There were 14.1 million people with alcohol use disorder (AUD) in the United States in 2019, and 414,000 adolescents aged 12 to 17 with AUD, as reported on the 2019 National Survey on Drug Use and Health by the National Institute on Alcoholism and Alcohol Abuse (NIAAA).
Alcohol use disorder is defined as “chronic relapsing brain disease characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. AUD can range from mild to severe, and recovery is possible regardless of severity, per the NIAAA.
People who are heavy alcohol drinkers and those who binge drink may find it very difficult to stop drinking. Alcohol cravings can be very strong and difficult to manage without help. Individuals who are dependent on alcohol could experience daunting withdrawal symptoms if they stop drinking. The intense cravings coupled with troubling withdrawal symptoms are why many people who try to quit drinking on their own fail.
In light of this information, there are prescription medications available to help you or someone you care about end alcohol abuse. There also are various natural supplements and therapies to consider.
Currently, the Food and Drug Administration (FDA) has approved three medications for AUD. Each one works differently.
Naltrexone. Brand names for this drug are Vivitrol and Revia. It comes in two forms: a tablet taken daily or a once-a-month injection given by a medical professional. It works best if the individual can stop drinking before taking it. It should not be taken if opioid medications are also being taken because it can cause severe withdrawal or block the effects of the medications.
Naltrexone blocks the effects of natural opioids in the body, therefore, helping to suppress alcohol cravings. It reduces feelings of reinforcement that alcohol can produce. It is thought to be an effective treatment for alcohol cravings. Because it can be taken daily or injected once a month, Naltrexone holds an advantage over other prescription medications that are taken several times a day.
Naltrexone does come with some effects to know:
Acamprosate. Campral is its brand name. It should be used once the person stops drinking. It comes in pill form and two pills taken three times per day is how it is prescribed. This drug requires the person to stop drinking before it can be taken.
The drug works by interacting with two chemical messenger systems in the brain: GABA (short for gamma-Aminobutyric acid) and glutamate. GABA stifles certain nerve cells and might help control the fear or anxiety someone feels when those cells are overexcited. Glutamate stimulates nerve cells, as noted by WebMD.
Acamprosate comes with side effects. Most people who take it experience very few side effects and the drug is well-tolerated. Side effects may include:
- Abdominal cramps
- Decreased sex drive
Disulfiram. Its brand name is Antabuse. It cannot be started if the individual is still drinking. If they are still drinking and take it, it will cause them to become very sick. It comes in pill form, and one pill per day is the prescribed dose.
It works to prevent alcohol from being metabolized, which can cause the individual to feel nauseous, get headaches, and feel flushed if alcohol is drunk when taking it. It is most effective when the person taking it is 100 percent motivated to not drink and continues to take it despite how they feel.
Disulfiram has some side effects, although mild, felt within the first two weeks of use:
- Skin irritations
Other Prescription Medications
These medications are FDA-approved but not specifically for AUD. However, they can be beneficial.
Topiramate. Its brand name is Topamax, and it is mainly used to prevent migraines, suppress appetite, and treat seizure disorder. It can be taken if the person is still drinking and before other therapies begin. It comes in tablet form in 25 mg per day doses and is increased over time.
It works by changing the balance of chemicals in the brain pertaining to reward, which reduces the reward effect of alcohol. Topiramate is thought to be effective when taken over the course of 14 weeks by reducing heavy drinking and helps some people stay abstinent longer.
Topiramate has some side effects to know:
- Blurred or double vision
- Memory problems
- Tingling sensations
- Weight loss
Gabapentin. The brand name of gabapentin is Neurontin. This is primarily a drug used to treat epilepsy and postherpetic neuralgia, a condition that causes nerve pain after shingles recovery. It comes in capsule form in different doses.
It works by normalizing brain chemicals, therefore, helping the person maintain abstinence and preventing relapse. It is thought to be an effective medication for AUD, though it is not FDA-approved for that diagnosis.
Gabapentin has some side effects, which include:
- Trouble with coordination
- Nausea and vomiting
- Double vision
- Trouble speaking
Healthline reports that study participants who received a single infusion of ketamine, along with a five-week regiment of motivational enhancement therapy, had a higher rate of abstaining from alcohol than those in the study who were given midazolam, a sedative along with the above-mentioned therapy.
The other study focused on how ketamine affected the maladaptive reward memories, which produce triggers in the environment and drug reward feelings. There were 90 study participants who were given either a placebo or a single infusion of ketamine. Researchers found that those who received the ketamine developed a significant reduction in the overall enjoyment and desire to drink.
We do caution that these studies are new. Ketamine is not regularly used for alcohol cravings or withdrawal.
Natural Remedies for Alcohol Cravings and Withdrawal
Many people prefer to forgo prescription medicine in favor of natural remedies and therapies to help them forge through alcohol cravings and withdrawal symptoms. While this is admirable and may seem a healthier way to stop using alcohol, it is best to bolster these natural supplements and therapies with strong and steady support from behavioral therapies and support groups.
Traditional Chinese medicine practice includes the use of herbs to heal many symptoms. Kudzu extract is one. Kudzu is a vine that is a nuisance plant in the southern US. However, it is thought to reduce excessive alcohol consumption. Puerarin is an ingredient in the plant that boosts the flow of blood in the brain. It is also considered to prevent the clearing of acetaldehyde, which is a breakdown product of alcohol that has discomforting effects, as noted by Verywell Health.
Ashwagandha is an herbal supplement from the Withania somnifera plant. It has been used in Ayurvedic medicine for alcohol withdrawal and cravings. Studies done with rats showed it reduced anxiety, but more studies are needed with human beings.
Other Natural Supplements
It is thought that B-vitamins and L-glutamine could be beneficial to manage alcohol cravings.
Heavy drinks bouts deplete the body of thiamine, which is a B vitamin, thus resulting in anemia. Anemia can cause an individual to feel weak, fatigued, unfocused, and depressed. When a B vitamin complex is taken, it could aid in reducing cravings, increase energy, and restore the natural composition of the body.
L-glutamine, an amino acid, is naturally produced by the body. Heavy alcohol drinking may impede how l-glutamine is incorporated and absorbed in the body. When it is added back into the body while abstaining from alcohol, it could help regulate body chemistry. It may also be useful for the management of cravings and boost mood.
Effective Treatment for Alcohol Cravings and Withdrawal
The most effective treatment for alcohol cravings and withdrawal is medical detoxification at an addiction treatment center like Arete Recovery. Without the medically supervised detox process, individuals can easily become dehydrated and have seizures and other symptoms, which can eventually cause death.
After medical detox, the individual may be admitted for inpatient treatment. This entails residing at a treatment center and engaging in various behavioral therapies, such as cognitive behavior therapy, family therapy, individual therapy, and group therapy. Therapeutic plans for the patient include relapse prevention, motivational interviewing, which helps the individual identify the cons of alcohol abuse.
Alcohol cravings and withdrawal symptoms can be dangerous to experience when attempted alone or even with support from a significant other. There is more to quitting alcohol than just stopping use. One needs to be committed to becoming alcohol-free and staying alcohol-free. While addiction is defined as a chronic, relapsing disease of the brain, it is treatable. There is no reason to struggle with alcohol cravings and withdrawal alone. You can overcome alcohol abuse.