If you are dealing with an alcohol use disorder, you have the option of medication-assisted treatment. One of the more common medications used to manage alcohol is disulfiram. This unique drug works by removing the positive feedback associated with alcohol intake. To see if it may be right for your situation, check out this helpful guide.
What Is Disulfiram?
Disulfiram is a type of addiction treatment medication that can be used to treat alcohol use disorders. It is sold under multiple brand names, including Antabuse and Antabus.
Disulfiram is classified as an alcohol antagonist drug, which means that it blocks the way the body usually processes alcohol. The primary effect of disulfiram is that it interacts poorly with alcohol. When a person consumes alcohol after taking disulfiram, he or she essentially feels symptoms similar to a severe hangover within just a few minutes.
Common symptoms of drinking alcohol while on disulfiram include:
- Headache
- Nausea
- Vomiting
- Mental confusion
- Anxiety
- Rapid heart rate
- Sweating
- Fatigue
- Low blood pressure
- Vision impairments
- Impotence
Disulfiram is typically taken as a pill once a day though there are some experimental treatment methods that involve implantation. You usually cannot take it unless a doctor prescribes the medication to you. Currently, the recommended daily dosage is no more than 500 milligrams. However, many people use significantly less to get the desired results.
Disulfiram is absorbed very slowly by the body. It has a half-life of around 60 to 120 hours. This means that a significant portion of a dose can stay in the body for a week or so. Usually, a person cannot consume alcohol comfortably for at least 14 days after taking disulfiram.
Disulfiram is primarily used to treat alcohol use disorders. However, it may also have some other medical uses. Disulfiram has been used to remove parasites, and new research indicates it may be helpful for treating certain symptoms of cancer and HIV.
Treating Alcoholism with Disulfiram
Disulfiram was originally a compound used to process rubber in factories. However, around the 1930s, factory workers started complaining that they felt extremely ill any time they consumed alcohol. This fact was recalled a few decades later when disulfiram started being described to treat stomach parasites. A few doctors realized that the medication’s side effects could also be put to use for treating alcohol use disorder.
In 1951, disulfiram became the first drug approved by the FDA for treating alcohol use disorder. At first, it was prescribed in such high doses that people became dangerously ill when using alcohol. Over time, doctors realized this was doing more harm than good. Such a harsh deterrent to alcohol consumption scared people away from taking disulfiram at all. Since then, the recommended dosage has dropped sharply.
As medical experts have become familiar with disulfiram, they have gradually fine-tuned the process of using it for alcoholism. Since the 1950s, there has been a lot of research done regarding the best dosages and treatment regimens involving disulfiram. There are now many substance use treatment centers that specialize in using disulfiram to manage alcohol use disorder.
How Does Disulfiram Work?
Disulfiram works to make alcohol unpleasant by interfering with the way the body processes alcohol. Usually, the body converts alcohol into fairly toxic acetaldehyde and then into less-toxic acetic acid. When you are taking disulfiram, it keeps acetaldehyde from turning into acetic acid. This results in a big upsurge in acetaldehyde levels, so the person drinking alcohol quickly becomes ill.
Disulfiram will not automatically lower alcohol cravings or reduce withdrawal from alcohol. Instead, its main function is just making alcohol unpleasant to consume. Even a few sips of a beer may be enough to make a person feel extremely sick. Without the positive feedback mechanism of alcohol, there is less of a reason to drink.
For those who struggle with finding motivation for sobriety, disulfiram may be quite effective. It works as a deterrent that removes all the pleasant effects of alcohol and magnifies the unpleasant ones. This can be a powerful motive on the journey to sobriety. According to 2011 research, disulfiram treatment can reduce a patient’s risk of relapse significantly.
What are the Side Effects of Disulfiram?
