Medication-assisted treatment (MAT) is the term used to describe the use of medications to target substance use disorders. As we’ve just concluded Alcohol Awareness Month, it is important to know that there are several effective medications to treat alcohol use disorders (AUDs).
Which Medications Can Treat AUD?
The most evidence available for MAT targeting alcohol use suggests naltrexone and acamprosate as effective first-line agents for alcohol craving reduction. Naltrexone is available in an oral tablet that is dosed once a day or in an injection that can be administered once a month (Vivitrol®). Both formulations of the medication have significant benefits in reducing cravings, reducing time to relapse, and if a relapse occurs, in reducing the average amount of alcohol used during the relapse while on medications.
Acamprosate is available in a tablet form, taken three times per day, and is also effective in craving reduction. While both medications can be started in both inpatient and outpatient settings, acamprosate should be started when alcohol use has stopped, whereas naltrexone can be started while alcohol is still being used if liver enzymes are appropriate.
There is also evidence for the use of topiramate and baclofen for alcohol craving reduction, but this evidence is not as strong, and there is limited data available supporting the use of gabapentin for craving reduction as well. Another medication, disulfiram, is helpful in deterring alcohol use for some patients, as it prevents the breakdown of alcohol and causes unpleasant reactions. Though this can be a helpful tool for some patients, it does not reduce cravings.
Accessing Medications for Alcohol Use Disorder
Though there are available medications for alcohol use disorder, these treatment options are regrettably not offered enough in many treatment settings, and often patients are left to struggle without the knowledge of these adjuncts to their recovery. MAT can improve quality of life, reduce potential for risky or criminal behaviors that occur while under the influence of alcohol, and significantly improve general health outcomes as substance use is reduced.
For those patients who also have a co-existing psychiatric (dual) diagnosis, the use of MAT could also help with mental health outcomes. It is imperative that MAT be offered when treatment plans are developed to offer the affected individual as great a chance at success with sobriety and recovery as possible. MAT is an essential tool to consider for all patients with an AUD as an available treatment option, and should be as openly-discussed as establishing a sober support network and working the twelve steps.