Medications for the Treatment of Alcohol Use Disorder

Alcohol use disorder (AUD) can have devastating effects on a person with the diagnosis as well as those around them, and it impacts millions of people each year. According to the 2023 National Survey on Drug Use and Health, 28.9 million Americans aged 12 and older had an AUD in the past year.¹ AUD is characterized by a problematic pattern of uncontrollable alcohol use despite negative consequences.

If you are concerned about your alcohol use or that of a loved one, consider taking our self-assessment. Please note this tool is for educational purposes only and is not a substitute for a formal clinical assessment conducted by a licensed healthcare professional. Only a qualified professional can diagnose an AUD. This self-assessment can help you reflect on your behaviors and alcohol use patterns, but should not be used for self-diagnosis.

The good news is that treatment can help you end problematic alcohol use. Treatment, which may include alcohol use medications, can play an important part in helping you reduce or stop your alcohol consumption, sustain recovery, and regain control of your life.²

What Is MAT (Medication-Assisted Treatment)?

Medication-assisted treatment (MAT), often referred to as medication for addiction treatment, involves the use of FDA-approved medications in combination with evidence-based behavioral therapies to treat people with AUD and certain substance use disorders, primarily opioid use disorder.^2,3 Tailored to meet the needs of each individual—MAT for AUD or (MAUD) has been shown to be effective in increasing rates of abstinence; reducing a return to drinking after a period of abstaining; restoring normal brain functioning; and decreasing symptoms of protracted withdrawal, which refers to the lingering symptoms that can persist after acute withdrawal, such as cravings, mood swings, and insomnia.⁴ However, in 2022, less than 4% of the 29.5 million Americans aged 12 or older received medication treatment for AUD.⁵

What Medications Are Approved for Alcohol Use Disorder?

The U.S. Food and Drug Administration (FDA) has approved 3 medications for the treatment of AUD (MAUD): acamprosate, naltrexone, and disulfiram.^2,5,6

Acamprosate (Campral)

Acamprosate, formerly sold under Campral and now discontinued in the U.S., is still available as a generic formulation.^7,8 Acamprosate may be prescribed to individuals seeking to reduce their alcohol use or abstain from it altogether by helping to minimize alcohol cravings, reduce heavy drinking patterns, and support recovery.^5,7 It’s not used to treat acute alcohol withdrawal symptoms and is typically started after an individual has completed medically managed withdrawal or detox.⁴ 

Generally well tolerated, the most commonly reported side effect associated with acamprosate is diarrhea.^4,7 Other side effects may include nausea, nervousness, fatigue, sweating, dry mouth, insomnia, itching, and dizziness, though all side effects tend to be mild and fleeting.^4,6 Additionally, because acamprosate is cleared by the kidneys and not the liver, it is safe for use in individuals with decompensated liver disease but not in patients with severe kidney dysfunction.²

Although the precise mechanism of action is not fully understood, acamprosate is believed to interact with the glutamatergic neurotransmitter system, potentially reducing symptoms that linger after acute withdrawal ends. These protracted alcohol withdrawal symptoms, which can include sleep and mood changes, may contribute to relapse. By mitigating these effects, acamprosate may help reduce the risk of returning to alcohol use.⁷ Typically prescribed for up to 6 months (longer-term safety and efficacy have not been well studied), acamprosate can be safely combined with other AUD medications, and evidence indicates an improved benefit when acamprosate is combined with other treatment interventions such as counseling and mutual-help groups.⁴

Naltrexone (Revia and Vivitrol)

Naltrexone is an opioid agonist medication, which means that it binds to and blocks the opioid receptors in the brain. Research indicates that alcohol interacts with the body’s endogenous opioid system, contributing to the pleasurable and reinforcing effects of alcohol. By blocking opioid receptors, naltrexone reduces the gratifying effects of alcohol and diminishes cravings.^4,7 Available in oral (Revia) or extended-release injectable (Vivitrol) forms, naltrexone may be appropriate for individuals who want to cut back on their alcohol use or those who want to stop drinking completely.⁴ Studies show that when used for the treatment of AUD, naltrexone improves abstinence, reduces alcohol use, and prevents relapse to heavy alcohol use.⁵ 

In general, naltrexone is well tolerated. Common side effects include mild nausea and headache.⁵ Dizziness, fatigue, vomiting, sleepiness, and dysphoria, or a state of persistent low mood, are some of the other rare and mild side effects individuals with AUD have reported after taking naltrexone as part of their treatment.^4,7

Studies indicate that some individuals with AUD who take naltrexone experience positive responses, including a complete eradication of cravings. Others have successfully used naltrexone to stop drinking or reduce alcohol intake to moderate levels.⁵ 

Naltrexone can be used long-term and safely combined with other AUD and non-opioid medications. Additionally, research indicates that when used as part of a comprehensive treatment plan for AUD, naltrexone can enhance the effectiveness of other therapeutic interventions, such as cognitive-behavioral therapy (CBT) and motivational enhancement therapy.⁴

Disulfiram

Disulfiram is a medication for AUD that works by decreasing the liver’s ability to metabolize alcohol and thus acts as a deterrent to drinking.⁵

If alcohol is consumed, even in small amounts, it can trigger a disulfiram-alcohol reaction. This reaction can cause a range of unpleasant symptoms, including flushing, heart palpitations, anxiety, shaking, headache, difficulty breathing, nausea, and vomiting. In severe cases, it can include heart failure, seizures, respiratory depression, and death. Therefore, disulfiram is appropriate only for individuals with a strong commitment to abstinence and who understand the potential risk. When taken as prescribed under the guidance of a physician, disulfiram is generally considered safe for most people with AUD who do not have significant liver or heart disease.^5,7

Research indicates that the use of disulfiram produces positive outcomes when patients receive a high level of supervision and monitoring from either a supportive family member, loved one, or treatment program that supports the self-administration of disulfiram.^5,7

Which Medication Is Right For You?

If you struggle with your alcohol use or have a loved one who does, you should make an appointment with your primary care physician or mental healthcare provider to talk through your options.

When considering using medications as part of the treatment for AUD, licensed healthcare professionals consider several factors, including:^6,9,10

• What’s motivating you towards treatment? Do you want to stop drinking or cut back on the amount of alcohol you consume?
• Your stage of change and history of alcohol use. Have you gone through detox? Have you gone through treatment for AUD before?
• Your potential for relapse, which includes assessing the severity of your alcohol use disorder and the presence of cravings.
• The presence and severity of any co-occurring mental or physical health conditions, including kidney or liver disorders and/or mental health disorders.
• Your ability to tolerate medications and other medications you may currently be taking. 
• Your social support system.
• If you are pregnant.

Finding MAT for Alcohol Use Disorder Near You

MAUD may be incorporated as part of your comprehensive treatment plan for AUD, and you can receive medications in inpatient/residential or outpatient settings.¹¹ 

American Addiction Centers (AAC) offers all levels of care for AUD, including detoxification, inpatient/residential care, outpatient treatment, and aftercare at all of its treatment centers spread throughout the United States. 

Studies show that getting quality, individualized, evidence-based treatment can help you cut down or quit drinking, which can improve your health and overall quality of life.¹¹  So if you or a loved one is struggling, AAC can help. Call the free, confidential helpline at to speak to a compassionate admissions navigator about your treatment options, ask questions about medication and rehab, verify your insurance, and begin your journey to end your problematic use of alcohol and find lasting recovery.