Alcoholism is a destructive addiction that can literally ruin people’s lives. Whether you’re struggling with excessive drinking yourself or you love someone who is, you understand all too well the path of devastation this chronic condition can bring, from splintered relationships to serious medical issues. Professional addiction treatment, individual therapy and attending support groups can all help an alcoholic get on the road to recovery. In some cases, a medication called Antabuse may also be very beneficial.
Antabuse, also known as disulfiram, has been used to treat problem drinking since the mid-20th century. It was the first medication approved by the Federal Drug Administration (FDA) to treat alcohol abuse. Antabuse is one of several prescription drugs used to treat alcoholism. Others include Campral (acamprosate) and ReVia (naltrexone).
How Antabuse Works
When people drink alcohol, their body metabolizes it into a substance called acetaldehyde. This substance, in high levels, acts like a toxin in the body. It’s believed to play a role in triggering hangover symptoms. However, enzymes in the liver normally break much of it down into a less harmful substance known as aldehyde dehydrogenase.
Antabuse, available as a pill in the United States, stops these liver enzymes from breaking down acetaldehyde. As a result, the substance builds up in the bloodstream. This results in very unpleasant physical symptoms. A person who drinks alcohol while on Antabuse experiences a racing heart rate and drop in blood pressure, which triggers dizziness. Since high acetaldehyde levels directly impact the heart and blood vessels, reactions also include heart palpitations and shortness of breath. Consuming alcohol while taking Antabuse will also result in nausea and vomiting.
These physical reactions are intended to make an alcoholic want to abstain from drinking. The symptoms are highly unpleasant and can last for hours. You don’t need to drink a lot of alcohol to experience a reaction—as little as a portion of a drink can make you feel very ill. In addition, the drug stays in the system for a long time, sometimes up to two weeks after the last dose.
When taking Antabuse, it’s important to avoid sources of alcohol, including certain foods (like sauces that contain wine) or medications (such as cough syrups, cold remedies or sleep aids). Some physicians recommend avoiding mouthwashes with alcohol to ensure there’s no reaction. It’s a good idea to carry a list with you of medications and products that could trigger a reaction to the Antabuse. This will not only help you, but will also alert health care providers so they don’t inadvertently give you a medication that interacts with Antabuse and makes you sick.
This prescription treatment for alcoholism does have potential side effects. Some users report feeling more tired than usual during the first few weeks of Antabuse therapy. Others report a metallic-type taste in the mouth that dissipates after a few weeks or months. Long-term use may cause liver damage, so your physician may recommend regular liver function tests while you’re taking Antabuse.
It’s critical to disclose all medications you’re taking to your physician. Antabuse may interact with other prescriptions, including diazepam and warfarin. The drug is not recommended for those with cardiovascular problems, a history of heart attack or stroke, epilepsy, and women who are pregnant or breastfeeding.
Several studies have indicated that Antabuse works no better than placebos, largely because many alcoholics simply discontinue taking the medication in order to drink again. One of those reports suggests that up to 80% of alcohol abusers stopped taking the drug. One nine-year European study found that alcoholics who took deterrent drugs, including Antabuse, had abstinence rates of about 50%, with higher abstinence rates in those who took the medication for longer than 20 months. It’s important to note that the patients in the study received vigorous psychological counseling to cope with their addiction as well.
While Antabuse does work for some, it’s not the right treatment for everyone. This medication does not reduce or eliminate cravings; rather it makes the alcoholic so sick after drinking that he or she theoretically will not want to drink again. Alcoholics who cannot resist the urge to consume often stop taking the medication so they can drink without feeling sick. European physicians are able to implant Antabuse under the skin to deliver a constant dose over 12 months; however, implants are not yet available in the U.S.
Antabuse as Part of Treatment
Antabuse is not a cure for alcoholism. Instead, it’s used as additional motivation to choose sobriety. It can be a good tool for alcoholics who find themselves in tempting situations; for example, Antabuse can help someone who travels frequently for business avoid relapsing while on the road.
The key to long-term sobriety is to create a strategy that changes how you think and act. Addiction counseling will help you identify the triggers that compel you to drink. Once you’ve pinpointed the thoughts, actions, emotions, and situations that make you want to consume alcohol, you can learn healthy ways to cope with them.
Lifestyle changes are also part of staying sober for life. An addiction counselor will have recommendations, which may include choosing non-drinking friends, avoiding tempting situations, such as Friday happy hour, and learning stress management techniques, like meditation or deep breathing. A therapist will also help you find new, healthier routines that replace the role of alcohol in your life. For instance, you might replace a nightly glass of wine with a cup of hot tea.
Ongoing recovery support, often through a 12-step program, is also essential for maintaining sobriety. These networks provide an alcohol-free and non-judgmental environment in which you will learn recovery techniques and insights from others. Using tools like therapy or support groups lay the foundation for you to resist cravings in a healthy way; Antabuse treatment simply provides an extra layer of incentive.
If your treatment team determines Antabuse is right for you, a physician will prescribe a dose based on your medical condition and how you’re responding to therapy. Typically a higher dose is given for the first one or two weeks, and then the amount is reduced to a maintenance dose.
Alcoholics have a serious disorder that requires professional treatment. If you or a loved one is struggling with alcoholism, find help from a qualified rehab facility. An addictions team will develop a treatment strategy that’s appropriate for you; one that will include therapy and, possibly, a medication like Antabuse.