Controlling Alcohol Cravings With Medication

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People who have become alcohol dependent often experience withdrawal symptoms and cravings when they try to stop drinking. These cravings can pose problems for those trying to quit.

There are medications for alcohol cravings available that someone recovering from alcohol use disorder (AUD) may take. Here we review those that are FDA-approved, those under investigation, as well as alternatives to medication that could assist in managing these cravings.

In a 2019 study published in Alcohol and Alcoholism, among a group diagnosed with alcohol dependence, elevated cravings were associated with post-addiction treatment relapse.

Approved Medications for Alcohol Cravings

Currently, only the following three medications are approved by the Food and Drug Administration (FDA) for the treatment of AUD. Two may help you manage alcohol cravings.

Vivitrol (Naltrexone)

Marketed as Vivitrol, a once-monthly injection, naltrexone works by blocking the high in the brain that people experience when they drink alcohol. It's available as a tablet in the generic form. By blocking the pleasure the drinker receives from alcohol and the reward feedback loop in the brain, naltrexone eventually reduces cravings.

Acamprosate

Acamprosate reduces the physical distress and emotional discomfort people usually experience when they quit drinking. How it works to lessen the craving for alcohol is not completely understood, but researchers believe that it helps restore a chemical imbalance in the brain's reward system that is altered by long-term alcohol abuse.

Acamprosate does not help someone quit drinking. It is prescribed (usually three time-released pills a day) for those who have already stopped drinking alcohol. Because the side effects are mild and well-tolerated, it is usually prescribed for up to 12 months following alcohol abstinence.

Antabuse (Disulfiram)

Antabuse, the brand name for disulfiram, does not target cravings. It works by causing a severe adverse reaction when someone taking the medication consumes alcohol. This includes flushing, nausea, vomiting, headaches, and palpitations. There can be severe reactions, so it might be saved for use for high-risk patients, or when you are going into a high-risk situation such as a party where there will be alcohol.

Medications Under Investigation

Other than FDA-approved medications, there are those prescribed off-label to treat AUD, those being studied for this use, and others that have been approved to treat alcohol dependence outside of the United States.

  • Topiramate (Topamax): Topamax is not yet FDA-approved to treat alcohol addiction. It is an anti-epileptic medication that has shown promise in trials similar to naltrexone. Physicians may prescribe it off-label for alcohol dependence.
  • Gabapentin (Neurontin): Gabapentin is also an anti-epileptic drug approved to treat seizures and postherpetic neuralgia, a type of pain associated with shingles. While not FDA-approved to treat AUD, some research has shown it may be effective in helping to reduce cravings.
  • Ondansetron (Zofran): Zofran is indicated for nausea and vomiting in people being treated for cancer. Specifically, it's been found to help young adults with early AUD reduce cravings and how much they drank when combined with cognitive behavioral therapy (CBT).
  • Nalfemene (Selincro): Nalmefene has been approved for use in Australia and Europe. Some have noted controversy around this approval. It can be taken on an as-needed basis, as in before a high-risk situation, and has been associated with a reduction in heavy drinking days. However, some research on its efficacy has been mixed.
  • Baclofen: Baclofen, a muscle relaxant, is available in branded forms Ozobax, Lioresal, Gablofen and available as a pill, injectable, and an oral solution in the United States. It has been approved to treat AUD in France. The results on how well it treats AUD have been mixed.
  • Selective serotonin reuptake inhibitors (SSRIs): The American Psychiatric Association (APA) doesn't recommend antidepressants for AUD unless there is another disorder present they would treat.

Alternatives to Medications

In addition, there is more than just medication that may help with alcohol cravings. The following could be used with or without medication.

Cognitive behavioral therapy (CBT) is a form of psychotherapy, or talk therapy, used in the treatment of substance use disorders, including AUD. CBT works to help someone reframe their thoughts and change their actions. It can be useful in addressing cravings as it can help someone come up with coping mechanisms for when they occur.

