Medication-Assisted Treatment for Alcohol
Alcohol-related issues are among the highest-ranked health problems in the U.S.1 Problems with alcohol may vary in their severity, quantities of alcohol consumed, and frequency of consumption. However, there are available treatment options that are effective in helping people struggling with alcohol reduce or stop using it altogether.
Research results suggest that one in three persons who undergo alcohol treatment do not have issues with alcohol one year later, while many others from this group reduce their drinking. As a result, their other alcohol-related issues also decrease.1
When trying to quit alcohol, many people experience very unpleasant withdrawal symptoms and cravings which they cannot withstand, so they resume using alcohol. In such cases, medication-assisted treatment for alcohol can help the patient remain abstinent.2
In addition to medicines, effective therapy also involves behavioral counseling, the purpose of which is to change the patterns of thinking and behavior that have resulted in alcohol abuse. This approach to addiction treatment is referred to as medication-assisted treatment. It is applied in opioid use disorder treatment and in alcohol use disorder treatment.3
Medication-Assisted Treatment for Alcohol
Alcohol use disorder (AUD) is a chronic psychological and physical condition characterized by compulsive alcohol consumption despite adverse consequences. It affects millions of people in the United States and can have severe physical, psychological, economic, and social repercussions. In many cases, AUD requires medical intervention and/or professional treatment to manage symptoms or reduce cravings.12
Left untreated, AUD can lead to a range of health issues such as: liver damage, pancreatitis, heart problems, and various types of cancer; mental health conditions such as depression and anxiety; and social problems related to family dynamics or employment. The severity of these effects varies from person to person but all are considered serious risks that warrant attention when it comes to managing AUD effectively.12
Fortunately, there are options for treating AUD ranging from psychotherapy approaches like cognitive behavioral therapy (CBT) which may help struggling individuals identify triggers for drinking and develop strategies for avoiding them to medication-assisted treatment designed for alcohol use disorder.12
What Is Medication-Assisted Treatment?
A medication-assisted program includes medicine prescribed by a doctor to the treatment-seeking individual to help reduce the cravings for alcohol and make it easier to stop drinking. MAT treatment for alcohol combines prescription medicine with psychosocial support to provide a comprehensive approach to treating AUD.13
That’s why it also typically includes talking with a therapist to help the struggling individual understand why they drink and how to avoid triggers that can make them want to drink again. Treatment-seeking individuals may also get help from other struggling individuals in a support group who understand what it’s like going through recovery, which can be a valuable element of MAT treatment for alcohol use disorder.13,14
What are the Benefits of Medication-Assisted Treatment?
The main benefits of MAT for alcohol use disorder are that it can help to reduce the craving for alcohol, block the effects of alcohol on the brain, and reduce the risk of relapse. By blocking the effects of alcohol on the brain, it can help to normalize its neurotransmitter levels and restore balance in reward pathways. This can help to reduce cravings, as well as lessen the intensity of withdrawal symptoms when someone stops drinking. Additionally, in combination with psychotherapy, it may even decrease the struggling individual’s likelihood of relapsing.13,15
How Are Medications Used in Medication-Assisted Treatment for Alcohol Abuse?
In treating alcohol use disorder (AUD), medications are used to achieve the following purpose:4
- Reduce alcohol use
- Prevent overdose
- Mitigate withdrawal symptoms
- Prevent relapse
- Maintain abstinence
It is important to note that medications are not a cure for AUD.3 They are a tool that helps the patient recover from addiction by working on resolving the issues that have led to substance abuse. When used to treat withdrawal, medications help the patient maintain stability, which is necessary in order to focus on other forms of treatment, such as individual psychotherapy, family therapy, peer support groups, etc.2 Therefore medications in medication-assisted treatment for alcohol should not be seen as treatment in itself but rather a key that opens the door to treatment.5
What Are Other Elements of MAT Besides medication for alcohol use disorder?
A variety of other elements are typically combined with prescription medicine to devise a comprehensive plan for each treatment-seeking individual.
- Individual Psychotherapy: Individual psychotherapy is a type of therapy used to treat the underlying causes of AUD. This can include exploring patterns in life that have led to alcohol use, confronting feelings and beliefs around alcohol, identifying triggers for drinking, and learning techniques to manage cravings. With individual therapy, the patient may be able to identify and address their unique needs in order to develop healthier coping strategies.12,14
- Group Therapy: Group therapy involves a group of individuals with AUD meeting with a therapist for discussion on topics related to their substance abuse issues. During this session, patients are usually able to interact with other struggling individuals who share similar experiences in overcoming addiction and they can also learn from one another’s progress and insights into recovery.12
- Family Therapy: Family therapy is designed to help individuals affected by the struggling individual’s actions under the influence of AUD (family members, partners, etc.) understand the condition and its impact on their lives. This type of therapy explores family dynamics and works on improving communication between family members as well as providing support in family relationships that can help prevent relapse or further problems associated with AUD.12
- Alcoholics Anonymous (AA): Alcoholics Anonymous is an organization dedicated to helping struggling individuals overcome AUD through peer-support meetings. These meetings provide a safe place for those struggling with AUD to learn from others who have experienced similar struggles as well as get practical advice on how to handle difficult situations without resorting back to alcohol use.12
- Recreational Activities: Recreational activities such as yoga classes, sports teams, art classes, etc. can be beneficial for individuals recovering from AUD because it allows them an opportunity to connect with others who don’t drink while engaging in enjoyable activities that promote personal growth and wellbeing. This may also reduce stress levels which may be helpful for the recovery process.12
Education on the Condition: Education is important when it comes to treating AUD because it helps provide knowledge about the condition (i.e., its signs, symptoms and consequences), encourages self-awareness of behaviors related to drinking, helps reduce the stigma associated with seeking treatment, facilitates positive lifestyle changes and more. This allows individuals affected by AUD to gain insight into their own situation so they can better manage their recovery efforts.12
Who Qualifies for MAT for Alcohol
In some cases, medications may be administered through outpatient care. However, there are cases where there is a risk of severe withdrawal symptoms, such as delirium tremens or escalation of co-occurring mental disorders, so inpatient care is necessary when such a patient goes through medically assisted withdrawal.4
Additionally, not all forms of alcohol abuse qualify the patient for medication-assisted treatment for alcohol. In cases where the patient does abuse alcohol but does not meet the criteria for AUD (for example, occasional binge drinking), the patient may be encouraged to abstain from alcohol and is not prescribed medications.4
What Are The Risks Of Medication-Assisted Treatment?