As long as you do not consume alcohol while on disulfiram, the side effects are few. It is not an addictive medication, so you will not experience any withdrawal symptoms if you decide to quit using it. The most common side effect that patients report is a strange taste in their mouth. Taking disulfiram may also cause side effects such as:
- Headaches
- Reduced libido
- Skin rashes
- Acne
- Fatigue
Though rare, disulfiram may also cause liver problems. Therefore, it is important to seek medical help and to discontinue use if you notice severe stomach pain, persistent nausea, dark urine, or yellowing skin and eyes. Because of the way that it is metabolized, disulfiram can interact poorly with caffeine, cough syrups, blood thinners, and seizure medications.
The main danger of disulfiram is the way it interacts with alcohol. Much like alcohol withdrawal or an intense hangover, taking alcohol with disulfiram puts you at risk for general poor health. Especially if you take higher doses of disulfiram, drinking alcohol can be quite risky. In some cases, it can exacerbate preexisting conditions and cause potentially fatal health problems.
How Is Disulfiram Used in Addiction Treatment Programs?
Alcohol disulfiram therapy is usually started while a patient is in rehab. Usually, your counselors will discuss treatment options with you and decide if you may benefit from disulfiram. If you decide to give this therapy a try, your doctor will typically start with a lower dose of around 250 milligrams. If you can tolerate this lower dose without side effects, then it may be increased slightly. Throughout the entire treatment, you will need regular visits and checkups from a medical professional.
Disulfiram can help decrease a patient’s desire to relapse. However, it is only one of the tools used for alcohol use disorders. In order to be effective, disulfiram needs to be administered alongside alcohol addiction therapy and counseling. The typical treatment regimen will usually involve a person taking disulfiram each day, visiting support groups weekly, and getting therapy sessions a few times a week.
You can expect to spend some time discussing the disulfiram therapy with your counselor. They may ask you questions about how it feels to be unable to use alcohol or discuss whether you still have a desire to abuse alcohol. In addition to discussing disulfiram directly, your treatment will also include more general substance use therapy. You might learn coping tools for handling addiction triggers, and your therapist may help you address some of the reasons you were often tempted to drink.
Disulfiram is usually not meant to be a permanent treatment. Instead, it just gives you time to process your feelings and to get the tools you need to manage your addiction. Since disulfiram makes it easier to stay away from alcohol, your body has a chance to heal from chronic alcohol abuse. Once you feel like your alcohol addiction is under control, your doctor may help you discontinue use. Some people take disulfiram for a few months while others may use it for years.
Issues With Using Disulfiram for Alcohol Use Disorders
A major challenge in disulfiram treatment is that alcohol cravings are still there. Without proper support, a patient may be tempted to quit disulfiram use and to go back to abusing alcohol. Because of this challenge, treatment advisors are looking into other ways of administering disulfiram. If possible, they recommend that a spouse, parent, or medical professional administer the medication each day. Another potential option is disulfiram implantation, which allows patients to get a slow, steady dose of the medication over the course of several weeks.
Another thing to keep in mind is that disulfiram only addresses the physical signs of alcohol use disorders. It does nothing to treat the mental health conditions that may exacerbate addiction. Therefore, most patients will also benefit from various forms of psychotherapy. This can help address grief, trauma, depression, and other issues that lead to addiction. It is important to remember that disulfiram alone is not usually a cure-all. Instead, it works best when incorporated into a treatment program with other helpful addiction management methods.
Finally, keep in mind that disulfiram only affects the alcohol absorption process. It does not interfere with the way the body processes most other drugs. Research has shown that it slightly diminishes the use of cocaine or other drugs often taken alongside alcohol. This happens simply because people make smarter choices and avoid drugs more effectively when they are sober. However, it cannot directly deter patients from using other drugs to get intoxicated. People who struggle with addictions to multiple substances may need more medical intervention than just disulfiram.
Is Disulfiram Right for You?
Since the drug can interact poorly with other medications, you need to consult with a doctor and discuss all medicines you take before proceeding. You need to be in decent health and not be pregnant to take disulfiram. It is not recommended if you have:
Cardiovascular disease
Diabetes
Hypothyroidism
Brain disorders
Kidney disease
Liver disease
You should only take disulfiram once you are sober for at least 12 hours and have left the withdrawal stage. Disulfiram is also not recommended if you are allergic to thiuram. