Medication-Assisted Treatment for Alcoholism

Medication-assisted treatment (MAT) involves using medications, counseling, and behavioral therapies to treat alcoholism and drug addiction. The idea is to provide a holistic approach to treating substance use disorders (SUDs).¹

During MAT, health professionals also address other health conditions. Counseling and behavioral therapy are required with medical, educational, vocational, and other treatment services.

Regardless of what setting MAT is provided in, treatment is more effective when counseling and other behavioral therapies are included.

The coexistence of a substance use disorder and a mental health condition is common among people in MAT. This is known as a co-occurring disorder. Additionally, people in MAT may have other health-related conditions that require treatment, like hepatitis, HIV, or AIDS.

Who is a Candidate for MAT?

You may be a good candidate for MAT if you:

• Are willing to comply with treatment
• Have an official diagnosis of an alcohol or drug addiction
• Have a lack of physical health issues that medication could worsen
• Are fully educated on alternative options

You may not be a good candidate for MAT if you have:

• A history of medication misuse
• An addiction to a substance that can’t be treated with an FDA (U.S. Food and Drug Administration)-approved medication
• A co-occurring substance addiction whereby the drug may negatively interact with medication
• A low level of motivation to become sober

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Medications Used in MAT for Alcoholism

Acamprosate, disulfiram, and naltrexone are the most common drugs that treat alcoholism. They don’t provide a cure for the disorder. However, they’re effective in people who participate in a MAT program.

Acamprosate

This drug is for people in recovery who aren’t drinking alcohol anymore. It’s for people who want to avoid drinking.

Acamprosate works to stop people from drinking alcohol, but it doesn’t prevent withdrawal symptoms from occurring. The medication hasn’t been shown to work in people who continue drinking.¹ 

Acamprosate usually starts on the fifth day of abstinence, reaching full effectiveness between 5 to 8 days. The drug is available in tablet form. It’s taken 3 times a day, preferably at the same time daily.

Side effects of acamprosate may include:

• Diarrhea
• Upset stomach
• Appetite loss
• Anxiety
• Dizziness
• Difficulty sleeping

Disulfiram

Disulfiram treats chronic alcoholism. The drug is most effective for people who’ve already experienced detox or are in the first stage of abstinence. 

The medication is provided in tablet form. It’s taken once a day. It should never be taken while intoxicated or at least 12 hours after drinking alcohol.¹

Side effects of disulfiram may include:

• Nausea
• Headache
• Vomiting
• Chest pains
• Difficulty breathing

These side effects can occur as quickly as 10 minutes after drinking even a small amount of alcohol. They can last for an hour or longer.

Naltrexone 

Naltrexone blocks the euphoric feelings and effects of alcohol intoxication. It helps people with alcoholism reduce their drinking and remain motivated to become sober.¹

Medication for Alcohol Withdrawal

People suffering from alcoholism are often fearful of detox because of the typical discomfort linked with alcohol withdrawal symptoms. 

Many withdrawal symptoms are often physical. However, many substances can also be linked with challenging mental health and psychiatric issues during withdrawal.

Fortunately, many FDA-approved medicines are safe and effective in helping people through detox and withdrawal comfortably. 

Each person who enters detox will be seen, addressed, and evaluated by a doctor. Depending on their medical and alcoholism history, they’ll be put on medications to help treat their symptoms.

A psychiatrist should also evaluate every person in MAT. They can ensure they’re properly assessed for mental health and psychiatric issues. In some cases, the psychiatrist can prescribe medication to ensure mental health and psychiatric problems are properly managed during the treatment process.

Aside from the drugs already listed, here are some additional medications used to help alcohol withdrawal.

Antidepressants

Antidepressants help relieve symptoms of depression, social anxiety, and other types of anxiety disorders. These drugs help correct chemical imbalances in the brain, specifically of neurotransmitters that affect changes in mood and behavior. 

Examples of antidepressants include:

• Celexa
• Lexapro
• Prozac
• Paxil
• Zoloft

Anti-nausea medications

During detox, many people experience withdrawal symptoms, including nausea. To treat nausea during withdrawal, many health professionals prescribe anti-nausea medications. 

Some examples of anti-nausea medication include:

• Zofran
• Promethazine
• Metoclopramide

Antipsychotics

For people in detox with co-occurring or psychiatric issues, a health professional may prescribe antipsychotic medication.

These medicines can be used to treat psychiatric issues like:

• Schizophrenia
• Bipolar disorders
• Dementia

Antipsychotics don’t cure psychosis. However, antipsychotics can help reduce and control many symptoms, including:

• Delusions
• Hallucinations
• Paranoia
• Hearing voices

Sometimes antipsychotics can treat withdrawal symptoms like anxiety and major agitation.

Some examples of antipsychotics used in a detox setting for alcohol include:

• Olanzapine
• Risperdal
• Seroquel
• Abilify
• Clozaril

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Differences Between MAT and Traditional Alcoholism Treatment

Remember that not every type of alcoholism treatment is ideal for everyone. Every person benefits from having a tailored approach to their treatment. There are various other types of treatment for alcohol addiction other than MAT. Each has its benefits.

Some traditional options in treating alcoholism include:

• Counseling
• Medical devices to treat withdrawal symptoms
• Assessment and treatment for co-occurring mental health issues, including depression and anxiety
• Long-term, follow-up care to prevent relapse

Care programs combined with a tailored treatment program and follow-ups can be essential for lifelong recovery from alcoholism.

Treatment should include both medical and mental health treatment as required. Follow-up care may include community or family-based recovery support systems.

Can You Get Addicted to the Medication Used in MAT? 

There are benefits and risks linked with all types of recovery treatment. There isn’t one method that works for everyone.

Find the treatment that best suits your situation. It’s possible to abuse methadone and buprenorphine, both used in MAT to treat drug addictions.

Drug abuse can develop if you take more of the medication than prescribed. This is why it’s always important to take medications as directed by a medical professional.

If you’re worried about misuse, speak to your doctor immediately about alternative options.

Summary

• MAT includes medications, counseling, and behavioral therapies to treat alcoholism and drug addiction
• Acamprosate, disulfiram, and naltrexone are the most common drugs to treat alcoholism
• Antidepressants, anti-nausea medication, and antipsychotics can help relieve alcohol withdrawal symptoms
• MAT isn’t suitable for everyone. All options for treated alcoholism should be explored
• It’s possible to become addicted to MAT medication, depending on the drug. Alwaystake medication as prescribed by a healthcare provider