The three-step road map outlined in the NIAAA Alcohol Treatment Navigator offers expert guidance to focus and support your efforts. Learn how to find higher quality, science-backed alcohol treatment to raise your changes for success. Given the diverse biological processes that contribute to AUD, new medications are needed to provide a broader spectrum of treatment options.

Join a support group

Neuroinflammatory signaling pathways in the CNS are of current interest as potential pharmacotherapy targets for alcohol dependence. Ibudilast is a neuroimmune modulator that inhibits phosphodiesterase (PDE)-4 and PDE-10 and macrophage migration inhibitory factor (MIF). In a recent study, ibudilast reduced alcohol drinking and relapse in alcohol-preferring P rats, high-alcohol drinking HAD1 rats and a mouse model exposed to alcohol vapor. When administered twice daily, ibudilast reduced alcohol drinking in rats by approximately 50% and it also suppressed drinking in alcohol-dependent mice at doses which showed no effect in non-dependent mice. These findings support the usage of ibudilast as a potential treatment for alcohol dependent patients (Bell et al., 2016).

What types of alcohol treatments are available?

This avoids unintended precipitation of opioid withdrawal through administration of an opioid antagonist. Of note, naltrexone can cause hepatocellular injury when used in higher than recommended doses and is contraindicated in individuals with acute hepatitis or 14 ways to cure a headache without medication liver failure. Yet medications for alcohol use disorder can work well for people who want to stop drinking or drink a lot less. The brainstem nucleus incertus (NI) containing ORXR1 and ORXR2 are implicated in stress-induced reinstatement of alcohol seeking.

National Recovery Month Toolkit

Prazosin (1.0 or 1.5 mg/kg, i.p) or vehicle was administered in alcohol preferring (P) rats and anxiety-like behavior was measured. Prazosin showed promising results in treating alcoholism by blocking α-1 adrenoreceptors in rats. Intracerebroventricular (ICV) administration of prazosin (2 and 6 nmol) or systemically (1 mg/kg) on antagonist yohimbine (1.25 mg/kg)-induced reinstatement of alcohol craving in rats was assessed by using footshock stress.

Genetic, psychological, social and environmental factors can impact how drinking alcohol affects your body and behavior. Theories suggest that for certain people drinking has a different and stronger impact that can lead to alcohol use disorder. If your pattern of drinking results in repeated significant distress and problems functioning in your daily life, you likely have alcohol use disorder. However, even a mild disorder can escalate and lead to serious problems, so early treatment is important. “Although medical management is somewhat more intensive than the alcohol dependence interventions offered in most of today’s health care settings, it is not unlike other patient care models such as initiating insulin therapy in patients with diabetes mellitus.” The FDA approved the use of naltrexone to treat alcohol use disorders in 1994.

1. It has moderate affinities for histamine and α-adrenergic receptors and serotonin transporters.
2. Assistance needs to be sought for any known or suspected accidental ingestion.
3. Based on clinical experience, many health care providers believe that support from friends and family members is important in overcoming alcohol problems.
4. In a clinical trial, the effects of low dose topiramate were studied for the treatment of alcohol dependence.
5. Remember that changing long-standing patterns is hard, takes time, and requires repeated efforts.
6. They may binge drink once or drink for a period of time before getting sober again.

In ethanol-dependent animals, prazosin (1.5 and 2.0 mg/kg) was effective in suppressing alcohol consumption, suggesting the involvement of noradrenergic receptors in the excessive alcohol drinking during acute withdrawal in ethanol-dependent rats (Walker et al., 2008). In nondependent rats, only 2.0 mg/kg dose was effective and at 0.25 mg/kg doze prazosin mediates anxiolytic effect on ethanol self-administration in nondependent rats. In general, stress-induced anxiety is a major risk factor for reinstatement to alcohol drinking. Medications such as SSRI and SNRI inhibitors, buspirone, benzodiazepines, diphenhydramine, propranolol, tamoxifen, prazosin, doxazosin, that help to block the stress-induced anxiety may also reduce alcohol consumption. Among them, prazosin and doxazosin are known medications for the treatment of high blood pressure.