MAT for alcohol use disorder may be an effective way to help reduce cravings and decrease the urge to drink, but it also poses a number of risks if practiced unsafely. This has nothing to do with the effectiveness of this model itself, but with unsafe or incomplete approaches to this kind of treatment.15
Mixing alcohol with medicine prescribed during MAT can be especially dangerous, as it can lead to a variety of health consequences or even death. Medicine such as Disulfiram can also cause severe liver damage if combined with alcohol, resulting in abdominal pain, nausea, and vomiting and other more severe effects on the liver.16
Lastly, there is a potential risk of relapse despite using this form of treatment if struggling individuals do not adhere strictly to their medication-assisted treatment regimen or fail to access the necessary counseling and support services needed for long-term recovery.15
One medication often used in MAT for alcohol use disorder is naltrexone, an opioid antagonist that blocks the effects of opioids such as heroin or oxycodone but also blocks some effects of alcohol in the brain. Common side effects may include nausea and vomiting, dizziness or lightheadedness, headache, sleep problems, and anxiety.17
Another medicine used in this form of therapy is acamprosate which works by restoring a chemical balance in the brain that has been altered by the long-term use of alcohol. Common side effects include diarrhea, headache, and dizziness.18
Which Medications Are Used In Medication-Assisted Treatment For Alcohol Disorders?
There are three medications for treating AUD approved by the Food and Drug Administration (FDA): disulfiram, naltrexone, and acamprosate.3
This medicine is an alcohol aversive, which means that it deters the patient from using alcohol by causing an adverse physical reaction when a patient drinks alcohol. In about 10 to 30 minutes after the person takes alcohol, disulfiram triggers some of the following unpleasant reactions:4
- Heat and hyperventilation
- Blurred vision
- Chest pain or tachycardia
The intensity of these reactions depends on the amount of medicine and the amount of alcohol that is consumed.4
Disulfiram is typically prescribed to people who have gone through detoxification and are in the initial stage of abstinence. It is available in the form of an oral tablet that is taken once a day.5
This medication is used to reduce alcohol cravings by binding to endorphin receptors of the nervous system and blocking the effects of alcohol. In other words, the person on naltrexone does not feel pleasure in consuming alcohol.6
Naltrexone is used in medication-assisted treatment for alcohol to maintain sobriety in patients who are no longer using alcohol. It is available in the form of an oral pill that is taken once a day or an extended-release intramuscular injection that is given by a physician once a month.6
Acamprosate is used to stabilize the chemical balance in the brain that has been affected by alcohol.7 It is prescribed to patients who are in recovery and are motivated to stop drinking.4
It is used in the initial stages of treatment, usually on the fifth day of abstinence,1 to help the patient go through withdrawal more easily and prevent relapse at this stage. It comes in the form of an oral tablet which is taken three times a day.
How Long Does MAT Last?
The duration of this type of treatment varies depending on the severity of the disorder, as well as the individual goals and needs of treatment-seeking individuals. While some struggling individuals may exit a program after 30 days, others may require a longer period of care. Typically, inpatient medication-assisted treatment programs at facilities will last between 30 and 60 days.19
In addition to the time spent at a facility for treatment, MAT for alcohol typically lasts two years or longer. This is because medicine prescribed as part of medication-assisted treatment can have lasting effects when taken in combination with psychotherapy. Such medicines work to reduce cravings so struggling individuals can focus on behavioral changes needed to prevent relapse.19
Furthermore, psychotherapy helps foster healthier coping skills for managing stress and emotional triggers associated with drinking alcohol. For these reasons, it’s important that MAT for alcohol use disorder extends beyond initial treatment and continues periodically over time in order to support long-term recovery from AUD.19, 13
How to Find MAT Treatment Near Me
Treatment centers for AUD like American Addiction Centers (AAC) specialize in providing comprehensive care to help individuals suffering from an AUD recover and regain control of their lives.
At AAC, diagnosis of the disorder typically begins with an assessment by a qualified professional such as a physician or psychiatrist. This assessment includes evaluating the individual’s history of alcohol abuse and any existing physical or mental health issues that may be contributing factors, causes or consequences of the disorder. Based on this assessment, a treatment plan is developed to best address the struggling individual’s specific needs.
Detoxification and withdrawal are other important elements of medication-assisted treatment at AAC. Detoxification involves removing all traces of alcohol from the body while withdrawal occurs after detoxification when the struggling individual experiences symptoms that are associated with not having alcohol available in their system anymore. Appropriate medicine is used to ease these processes and the effects of too much alcohol in the system.
In addition to psychotherapy, medication therapy may also be prescribed at AAC’s facilities if deemed appropriate by qualified healthcare professionals based on evaluation results. All medicine prescribed is taken under close medical supervision since they can have potential side effects which should be monitored regularly throughout therapy sessions at the treatment facility.
Treatment-seeking individuals can discuss their situation with a rehab navigator at a designated treatment center hotline. They can ask the rehab navigator about anything from the potential cost of treatment to professional help in choosing the facility appropriate for their needs.