Drugs to Stop Alcohol Cravings
Alcohol addiction is a condition that affects people of all ages, backgrounds and genders. Similar to opioid treatment medications, there are drugs to stop alcohol cravings and assist in alcohol use disorder treatment. These anti-craving medications are designed to help patients maintain sobriety by reducing overall alcohol consumption.
Alcohol use disorder is characterized by a strong addiction to alcohol, a loss of control of drinking and experiencing alcohol withdrawal symptoms due to dependence. Oftentimes, during the detox treatment phase for alcohol addiction, cravings can be the biggest and most difficult obstacle to overcome.
What are Alcohol Cravings?
Alcohol cravings can stem from internal or external stimuli. Internal cues for alcohol use include varying emotional states of mind or symptoms of acute alcohol withdrawal. External cues for alcohol use include exposure to alcohol-related environments or physical objects that may be associated with drinking.
In general, cravings are a very subjective phenomenon. Everyone experiences them differently and has different parameters for craving intensity. Sometimes cravings can be measured by certain physiological changes believed to accompany alcohol side effects. This can include symptoms such as increased heart rate, blood pressure, salivation and sweat gland activity.
Following the patient’s drinking pattern and behavior can also assess cravings. How many drinks do they usually consume? How long is the time between drinking? What is the time between initiating a new drink? How much time between starting and ending their drinking episode?
Drugs to Stop Alcohol Cravings
Acamprosate
Acamprosate. Acamprosate is considered the first choice of medication to treat moderate to severe alcohol use disorder. The medication works by stabilizing the chemical balance in the brain that has been disrupted by prolonged alcohol abuse. It restores the balance of excitatory and inhibitory neurochemicals and corrects alcohol-induced brain changes.
This drug helps reduce dependence on alcohol, reduce the severity of withdrawal symptoms and minimize cravings. Side effects of the drug include diarrhea, nausea, vomiting, stomach pains, loss of appetite, dizziness, tiredness and depression.
It is a commonly used prescription medication for medication-assisted treatment.
Acamprosate comes in a tablet form with an average dosage of 2 tablets, 3 times per day. The drug is meant to be started after the user has quit drinking. It is used to help maintain abstinence, reduce cravings and reduce relapse.
Disulfiram
Disulfiram. Disulfiram is one of the oldest FDA-approved medications for alcohol use disorder treatment. It is an alcohol blocker. It prevents alcohol from being broken down in the liver, which causes an unpleasant alcohol reaction in the user. This helps to discourage drinking.
Disulfiram works by interfering with the metabolism of alcohol in the liver, resulting in an accumulation of alcohol in the bloodstream. This causes side effects such as flushing, palpitations, difficulty breathing, headache and nausea. It causes the users to have a severe adverse reaction when alcohol is consumed.
Side effects include drowsiness, tiredness, headache, vomiting and an unusual metallic aftertaste. These symptoms can last for as long as an hour or longer depending on the severity of the alcohol addiction. And a reaction can occur as far out as 2 weeks after the last dose of the medication.
The medication is taken once in the morning for about 1-2 weeks and should be administered under clinical guidance for the most effective treatment results.
Naltrexone
Naltrexone. Naltrexone is an opioid antagonist. It is usually used for opioid use disorder treatment. It works by blocking opioid activity that reinforces the effects of alcohol. When drinking alcohol, the body releases natural opioids and the chemical dopamine. Excessive amounts of opioids and dopamine can lead to the development of an addiction.
By blocking these areas where the opioids attach, it can block the rewarding effects of alcohol. It makes drinking alcohol less enjoyable and cravings are diminished. Blocking the euphoric effects of alcohol use can reduce motivation to drink, reduce heavy drinking and help a user maintain abstinence.
Naltrexone is one of the first choice medication options for moderate to severe alcohol use disorder, according to the American Psychiatric Association. Side effects of the medication include nausea, headache, dizziness, fatigue, appetite changes, depression, anxiety and insomnia. Naltrexone can be administered as a once-daily tablet or once-a-month injection. The starting dose is around 50mg per day for the tablet and a dose of around 380mg for the monthly injectable.
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Other Drugs that Treat Alcohol Cravings
Acamprosate, disulfiram and naltrexone are the most popular drugs used in medication-assisted treatment for alcohol use disorder. They are FDA-approved and have been proven to be effective in treating different aspects of alcohol addiction. However, there are other medications that are not FDA-approved and have also shown promising results in helping to reduce cravings and treat symptoms of alcohol withdrawal.
- Topiramate (Topamax) – Some doctors prescribe this anti-convulsive medication to help reduce cravings for alcohol as well as prevent alcohol-induced seizures.
- Gabapentin (Neurontin) – Doctors prescribe this nerve pain medication to help reduce the severity of seizures that can occur during alcohol withdrawal.
- Zofran (Ondansetron) – This drug is used to ease the symptoms of nausea and vomiting for people with cancer. It has been found to help reduce cravings for those with early-onset alcohol use disorder.
- Selincro (Nalmefene) – This drug is approved in Europe to help reduce alcohol cravings but it comes with certain safety risks.
- Baclofen is a muscle relaxant drug that some studies have found can reduce alcohol cravings and has been approved in France for the treatment of alcohol use disorder.
- Tiapride – This dopamine antagonist has been shown to possibly reduce alcohol consumption and cravings. In some studies, it showed effectiveness in increasing alcohol abstinence.
- Bromocriptine (Parlodel) – This drug is typically used to treat symptoms associated with high levels of prolactin. This can help reduce alcohol cravings.
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Treatment for Alcohol Use Disorder
Alcohol use disorder is one of the most common mental illnesses. It is a disease that can significantly impact the brain as well as other organ functions. Cravings and relapse are some of the most difficult obstacles to overcome during addiction treatment. Cravings and the urge to use alcohol can often lead to relapse and a continuation of the unhealthy cycle of alcohol addiction.
Oftentimes, medication-assisted treatment (MAT) is needed to help with alcohol cravings. These medications include disulfiram, acamprosate and naltrexone. Despite their success, anti-craving medications are the most effective when used in conjunction with other treatment methods such as cognitive psychotherapy.
Behavioral health treatment programs such as Hotel California by the Sea provide treatment for alcohol use disorder and co-occurring mental health disorders. We offer all levels of treatment including alcohol detox, residential, PHP and IOP. We utilize evidence-based treatment methods such as CBT, DBT and family therapy. Hotel California by the Sea is dedicated to helping clients achieve their goals for sobriety and overcome their alcohol addiction.
References:
https://rehabsuk.com/blog/does-anti-craving-medication-work-for-alcoholism
https://pmc.ncbi.nlm.nih.gov/articles/PMC6760374
https://www.verywellmind.com/is-there-medication-that-will-reduce-alcohol-craving-67516
https://www.drugrehab.com/addiction/alcohol/medications-for-alcoholism