Seeking professional treatment for an abuse disorder is imperative as quitting alcohol without any medical intervention can lead to severe withdrawal seizures and even death. Treatment initially aims to ease the withdrawal symptoms by close monitoring and prescribing a slow taper off medications, formally known as medication-assisted therapy (MAT). Medication-assisted treatment is used for opioid abuse, nicotine addiction, and alcohol use disorder and consists of a combination of medications that works to alleviate the withdrawal effects so the recovery journey can go as smooth as possible. Alcohol withdrawal can be excruciating, anxiety-ridden, and even life-threatening. Therefore, the combination of medically assisted treatment for alcohol and psychotherapy is known to be the most successful in the treatment of alcohol use disorder. Effective MAT for alcohol dependence has been shown with the FDA approved medications Naltrexone (ReVia, Depade), Naltrexone for Extended-Release Injectable Suspension (VIVITROL), Disulfiram (Antabuse) and Acamprosate Calcium (Campral).
Benzodiazepines as a treatment for alcohol abuse
Long-acting benzodiazepines such as diazepam (Valium) and chlordiazepoxide (Librium) are used in the acute detoxification phase of alcohol addiction since benzodiazepines work on the same receptors in the brain as alcohol. Benzodiazepines can be administered immediately to an individual who is in danger of alcohol withdrawal and can be slowly tapered off once the individual is out of the dangerous withdrawal phase, approximately five days after their last drink. Some individuals may stay on a slow long taper of benzodiazepines, but others will often switch to a safer alternative that is FDA approved from alcohol abuse.
Naltrexone is commonly used for opioid treatment as it blocks the opioid receptors in the brain, helping clients decrease cravings and prevent users from getting high when they use opioids. Although naltrexone was initially used for opioid treatment, it was discovered that naltrexone also works to treat alcohol abuse disorders. Although the specific mechanism of action is unknown, it is believed that the brain interacts with alcohol in the same manner that it interacts with opioids and therefore naltrexone suppresses the euphoric and pleasurable effects associated with alcohol. Individuals who abuse alcohol no longer receive a “reward” for drinking once they are on naltrexone. Naltrexone does not reduce the symptoms of alcohol withdrawals, and therefore, the individual must undergo detoxification before they can begin treatment with naltrexone.
Another medically assisted treatment for alcohol drug is Disulfiram creates unpleasant, hangover like effects when alcohol is consumed and therefore, is used to treat alcohol abuse disorder for individuals who are still craving alcohol. These unwanted effects include facial flushing, headache, nausea, vomiting, chest pain, weakness, and sweating and usually begin 10 minutes after alcohol enters the body and usually lasts for one hour. Disulfiram is not specifically a cure for alcohol use disorder, but rather deters individuals from drinking.
Acamprosate is known to reduce cravings associated with alcohol and can also decrease alcohol withdrawal symptoms. It is the most likely used medication in the United States for alcohol abuse disorder. Acamprosate works by reducing the brain’s dependence on alcohol as alcohol abuse is known to change the brain’s chemistry and functionality. Acamprosate is known to interact with neurotransmitters in the brain by helping to modulate and normalize brain activity that has been thrown into disarray by the cessation of alcohol abuse. When the user stops drinking alcohol, the brain is no longer to function in the same manner; it was in the presence of alcohol, thereby eliciting withdrawal symptoms in the body. Acamprosate should only be taken after the individual has gone through alcohol detoxification. This medication is often taken in combination with other medications such as naltrexone and disulfiram.