Medications are not required for effective treatment for alcohol addiction, but they can help the process be more manageable and effective. Medications have been developed to help people reduce or completely stop their alcohol intake without struggling with the range of withdrawal symptoms that can present themselves.
Medications are not the only aspect of comprehensive addiction treatment, but they can be the catalyst that helps people make significant changes in the direction of sober living. Drugs approved specifically for the treatment of alcohol use disorder can provide enough relief from the addiction that psychological changes that are necessary for long-term recovery can begin.
What Is Medication-Assisted Treatment?
Medication-assisted treatment (MAT) is a specific type of addiction treatment that incorporates medications and behavioral therapies to treat substance abuse issues. It aims to provide a holistic approach to addiction treatment by addressing both chemical and behavioral imbalances that could be affecting one’s ability to get sober.
Primarily developed in response to the opioid overdose epidemic that is currently happening across the United States, MAT has also been proven to be highly successful for treating alcohol use disorders as well as to help people quit smoking. Researchers continue to investigate other substance use disorders that can be helped by MAT, such as addictions to stimulants.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), MAT has been clinically proven to significantly reduce the need for people to receive detoxification services, and it has been shown to lead to positive treatment outcomes. The primary goal of MAT is to assist patients in making a full recovery from their addiction. Critics of MAT, however, question the use of medications in addiction treatment. They feel that drugs being used in MAT are only replacing the drug of addiction. The difference, however, is that drugs used in MAT are closely monitored and do not provide an addictive high, like drugs of abuse. Rather, dangerous withdrawal symptoms are controlled, patients can fully participate in therapy, and adverse effects of MAT are rarely observed.
FDA-Approved Drugs for Alcohol Treatment
Currently, three drugs have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of alcohol use disorders. Disulfiram, naltrexone, and acamprosate are the medications most commonly used to treat alcoholism.
- Disulfiram: First approved to treat alcoholism in 1949, disulfiram has the longest history of use in MAT. It works by increasing the number of toxic byproducts caused by drinking alcohol, which produces unpleasant symptoms such as nausea. The anticipation of experiencing such unwanted side effects is believed to prevent people from drinking.
- Naltrexone: This was the second drug to be approved by the FDA for treating alcohol use disorders. It first became available as an oral drug in 1994 and then as an extended-release injectable in 2006. Naltrexone works by blocking opioid receptors that are responsible for producing the pleasant sensations produced by alcohol. In turn, cravings for alcohol are reduced.
- Acamprosate: Acamprosate, approved for use in 2004, is most helpful in relieving negative withdrawal symptoms by reducing hyperexcitability in the brain that happens during withdrawal from alcohol.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) explains that benzodiazepines have also been shown to be effective for managing withdrawal symptoms. They limit hyperexcitability in the brain during withdrawal by inhibiting neurotransmitter gamma-Aminobutyric acid (GABA). By doing this, benzodiazepines help the brain return to its natural chemical balance, free from alcohol.
Side Effects of MAT Drugs
Each drug used in MAT is different, and side effects vary from drug to drug, but there are a few commonly experienced side effects. Additionally, every person will tolerate each drug in their own way. While disulfiram encourages abstinence, it can cause drowsiness, headaches, and leave a metallic taste in your mouth. Naltrexone’s most common side effect is nausea. Acamprosate’s most common side effect, on the other hand, is diarrhea. Any signs of severe side effects after taking any one of these three drugs, such as anxiety, depression, suicidal thoughts, excessive tiredness, vomiting, hallucinations, blurred vision, and confusion, should be assessed by a medical professional immediately. Each medication comes with its own set of warnings and can potentially interact with other medications you may be taking. To avoid complications associated with these drugs, it is important to avoid drinking alcohol and speak with your doctor about medications you are already on.
The Best Drugs for Alcohol Treatment
There are many drugs available for the treatment of alcohol use disorders and their withdrawal symptoms. Researchers have found, however, that benzodiazepines are one of the most effective drugs for treating alcohol withdrawal and its accompanying symptoms.
They can be administered as needed and used to target specific withdrawal symptoms. When doctors aim to address specific symptoms, lower doses of benzodiazepines are needed, patients experience less sedation during withdrawal, and patients are often discharged from the withdrawal phase of treatment earlier.While some doctors and researchers have recognized certain drugs to be more effective than others for treating alcohol addiction and withdrawal, no single medication is best for everyone. Individual responses to medications can vary, and you may find more success with one drug over the other.
If you are seeking medication support to treat an alcohol use disorder, speak with your doctor about how you are responding to the drug. If it does not feel like it is effective, your doctor may switch you to a different medication.
The Underuse of MAT Services
In spite of evidenced-based research conclusively supporting the use of MAT for alcohol and substance use disorders, it is a highly underutilized form of treatment. SAMHSA estimates that 18 million people in the United States are struggling with an alcohol use disorder. Less than 10 percent of those people receive any formal addiction treatment. Of those 10 percent, only a small portion is given any medication to help them through the recovery process.
People speculate that the belief that MAT is merely a replacement drug prevents many practitioners from gaining an educated understanding of how MAT works and informing patients about the option. There is also a general lack of awareness in the public that MAT is available to them. For people who have tried using MAT, there have been reports of unfair and biased treatment in health care settings as it appeared they were just relying on a different substance instead of alcohol. In an effort to clear up misconceptions about MAT among health care providers and the public, SAMHSA and NIAAA worked together to produce a clear and comprehensive guide that can be downloaded for free from SAMHSA’s website. The guide provides an explanation of MAT, which drugs have been approved for the treatment of alcohol addiction, useful screening and assessment tools, how to form a proper treatment plan, and how to monitor patients who are using MAT.
When to Use Medication-Assisted Treatment
Proponents of MAT advocate for the beneficial effects of using medications to promote recovery. People in support of MAT are clear, however, that medications are only part of the treatment process.
MAT has been developed to provide a comprehensive approach to addiction treatment. Medications alone will do little to instill behavioral habits that are necessary for maintaining sobriety in the long-term. In fact, MAT researchers have found that people who take advantage of medications to stabilize their moods during withdrawal are more likely to participate and fully engage in behavioral therapies.
MAT is a good treatment option for people who are ready to achieve a stable mindset, stop constantly thinking about alcohol, experience fewer cravings to consume alcohol, and move forward with counseling and behavioral therapy. If you are ready to safely quit drinking and do not want to run the risk of experiencing dangerous withdrawal symptoms, MAT can help.
The drugs used in MAT cannot guarantee that you will achieve and maintain sobriety, but they can greatly assist you in the recovery process. Though MAT services are generally underused, they present an effective approach to alcohol addiction treatment that may just work for you.