoms, disulfiram discourages alcohol consumption because the reactions after consumption are so unpleasant that patients try to avoid them. These medications are used in the form of tablets or implants. Acamprosate – acts on the nervous system, helping reduce symptoms related to alcohol cravings. It helps restore the balance of neurotransmitters in the brain (e.g., in the GABA and glutamate systems), which were disrupted by long-term drinking. The medication helps the patient reduce alcohol hunger and maintain abstinence. Naltrexone – a medication that blocks opioid receptors in the brain, which reduces the pleasure derived from alcohol consumption. As a result of this action, patients have less tendency to reach for alcohol because it no longer gives them the same sensations.

Medications for Alcohol Withdrawal – Help in Detoxification

Medications used in the detoxification process aim to alleviate alcohol withdrawal symptoms and prevent complications associated with sudden cessation of drinking. Withdrawal symptoms may include:

• anxiety states

• hand tremors

• sweating

• headaches

• vomiting

• seizures and delirium tremens (in severe cases)

Medications Used During Detox

• Benzodiazepines – medications commonly used in the alcohol withdrawal phase because they help alleviate physical symptoms associated with the process.

• Anticonvulsants – in cases of people at risk of seizures related to alcohol withdrawal, anticonvulsants are used to help prevent symptoms.

• Medications supporting treatment of coexisting health problems – during alcohol detoxification, patients may need medications supporting liver and digestive system functions, as well as replenishing electrolytes and vitamins (e.g., thiamine, magnesium), which may be deficient as a result of alcohol abuse.

Alcohol detoxification should take place under strict medical supervision because alcohol withdrawal can be dangerous, especially in people who have been dependent for a long time. The medications used in this process help go through the process and also reduce the risk of complications.

Are There Over-the-Counter Medications for Alcoholism?

There are no over-the-counter medications for alcoholism that are recognized as effective in treating addiction. Although various dietary supplements and herbal preparations are available on the market, they are neither officially approved nor recognized by medical organizations as substances that effectively treat addiction. Why aren't medications for alcoholism available over the counter? Addiction treatment is complex and requires specialized care because it is a chronic disease that affects both the body and psyche of the patient. Effective medications used in therapy are available only by prescription because they require medical supervision and are used in specific cases, depending on the health status and needs of the individual.

How to Treat Alcoholism with Pills – Effective Pharmacological Therapy

Pharmacological therapy is one of the elements of comprehensive addiction treatment. It should be used as part of a comprehensive plan that also includes psychological therapy and long-term support. Medications for alcoholism can help reduce alcohol hunger, alleviate withdrawal symptoms, and maintain abstinence.

Why Is the Combination of Pharmacotherapy with Psychotherapy Effective?

• Pharmacotherapy helps alleviate physical symptoms related to addiction and also triggers unwanted reactions after alcohol consumption (e.g., in the case of disulfiram).

• Psychotherapy focuses on emotional, mental, and social problems related to addiction. It helps understand the mechanisms that lead to addiction and offers tools for dealing with difficult emotions and life situations that can lead to relapse.

The combination of these two methods increases the chance for long-term abstinence because medications help in the detoxification process and maintaining abstinence, while psychotherapy enables better understanding and control of the mental aspects of addiction.

Who Are Pills for Quitting Alcohol Intended For?

Pills for quitting alcohol are primarily intended for people who:

• Have decided to treat alcoholism, want to fight addiction, and are ready to cooperate with a doctor and psychotherapist.

• Are looking for support in maintaining abstinence. Medications for alcoholism are effective in cases where the patient has difficulty controlling alcohol consumption or experiences strong temptations to drink alcohol.

• Are in the detoxification phase and need medications that alleviate withdrawal symptoms and reduce alcohol hunger.

Such medications are used at various stages of treatment, depending on the patient's condition and individual needs. For example, disulfiram is used mainly to discourage alcohol consumption by causing unpleasant symptoms after consumption, while naltrexone reduces the pleasure from drinking, and acamprosate helps reduce alcohol hunger.

Do Pills Against Drinking Alcohol Work for Everyone?

Pills for alcoholism can be effective but don't work for everyone. Their action depends on several factors:

• Patient motivation – medications can help in addiction treatment, but only when the patient has strong motivation to stop drinking and is ready for active cooperation with the therapist. Without this motivation, medications may not bring desired results.

