Disulfiram Treatment for Alcohol Use Disorder 

Disulfiram is one of three medications approved by the United States Food and Drug Administration (FDA) for use in the treatment of alcohol addiction. While it is not a cure for Alcohol Use Disorder (AUD), it may be effective in reducing alcohol use in individuals committed to recovery.

While treatment plans may vary, some patients receiving medications for alcohol addiction may consider disulfiram for help with AUD recovery. Understanding what disulfiram is, how it works, and how it may factor into a comprehensive treatment plan can be important information while working towards recovery.

What Is Disulfiram?

First approved under the brand name Antabuse for the treatment of alcohol addiction in 1950s, disulfiram is a medication that interferes with a key metabolic process as the body attempts to break down and clear alcohol from the system.1, 3 As a result of taking disulfiram, the toxic metabolite acetaldehyde accumulates in the body, should alcohol be consumed; patients who drink while taking disulfiram will likely experience a range of unpleasant side effects, such as nausea, vomiting, and headaches as acetaldehyde concentrations increase^{.3, 4}

Unlike acamprosate and naltrexone—two other FDA approved AUD treatment medications—disulfiram’s primary therapeutic effect does not involve altered brain chemistry.⁴ Rather, it is believed that disulfiram’s usefulness for treating addiction comes from its ability to create an unpleasant, aversive reaction if drinking were to occur while taking it. It is believed that patients who take disulfiram may be more likely to avoid alcohol to not experience these unpleasant effects.²

As such, disulfiram is believed to be most helpful for patients who have already achieved abstinence (or are approaching such a state) and are highly motivated to maintain recovery.^{1, 5}

Disulfiram may be prescribed at doses ranging from 125mg to 500mg, with the average maintenance dose being 250mg.  Disulfiram is available in tablet form, and taken orally once per day.⁵ The tablet can also be crushed and mixed with a non-alcoholic beverage for oral administration.⁵

What Is Disulfiram Used For?

Disulfiram is medication for treating alcohol use disorder, and is primarily used to help highly-motivated patients maintain recovery. Disulfiram will only be prescribed after a period of abstinence, due to the severely uncomfortable reaction to develop when alcohol is in the system.  Disulfiram is not on its own sufficient treatment for alcohol addiction. Along with other AUD treatment medications,  disulfiram is often paired with a comprehensive treatment plan that also includes behavioral therapies and counseling.6

How Does Disulfiram Work?

Disulfiram works by interfering with the body’s ability to break down alcohol.¹ By blocking an enzyme known as aldehyde dehydrogenase, disulfiram therapy will result in an accumulation of acetaldehyde in the body shortly after someone consumes alcohol.²  This build-up of acetaldehyde results in extremely unpleasant symptoms, including:⁴

• Sweating.
• Skin warmth and flushing.
• Fast breathing.
• Increased heart rate.
• Feeling faint or dizzy.
• Nausea and vomiting.

While on the medication, the disulfiram-alcohol reaction begins quickly after alcohol is consumed, with symptoms appearing within 10 to 30 minutes after drinking.⁴

Side Effects of Disulfiram

Like many medications, disulfiram may have some minor side effects, even in the absence of alcohol use. Potential disulfiram side effects include:⁶

• Drowsiness and fatigue.
• Headache.
• Skin inflammation.
• Metallic aftertaste.

More rare disulfiram side effects include:⁶

• Paresthesias (numbness or tingling).
• Impaired liver function.
• Liver inflammation (hepatitis). 

Though rare, due to the risk of occasional liver injury in association with the use of this medication, clinicians will provide ongoing monitoring of liver function while being treated with disulfiram.⁴

How Long Does Disulfiram Treatment Last?

The length of disulfiram treatment can vary from person to person, with some benefiting from months to years of treatment.⁴ Evidence seems to suggest that longer disulfiram treatment, usually under supervision in order to ensure treatment adherence and to monitor for any adverse effects, can lead to individuals remaining abstinent for longer periods of time after treatment completion.^{2, 4} At the end of the day, treatment length is something that if often determined on an individual basis, so patients should speak with their treatment to get an idea of how long disulfiram treatment may last.⁵

Benefits of Disulfiram

While disulfiram is not a direct cure for alcohol addiction, it can help support highly motivated individuals to decrease relapse risks, limit future drinking behavior, and better maintain successful recovery.⁴ Patients who can recognize the consequences they may face if they drink while in disulfiram treatment are more likely to be successful at avoiding drinking and thereby avoiding the unpleasant symptoms caused by alcohol-disulfiram interactions.⁴ Disulfiram has been demonstrated to be safe and effective in treating alcohol addiction, and can be restarted at times when additional support is needed.⁵

Does Insurance Cover Disulfiram?

The Affordable Care Act is a law established in 2010 to make health insurance available for more people.⁷ As part of the act, insurance plans are required to provide some amount of coverage for medically necessary treatment of mental health and substance use disorders.⁸ As such, insurance plans may provide some coverage for disulfiram treatment, but this may vary by plan. It is important to reach out to one’s own insurance company to determine what coverage will be provided and your payment options.

Disulfiram for AUD in Las Vegas

Anyone seeking treatment for alcohol addiction that incorporates the use of medications like disulfiram can consider Desert Hope Treatment Center in Las Vegas, Nevada. The Desert Hope facility offers a variety of types of rehab and levels of care, including:

• Detox.
• Inpatient treatment.
• Outpatient services.

Treatment at Desert Hope combines the use of behavioral therapies, mental health counseling, and medications to address addiction and assist with recovery. Don’t delay, call us today at to get started with treatment.