Treatment for alcohol use disorder may include medications, psychotherapy, and 12-step meetings. It has been shown that a combination of these three methods results in greater remission of symptoms.
The FDA currently has three approved medicines for the treatment of alcohol use disorder: Naltrexone, Acamprosate, and Disulfiram. Naltrexone, also known by the brand names of Revia and Vivitrol, helps reduce heavy drinking by diminishing the pleasurable effects of alcohol and reducing cravings by blocking mu opioid receptors in the brain. By blocking the mu opioid receptors, Naltrexone may diminish the euphoric effects of alcohol. Acamprosate, also known by its brand name Campral, helps influence abstinence from alcohol use by reducing excitatory glutamate neurotransmission and increasing inhibitory GABA neurotransmission. Withdrawal following chronic alcohol use generally leads to excessive glutamate activity and insufficient GABA activity. Acamprosate acts as an “artificial alcohol” by binding to and blocking certain glutamate receptors to mitigate withdrawal effects. Disulfiram (Antabuse) works by blocking the metabolism of alcohol in the body, causing uncomfortable symptoms such as nausea, headache, vomiting and flushed skin. These symptoms may help individuals avoid alcohol use when taking Disulfiram in order to avoid the unpleasant side effects.
A combination of Motivational Interviewing (MI) and Cognitive behavioral therapy (CBT) have also shown to be helpful in the treatment of alcohol use disorder. MI focuses on activating internal motivating factors with support through the stages of change. CBT focuses on identifying feelings, modifying distorted thoughts, and finding alternatives to maladaptive behaviors.