Disulfiram For Alcohol Use Disorder

Disulfiram (Antabuse) For Alcoholism Treatment

Disulfiram is an alcohol treatment medication for alcohol use disorder (AUD). It is used by more than 200,000 Americans each year to help treat their AUD.

Disulfiram works by interfering with the body’s digestion and absorption of alcohol, creating a series of highly unpleasant reactions in the process. When an individual who is taking disulfiram consumes alcohol, they will begin to experience hangover-like side effects that include:

• Flushing of the skin
• Nausea and vomiting
• Headaches
• Sweating
• Weakness
• Higher blood pressure

These effects make it extremely unpleasant for someone who is taking disulfiram to consume alcohol. Disulfiram, therefore, acts as a deterrent to alcohol use. Although the drug does not actively reduce alcohol cravings, which are still present, many individuals are so sufficiently discouraged from alcohol use that they find it easier to remain sober.

Because disulfiram creates an unpleasant feeling in the body when alcohol is present, a person must first detox from alcohol to make sure that alcohol is cleared from the system before beginning treatment with disulfiram.

How Does Disulfiram Work?

Other medications used to treat AUD work on the brain’s chemical receptors, changing the balance of neurotransmitters. However, disulfiram is different as it acts by interfering with alcohol metabolism in the body. Specifically, it works by blocking an enzyme that breaks down alcohol, creating a buildup of a toxic substance called acetaldehyde that gives the unpleasant “hangover” feeling.

Alcohol (ethanol) is broken down in the body in a two-step process. In the liver, alcohol is converted into acetaldehyde by the enzyme alcohol dehydrogenase (ADH). Acetaldehyde is a “toxic” compound, but in regular alcohol metabolism, it is further broken down by aldehyde dehydrogenase (ALDH) into acetate, which is eventually broken down into carbon dioxide and water.

Disulfiram’s method of action is to block the functioning of ALDH, therefore causing a buildup of acetaldehyde, which causes an unpleasant reaction in the body in the presence of alcohol. The buildup of acetaldehyde causes feelings similar to a hangover, which is supposed to deter people from drinking. These effects are usually felt within 30 minutes of drinking alcohol while taking disulfiram.

How Long Does Disulfiram Stay In The Body?

It is not 100% certain how long disulfiram stays in the body, but it is known that disulfiram has effects for up to two weeks. This means that if someone drinks within the 2-week period of taking disulfiram, the person may experience the unpleasant effects associated with this medication.

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How Is Disulfiram Taken?

Disulfiram comes as an oral tablet that can be swallowed or crushed and mixed with liquid for easier consumption. The average initial dose of disulfiram is 250 milligrams once a day for 1-2 weeks, with an average maintenance dose of 250 milligrams a day thereafter. However, the daily dosage can range from 125 to 500 milligrams a day.

A person must be alcohol free for at least 12 hours before taking disulfiram. This means that the individual should have already gone through the initial period of alcohol withdrawal and detox, has completely abstained from alcohol for at least 12 hours, and has a blood alcohol content of 0.

Some studies indicate that disulfiram is most effective when taken in conjunction with other alcoholism medications, especially acamprosate (Campral). It is widely accepted that disulfiram is most effective for patients who are truly committed to their sobriety and that it is ideally taken under supervision to ensure the patient is compliant with treatment.

Special care must be taken around products that contain alcohol when taking disulfiram. Disulfiram might create reactions when patients inhale fumes of paint, paint thinner, varnish, shellac, and similar products. Similarly, disulfiram may cause reactions when patients’ skin comes into contact with aftershave lotions, colognes, and rubbing alcohol.

Although it is a highly effective deterrent to alcohol use, disulfiram alone is generally not sufficient to treat alcoholism. Disulfiram should be a part of a larger alcohol treatment regimen, including rehab, therapy, counseling, and 12-step programs.

Side Effects Of Disulfiram

Disulfiram has comparatively few and minor side effects compared to other alcohol treatment medications. Generally, these side effects will lessen or even disappear within a few weeks. However, some disulfiram side effects can be serious and even fatal, so it is important for anyone taking this drug to be vigilant.

Some of the most common side effects of disulfiram include:

• Drowsiness
• Metallic taste
• Headaches
• Sexual dysfunction
• Acne

Some of the less common but more serious side effects of disulfiram include:

• Liver toxicity, disease, and failure
• Hepatitis
• Optic neuritis
• Peripheral neuritis and neuropathy
• Psychosis
• Delirium
• Hypersensitivity to the drug
• Reactions with other medications

Benefits Of Disulfiram

Disulfiram is a reputable medication when taken as indicated and in conjunction with other treatment modalities for alcohol use disorder. Some of the benefits of disulfiram include:

• It helps individuals stop drinking by creating adverse reactions when they drink.
• Fewer side effects present themselves if the person refrains from drinking while on the medication.
• Many years of successful use mean that this drug is very well-studied and documented.
• It will cause adverse impacts when only a small amount of alcohol is consumed, making it a successful deterrent for mild drinking.

How Do I Get Disulfiram?

Disulfiram is a prescription medication and should only be taken under the supervision of a physician.

Disulfiram should only be taken after the patient has been educated about its impacts. Any licensed healthcare professional who can write prescription medications can distribute disulfiram, but it is important to seek treatment from a healthcare professional who is well-versed in addiction medication, since other medications and therapeutic processes are usually required.

Since it is not a controlled substance, people can also get disulfiram through telehealth services, making access easy for those needing support on their recovery journey.

Is Disulfiram Right For Me?

If you have an AUD, disulfiram may be a beneficial medication to help aid you in your recovery journey. It is important that you are not in current withdrawal, have not consumed alcohol in the past 12 hours, and have been cleared by a medical professional to take disulfiram. Disulfiram can be a beneficial option in conjunction with other treatment modalities for alcohol use disorder.

Find Help For An Alcohol Use Disorder

Disulfiram has a long history of success in treating alcoholism when used alongside other treatment methods. However, it should only be taken after initial withdrawal and detox have been completed.

If you or a loved one needs help overcoming alcohol addiction, help is available. Contact a treatment provider or visit our rehab directory today to explore the many alcohol addiction treatment programs available to you.