According to the National Institute on Alcohol Abuse and Alcoholism, participating in a mutual-help group like Alcoholics Anonymous (AA) or another 12-step program can provide even more support when combined with other treatment. In addition, being around a new community that encourages sobriety may be helpful to diminish external cues for alcohol cravings.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

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23 Sources
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  1. Seo D, Sinha R. The neurobiology of alcohol craving and relapse. Handb Clin Neurol. 2014;125:355-368. doi:10.1016/B978-0-444-62619-6.00021-5

  2. Stohs ME, Schneekloth TD, Geske JR, Biernacka JM, Karpyak VM. Alcohol craving predicts relapse after residential addiction treatment. Alcohol and Alcoholism. 2019;54(2):167-172. doi:10.1093/alcalc/agy093

  3. Rutkofsky IH, Fisher KA, Alvarez Villalba CL, Neuhut S. Gabapentin for post-hospitalization alcohol relapse prevention; should gabapentin be considered for FDA approval in the treatment of alcohol use disorder? : A case presentation and literature review. Cureus. 2020;12(6):e8931. doi:10.7759/cureus.8931

  4. Patel AK, Balasanova AA. Treatment of alcohol use disorder. JAMA. 2021;325(6):596. doi:10.1001/jama.2020.2012

  5. Canidate SS, Carnaby GD, Cook CL, Cook RL. A systematic review of naltrexone for attenuating alcohol consumption in women with alcohol use disorders (AUD). Alcohol Clin Exp Res. 2017;41(3):466-472. doi:10.1111/acer.13313

  6. Salib A-MN, Ho AL, Sussman ES, Pendharkar AV, Halpern CH. Neuromodulatory treatments for alcohol use disorder: A review. Brain Sciences. 2018;8(6):95. doi:10.3390/brainsci8060095

  7. Substance Abuse and Mental Health Services Administration. MAT medications, counseling, and related conditions.

  8. Plosker GL. Acamprosate: A review of its use in alcohol dependence. Drugs. 2015;75(11):1255-68. doi:10.1007/s40265-015-0423-9

  9. Skinner MD, Lahmek P, Pham H, Aubin HJ. Disulfiram efficacy in the treatment of alcohol dependence: A meta-analysis. PLoS ONE. 2014;9(2):e87366. doi:10.1371/journal.pone.0087366

  10. Morley KC, Perry CJ, Watt J, et al. New approved and emerging pharmacological approaches to alcohol use disorder: A review of clinical studies. Expert Opinion on Pharmacotherapy. 2021;0(0):1-13. doi:10.1080/14656566.2021.1892641

  11. Guglielmo R, Martinotti G, Quatrale M, et al. Topiramate in alcohol use disorders: Review and update. CNS Drugs. 2015;29(5):383-95. doi:10.1007/s40263-015-0244-0

  12. Food and Drug Administration. Neurontin highlights of prescribing information.

  13. Food and Drug Administration. Zofran highlights of prescribing information.

  14. Winslow BT, Onysko M, Hebert M. Medications for alcohol use disorder. Am Fam Physician. 2016;93(6):457-465.

  15. Palpacuer C, Laviolle B, Boussageon R, Reymann JM, Bellissant E, Naudet F. Risks and benefits of nalmefene in the treatment of adult alcohol dependence: A systematic literature review and meta-analysis of published and unpublished double-blind randomized controlled trials. PLOS Medicine. 2015;12(12):e1001924. doi:10.1371/journal.pmed.1001924

  16. Kim Y, Hack LM, Ahn ES, Kim J. Practical outpatient pharmacotherapy for alcohol use disorder. Drugs Context. 2018;7. doi:10.7573/dic.212308

  17. Shen WW. Anticraving therapy for alcohol use disorder: A clinical review. Neuropsychopharmacol Rep. 2018;38(3):105-116. doi:10.1002/npr2.12028

  18. American Psychiatric Association. Practice Guideline for the Pharmacological Treatment of Patients with Alcohol Use Disorder. American Psychiatric Association Publishing; 2018.

  19. Department of Health and Human Services. Medication for the treatment of alcohol use disorder: A brief guide.

  20. Magill M, Ray L, Kiluk B, et al. A meta-analysis of cognitive-behavioral therapy for alcohol or other drug use disorders: Treatment efficacy by contrast condition. J Consult Clin Psychol. 2019;87(12):1093-1105. doi:10.1037/ccp0000447

  21. National Institute for Drug Abuse. Cognitive-behavioral therapy (alcohol, marijuana, cocaine, methamphetamine, nicotine).

  22. National Institute on Alcohol Abuse and Alcoholism. Treatment for alcohol problems: Finding and getting help.

  23. Donovan DM, Ingalsbe MH, Benbow J, Daley DC. 12-step interventions and mutual support programs for substance use disorders: An overview. Soc Work Public Health. 2013;28(0):313-332. doi:10.1080/19371918.2013.774663

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