Disulfiram (Antabuse) for Treating Alcoholism
Researchers who study the treatment of alcoholism and alcohol abuse are continually trying to find better ways to treat these conditions and help people to get and stay sober. One of the paths this research involves finding or developing medications that can aid in the treatment process. The people involved in these studies hope that, through medication, individuals struggling with addiction can more easily stop using the substance, minimize or avoid uncomfortable withdrawal symptoms, and diminish the cravings that can lead to relapse.
Disulfiram, also known by brand name Antabuse, is one of the medications that has been used to treat alcoholism, specifically through discouraging individuals to relapse to alcohol use.
Treating Alcoholism with Medication
As explained by WebMD, there is no silver bullet treatment for alcoholism; medication cannot eliminate this mental health disorder completely. However, some medications can help with the challenge of treating alcoholism, in combination with other treatments and therapies. These medications work in multiple ways, including:
- Helping individuals to stop using one substance by substituting a less addictive substance
- Enabling use of the substance to be tapered and reduced over time
- Preventing withdrawal symptoms that make it difficult for a person to stop use
- Reducing cravings that lead to relapse during and after treatment
In some cases, this type of treatment is considered not to be helpful because of the potential that the individual will substitute one addiction for another; this is particularly true of drugs used for the first two objectives. However, certain medications can help without additional addiction risk.
How Disulfiram Works
The U.S. National Library of Medicine describes the way that disulfiram works as an aversion technique. When a person who is taking disulfiram consumes alcohol, the medicine causes unpleasant symptoms, such as:
- Nausea and vomiting
- Sweating and flushing
- Anxiety and confusion
- Breathing issues and chest pain
- Lack of energy and weakness
These symptoms can present a strong deterrent to those who consume even small amounts of alcohol, helping to discourage relapse to alcohol use by those in treatment.
Because of the way this medicine works, it is not used for people who are already in an intoxicated state. It is only prescribed for alcoholism treatment after the individual has detoxed from alcohol.
Multiple studies, analyzed by research reviews in PLoS One and Alcoholism, Clinical and Experimental Research, indicate that people who take disulfiram during alcoholism treatment are more likely to avoid relapse, especially in the short-term. In fact, some studies find it is better at prolonging abstinence and reducing relapse than other medicines used for the same purpose, as well as for those who were given placebos or no medicine for treatment.
That said, information from the Substance Abuse and Mental Health Services Administration’s Treatment Improvement Protocols demonstrates that supervised ingestion of the drug is usually necessary. It is important for the individual to experience the reaction that occurs after the drug is taken, under supervision, in order to understand how it works and then respond to the effect.
Issues with Disulfiram Treatment
Disulfiram is not necessarily an ideal alcoholism treatment for everyone. In fact, Medscape discusses the potential for toxicity regarding the reaction with alcohol and some toxic effects from disulfiram alone. One example of a problem with using disulfiram includes its propensity for drug interactions with prescription or over-the-counter medications or products that include more than 5 percent ethanol, including cough medicines, herbal extracts, and other items. The symptoms caused by the reaction between disulfiram and any amount of alcohol warrants care, education, and agreement before prescribing it to certain individuals.
However, taken in large doses, disulfiram itself can be toxic. Effects can occur neurologically, on the skin, and to the liver. These issues may mean certain people should not use disulfiram for treatment.
Finally, it is important to note that disulfiram cannot manage alcoholism alone and should not be taken indefinitely. Cognitive and social therapies are also vital elements of treatment to help the person achieve long-term recovery and further reduce risk of relapse. These helpful elements of treatment can be found through certified, research-based treatment programs that provide a range of treatments and services to give individuals the best chance at long-term recovery.