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Struggling With Alcohol? Medication May be Able to Help

Pills can help some people quit — or curb — their drinking

spinner image hand proffering a bottle of beer and woman saying no and putting up her hand to stop
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During the first year of the COVID-19 pandemic, adults 50 and older led the way as most likely to increase their alcohol consumption, according to a 2022 study from researchers in California. “And for many individuals, that spike has been maintained,” says Lara Ray, a professor of psychology and psychiatry at the University of California, Los Angeles and a coauthor on the study.

That’s bad news when it comes to the health of older adults. The latest research indicates that alcohol consumption increases risks for more than 200 health problems, including heart diseaseliver disease, depression, anxiety, stroke and cancer. And experts stress that those increased risks are incurred at every level of consumption — from a drink or two a day to heavier habits.

Scaling back alcohol use, however, can be difficult for many, including the more than 14 million U.S. adults with alcohol use disorder (AUD), which is defined as an impaired ability to stop or control alcohol use despite its known consequences. A variety of factors can play into people’s drinking patterns, including genetics, depression, anxiety and stress. And stigma often keeps people who are affected by alcohol from seeking help, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

The good news: There are a variety of treatment options that can help people curb — or quit — drinking. And what many people don’t know is that medication is one option on the menu.

What to know about medications for AUD

If you want to stop drinking, Nancy Beste, an addiction therapist in Steamboat Springs, Colorado, recommends talking to your doctor about the best way to do so. It may turn out that you’re a good candidate for one of three federally approved medications on the market.

Disulfiram, which can be used after at least 12 hours without alcohol, causes unpleasant symptoms (nausea, vomiting, chest pain, sweating and weakness) if alcohol is consumed. The dosage is one pill a day.

• Acamprosate can be used after alcohol abstinence to alleviate anxiety, restlessness, dysphoria and insomnia as your brain adjusts to life without drinking. Typically, two pills are taken, three times a day. 

• Naltrexone, which comes in pill form and as an injection, is generally useful for people at the lower levels of alcohol use severity. In fact, a recent study published in the American Journal of Psychiatry found that naltrexone helped to significantly reduce binge drinking among men with mild to moderate alcohol use disorder. It also reduces alcohol cravings and has helped patients curb overeating and smoking.

“All of these are very safe, and none of them are [addictive],” says Patrick Fehling, M.D., an addiction psychiatrist at the University of Colorado School of Medicine Anschutz Medical Campus in Aurora. “And that means that your family doctor or internist should feel comfortable prescribing them.”

What’s more, most of these medications are covered by health insurance plans; generic options are also available.

Not everyone will respond to medication, the NIAAA says, but for those who do, Beste finds it gives them the boost they need to meet their goals. Still, studies show these medications are widely underutilized. 

In 2019, only 1.6 percent of adults with AUD took a pill to help them stop drinking, according to a report published in JAMA Psychiatry that looked at national survey data.  

Starting the conversation

Curious if medication is right for you? Start out by letting your health care provider know you’d like to make a lifestyle change but need some help — just like many get for smoking cessation — recommends UCLA’s Ray. You might say: “In stressful times, I drink more, and I’d like to address that with some medical support,” she suggests.

At this point, it’s vital that you give your health care provider complete information on your health and drinking history, including how long you have been drinking, the amount you actually drink, any medical conditions you have and all the medications you take. 

And don’t be surprised if medication is just one treatment your health care provider recommends. Fehling says the medications work best “when they’re blended with even brief counseling by a doctor or a therapist.”

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What to expect when you stop drinking

Up to half of people with AUD will experience some withdrawal symptoms when easing off alcohol, experts say. These can include irritability, agitation, elevated blood pressure, increased heart rate, insomnia, increased anxiety, sweating, nausea and vomiting. Heavy drinkers may need hands-on medical care and monitoring, or a proper “detox” in a health care facility, to manage their symptoms.

When quitting alcohol, it’s key to rebalance your body and brain, Beste stresses. Eating healthy foods and having a balanced diet are important. So is exercise. Beste also advises her patients to take a vitamin B1 supplement (also known as thiamin), since many people with alcohol dependence become deficient.

Another tip: Form a support team. Plenty of individuals find that working with an addiction therapist and/or joining a group of other people with the same goal is very helpful. Ask your health care provider for a list of addiction therapists and groups near you (or online), like A.A. (Alcoholics Anonymous), SMART RecoveryWomen for SobrietySecular AALifeRing Secular Recovery and Secular Organizations for Sobriety (SOS).

The NIAAA has an alcohol treatment navigator with more information and resources. ​

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