Fighting Alcoholism With Medications
Drugs combined with support can help alcoholics kick alcohol addiction.
There is no magic pill or one-size-fits-all treatment that can banish an
alcoholic's need or desire to drink.
But a handful of FDA-approved medications, when used in combination with
psychological and social interventions such as 12-step programs, can help a
significant number of alcohol-dependent patients reduce their insatiable
cravings and cut back substantially on the number of heavy drinking days, say
experts in alcohol abuse and
"For me, the biggest issue is not whether these medicines work, it's why
they're not being used more often," says addiction specialist Joseph
Volpicelli, MD, PhD, associate professor of psychiatry at the University of
Pennsylvania School of Medicine.
Despite the current understanding that alcoholism is a tenacious
disease, there are lingering prejudices that cause some people to view alcohol
abuse and dependence as moral failings that can be overcome simply by
willpower, Volpicelli tells WebMD.
But as he and other specialists in addiction note, medications are not
substitutes for drinking, but can instead help make the difference between an
alcoholic's successful recovery or relapse.
"I think medications are very important and effective and work best when
they're used with psychosocial modalities," agrees Merrill Herman, MD, director
of psychiatric services for Montefiore Medical Center's substance abuse
treatment program and president of the New York Society of Addiction Medicine
in New York City.
Roger D. Weiss, MD, a professor of psychiatry at Harvard Medical School in
Boston and clinical director of the alcohol and drug abuse treatment program at
McLean Hospital in Belmont, Mass., notes that "medications can sometimes reduce
the desire to drink. They can attenuate [weaken] the response that people get
to alcohol, to make it less reinforcing, and they can, depending on which
medication you're talking about, help reduce protracted, longer-term withdrawal
There are three drugs approved by the FDA for the treatment of alcoholism; a
fourth drug has shown promise in recent clinical trials. The following is a
summary of the drugs and how they work.
Antabuse was approved for the treatment of alcoholism more than 50 years
ago, making it the oldest such drug on the market. It works by interfering with
the body's ability to absorb alcohol -- specifically by inhibiting production
of an enzyme that would otherwise allow the body to absorb an alcohol breakdown
product called acetaldehyde.