Antabuse, or disulfiram, and naltrexone are common medications used to treat alcohol use disorders. Both have been shown to improve outcomes in people who want to stop drinking. As with many forms of treatment, what works best depends on your situation. Here are some considerations that can help you decide which is better for you. Disulfiram has been used for decades to treat alcohol use disorders. It works by preventing your liver from metabolizing acetaldehyde, which is an extremely toxic intermediate product created by the breakdown of alcohol. Even drinking a small amount of alcohol while taking disulfiram will cause acetaldehyde to build up, making you violently ill. Symptoms typically include headache, nausea, and vomiting. Disulfiram is taken daily as a pill and it stays in your system for about two weeks. Naltrexone is an opioid antagonist, meaning it binds to opioid receptors and prevents them from functioning. It is also used as a medication to treat opioid addiction since it renders opioid drugs useless. How it works for alcohol is less clear. It likely works by interrupting the reward circuits in the brain by stopping the action of endogenous opioids. Whatever the mechanism, people who take naltrexone find that drinking is no longer pleasurable. You still experience the other effect of drinking, such as impaired judgment, poor coordination, and slurred speech, but you don’t enjoy drinking. This effect is the basis of a specific protocol called the Sinclair Method. In the Sinclair Method, you take a naltrexone pill an hour before you plan to drink. That way, your brain gradually unlearns the association between alcohol and pleasure. However, people also take naltrexone with no intention of drinking, as extra insurance against a slip up turning into a bender. Both of these medications work pretty well. Studies have shown that disulfiram may be more effective at promoting abstinence, since the consequences of drinking on disulfiram are so unpleasant and it stays in your system a relatively long time. However, many people take naltrexone with the goal of moderating their drinking and there is some evidence that naltrexone works for that purpose as well as abstinence. Both drugs require compliance. Obviously, neither works if you stop taking it. In that respect, neither drug is the clear winner. Disulfiram stays in your system for about two weeks, while naltrexone pills stay in your system for about a day. However, you can also take naltrexone in the form of a Vivitrol injection, which stays in your system for a month. You shouldn’t assume taking either drug alone is sufficient to stay sober. Medication can be an extra protection against relapse, but it should be used as part of a comprehensive recovery plan that includes counseling or therapy. You have to maintain your commitment to staying on the medication. Also, there’s more to recovery than just abstinence. Even if medication keeps you sober, it’s better to address the underlying causes of your addiction.
If you or someone you love is struggling with alcohol addiction or mental illness, we can help. Recovery Ways is a premier drug and alcohol addiction treatment facility located in Salt Lake City, Utah. We have the resources to effectively treat a dual diagnosis. Our mission is to provide the most cost-effective, accessible substance abuse treatment to as many people as possible. Request information online or call us today at 1-888-986-7848.
