Alcohol use disorder, the official name for alcoholism, is estimated to affect 17.6 million people in the United States, according to a report from the National Council on Alcoholism and Drug Dependence. Each year, there are more than 85,000 deaths attributable to excessive alcohol use. Growing rates of alcoholism and drug addiction have led to the proliferation of drug and alcohol rehabilitation centers, new prescription drugs, and emergent therapies.
Today, however, there remains no cure for alcoholism.
There are currently only three drugs on the market approved by the FDA for the treatment of alcoholism: Antabuse, Campral, and Vivitrol. It isn’t unusual for many of our guests to have tried one of these drugs in the past to either stop or control their drinking. Each drug treats alcoholism in a different way.
Here are three things to know if you’re considering medication-assisted treatment for alcoholism for yourself or someone you love:
1. You cannot medicate your way out of addiction.
At Discovery Place, our guests are introduced to and immersed in 12-step recovery from the moment they arrive. We are not a rehabilitation or treatment center. We are a spiritual retreat.
In the book Alcoholics Anonymous, the foundational text for the 12-step program Alcoholics Anonymous, the authors write, “Our liquor was but a symptom,” and later, “Bottles were only a symbol.” Understanding that alcohol and drugs are tools that have been misused and abused to treat a three-part disease—body, mind, and spirit—can often mean the start of a new kind of recovery for many of our guests.
Drugs like Antabuse, Campral, and Vivitrol will not transform an alcoholic into a nonalcoholic. What these drugs may be able to do, when used as part of a larger recovery plan, is help motivated individuals struggling to get any kind of sobriety under their belts lay enough groundwork to become more actively involved in the other parts of their recovery, like a 12-step program.
“It’s really hard to get sober when you’re drinking,” says Dr. Jan A. Mayer, a Nashville-based psychiatrist and expert on addiction. “You can be full of determination [to not drink] in the morning, but by the evening, it’s gone. You don’t have the brakes to stop.”
But medication cannot be the be-all, end-all plan for sobriety. “You can’t treat addiction or alcoholism with just medication,” adds Dr. Mayer. “I wouldn’t suggest using these without conjunction with recovery.”
2. Not all of these drugs are abstinence-based medications.
Of the three drugs approved by the FDA to treat alcoholism, only Antabuse is an abstinence-based medication, meaning its intent is to prevent an individual from drinking. Campral and Vivitrol do not do this.
Antabuse, or disulfiram, is taken in pill-form daily and works by blocking the enzyme that allows alcohol to be metabolized. If an individual drinks while taking Antabuse, he will become violently ill: nausea, severe vomiting, headaches, chest pain, dizziness. It’s like a hangover, but worse. Even coming in contact with aftershave on the skin can trigger a mild reaction.
If an individual taking Antabuse wants to start drinking again, all he has to do is stop taking the medication and wait about five days.
Vivitrol, or naltrexone, is an opioid antagonist. (It was also approved for the treatment of opioid addiction in 2010.) Taken orally each day or by monthly injection, Vivitrol works to block the opioid receptors, or pleasure centers, in the brain. In effect, alcohol can’t get to them and the reward center is not activated. This reduces the craving to drink and also eliminates the euphoric or reward-based feelings that accompany drinking. Unlike Antabuse, Vivitrol isn’t designed to stop an individual from drinking by bringing on negative side effects. If an individual drinks while taking Vivitrol, the experience, positive or negative, is essentially canceled out.
Campral, or acamprosate calcium, is designed to reduce the positive response to drinking and thus reduce cravings. An individual can still drink while taking this drug.
Like Antabuse and Vivitrol, Campral is only effective when it’s taken. That might seem obvious, but to many family members or loved ones looking to these drugs as a potential lifeline to the alcoholic in their life, it’s important to note that these drugs work best when an individual is actually motivated to quit drinking, not just cut back or moderate.
3. There is no cure for alcoholism.
There’s not much we haven’t seen or heard at Discovery Place. In fact, since nearly every staff member at Discovery Place is also an alum, it’s very likely we’ve tried it too. And often the last thing most people want to try is the thing we have found to be most effective: 12-step recovery.
We offer a community of men who know the disease of alcoholism firsthand and who, today, no longer have a desire to drink. Over the past three years, more than 60 percent of Discovery Place alumni report they are one year sober following their 30-, 60-, or 90-day stay with us.
There is no pill or shot that will cure alcoholism. What we do at Discovery Place is treat the mind, body, and spirit through the practice of spiritual principles (things like honesty, willingness, humility, and courage). We give men the foundation they need to obtain and sustain long-term sobriety.