Health care providers diagnose AUD when a person has two or more of the symptoms listed below. AUD can be mild (the presence of two to three symptoms), moderate (the presence of four to five gray death is the latest “scariest” opioid drug threat symptoms), or severe (the presence of six or more symptoms). The good news is that no matter how severe the problem may seem, most people with AUD can benefit from some form of treatment.

Also known as “alcohol counseling,” behavioral treatments involve working with a health care provider to identify and help change the behaviors that lead to alcohol problems. Alcoholics Anonymous® (also known as “AA”) and other 12-step programs provide peer support for people quitting or cutting back on their drinking. Combined with treatment led by health care providers, mutual-support groups can offer a valuable added layer of support. A dangerous supply of street drugs, fragmented treatment systems, lack of funding, lack of training, pervasive stigma, and complex logistics all work against people with substance use disorders as they work to rebuild their lives after incarceration. Support in recovery and continuity of care are essential during this vulnerable time.

These data suggest that, despite quetiapine showing promising results in preliminary human studies, it was not effective in a single site (Monnelly et al., 2004; Martinotti et al., 2008) and multisite RCT (Litten et al., 2012; Litten et al., 2016). Campral (acamprosate) is the most recent medication approved for the treatment of alcohol dependence or alcoholism in the U.S. It works by normalizing alcohol related changes in the brain, reducing some of the extended physical distress and emotional discomfort people can experience when they quit drinking (also known as post-acute withdrawal syndrome) that can lead to relapse. In 1951 disulfiram (Antabuse; now in generic formulations) was the first drug approved for the treatment of AUD by the FDA.

In the present article, we have focused on the existing medications and the repurposing of the FDA approved medications for the prevention and treatment of AUDs with a list of potential medication candidates, as summarized in Figures -1 & -2, and Tables -1 & -2. In addition to this, the novel medications with potential therapeutic use and in various stages of development are discussed. Comprehensive meta-analyses of randomized controlled trials of FDA-approved medications to treat AUD have shown a significant benefit on rates of abstinence and/or cessation of heavy drinking in studies that were typically 6 months in duration (see Table 1). It is critical to appreciate that those clinical trials included either the nonpharmacological treatment routinely provided for AUD in a given setting or protocol-specific behavioral treatments for all participants. Therefore, the medication (plus behavioral treatment) demonstrated a significant benefit over placebo (plus behavioral treatment) on drinking outcomes.

Monitoring medication compliance is paramount to successful treatment outcomes. To date, the FDA has approved three medications for the treatment of AUD. In other countries, the fentanyl patch European Medicines Agency approved the opioid antagonist nalmefene (Selincro) in 2013 for the treatment of alcohol dependence throughout the United Kingdom and European Union.

This again serves to highlight the importance of specific training in the treatment of AUD, given the need to explain complex information using clearly understood language. A written information sheet providing details about the prescribed medication can be taken home by the individual for future reference. It is recommended that the provider contact the individual a few days after an AUD medication is prescribed to address any concerns, to assess medication adherence and side effects, and to facilitate successful medication initiation. Chronic alcoholism has become a major health issue both in developed and developing countries with heavy social, medical and economic burdens. Despite the available pharmacotherapies for the treatment of AUDs, there are no such medication and treatment methods that give a hundred percent cure rate. Many of these drugs and medicines are known to exhibit some deleterious side effects or are only effective in some conditions.

A baseline urine drug screen may also be useful, as it may provide information about otherwise undisclosed drug use, including opioid use, which would rule out naltrexone treatment of AUD. FDA has approved several different medications to treat alcohol use disorders (AUD) and opioid use disorders (OUD). These medications relieve the withdrawal symptoms and psychological cravings that cause chemical imbalances in the body. Medications used are evidence-based treatment options and do not just substitute one drug for another.