Alcohol dependence medications: what works and how to use them

Looking for help to cut down or stop drinking? Medication can boost your chances. This page gives clear, practical info on the main drugs used for alcohol dependence, how they work, common side effects, and quick tips to stay safer while on treatment. Talk with a doctor before starting anything—meds are tools, not fixes on their own.

Core medications and what they do

Naltrexone — reduces the reward from drinking so cravings drop. It comes as a 50 mg pill (daily) or a 380 mg monthly injection (Vivitrol). Typical benefits: fewer heavy drinking days. Watch out: don’t take it if you’re using opioid painkillers or have acute hepatitis; liver tests are often checked before and during treatment.

Acamprosate — helps with withdrawal-related cravings and supports staying abstinent. Usual dosing is around 666 mg taken three times a day (doctors adjust by weight and kidney function). It’s often chosen when liver disease makes other options risky because it’s mainly cleared by the kidneys. Expect mild diarrhea or sleep changes in some people.

Disulfiram — creates a very unpleasant reaction if you drink (flushing, nausea, racing heart). It’s a deterrent for people who want a strong consequence to prevent relapse. Typical dose ranges from 250–500 mg daily but start low under supervision. Important: avoid alcohol in mouthwashes and some foods; the reaction can be severe.

Other meds doctors may suggest

Topiramate — an anti-seizure drug used off-label to lower drinking. It can help reduce heavy drinking but can cause memory or concentration problems and tingling in the hands/feet. Dosing is gradual and individualized (often up to a few hundred mg daily).

Gabapentin — sometimes used for cravings and sleep issues after stopping alcohol. It can help with withdrawal symptoms but causes drowsiness and carries misuse potential, so doctors watch closely.

Baclofen — used in some countries or clinics to curb cravings. Results are mixed and sedation or muscle weakness can occur. Doctors will weigh benefits and risks carefully.

Which med is right for you depends on goals (abstinence vs cutback), liver/kidney health, other meds you take, and whether you use opioids. A specialist or addiction-trained clinician can run tests and recommend the safest choice.

Quick, practical tips: always combine medication with counseling or peer support for the best results; set clear goals with your provider; report side effects early; keep a list of all drugs you take to avoid dangerous interactions. If you’re on naltrexone, don’t use opioid painkillers—this can be life-threatening. If disulfiram is used, be strict about avoiding alcohol and hidden sources.

Medication isn’t a silver bullet, but it’s a proven help for many people. If you’re ready, talk to your doctor or an addiction specialist about testing, monitoring, and a treatment plan that fits your life and health needs.