• Individual body reactions – each body reacts differently to medications. In some people, medications may be effective in maintaining abstinence, while in others they may not work as effectively.

• Degree of dependence – people who have been alcohol-dependent for a long time may require more intensive treatment and pharmacological support than patients in early stages.

• Health status and interactions with other medications – in some people, especially those with comorbidities, the use of medications for alcoholism may be contraindicated or require special caution.

Is Pharmacological Treatment of Alcoholism Effective?

Pharmacological treatment of alcoholism can be effective but does not constitute a complete solution to the addiction problem. Therapeutic preparations help reduce alcohol hunger, alleviate withdrawal symptoms, and prevent relapses. However, to achieve lasting abstinence, it is necessary to combine pharmacotherapy with psychological therapy. The doctor's role in choosing the appropriate treatment is crucial because proper medication selection and therapy monitoring help achieve better results.

Bibliography

• Habrat B. (2001). Leki stosowane w leczeniu uzależnienia od alkoholu. Alkoholizm i Narkomania 14(1):137–149.

• Habrat B. (2011). Farmakoterapia uzależnienia od alkoholu – aktualne standardy i perspektywy. Terapia 2011;(1):48–51.

• Bieńkowski P, Habrat B, Jarema M, Mierzejewski P, Samochowiec J, Wojnar M, Rybakowski J. (2013). Długoterminowa farmakoterapia wspierająca utrzymywanie abstynencji lub zmniejszająca spożycie alkoholu u osób uzależnionych od alkoholu: zalecenia Sekcji Farmakoterapii PTBU i Sekcji Psychofarmakologii PTP. Farmakoterapia w Psychiatrii i Neurologii 29(3–4):133–139.

• Bieńkowski P. (2013). Zastosowanie naltreksonu w terapii uzależnienia od alkoholu – aspekty farmakologiczne. Psychiatria Polska 47(1):117–126.

• Mierzejewski P, Bieńkowski P, Jakubczyk A, Samochowiec J, Silczuk A, Wojnar M. (2022). Farmakoterapia alkoholowych zespołów abstynencyjnych – zalecenia Polskiego Towarzystwa Psychiatrycznego i Sekcji Farmakoterapii PTBU. Psychiatria Polska 56(3):433–452. DOI:10.12740/PP/OnlineFirst/149321.

• Johnson BA, Rosenthal N, Capece JA, et al. (2007). Topiramate for treating alcohol dependence: a randomized controlled trial. JAMA 298(14):1641–1651. DOI:10.1001/jama.298.14.1641.

• Litten RZ, Wilford BB, Falk DE, et al. (2013). A meta-analysis of naltrexone and acamprosate for treating alcohol use disorders: when are these medications most helpful? Addiction 108(5):714–724. DOI:10.1111/add.12152.

• Ray LA, Meredith LR, Kiluk BD, et al. (2020). Combined pharmacotherapy and cognitive behavioral therapy for adults with alcohol or substance use disorders: a systematic review and meta-analysis. JAMA Network Open 3(6):e208279. DOI:10.1001/jamanetworkopen.2020.8279.

• McPheeters ML, O'Connor EA, Riley S, et al. (2023). Pharmacotherapy for alcohol use disorder: a systematic review and meta-analysis. JAMA 330(17):1653–1665. DOI:10.1001/jama.2023.19761.

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Frequently Asked Questions – FAQ

How do pills for alcoholism work?

Pills can block the effects of alcohol consumption (e.g., by causing unpleasant reactions), reduce alcohol hunger, or decrease pleasure from drinking.

What medications are most commonly used?

The most commonly used are disulfiram (Esperal), acamprosate, and naltrexone, each of which acts on a different mechanism of addiction.

Are medications for alcoholism available over the counter?

No, effective medications require medical supervision and are available only by prescription.

Why is the combination of pharmacotherapy with psychotherapy effective?

Medications alleviate physical symptoms of addiction, while psychotherapy helps deal with emotional and social aspects of the addiction.

Who are pills for quitting alcohol intended for?

They are dedicated to people who have decided to treat alcoholism, need support in maintaining abstinence, or are in the detoxification phase.

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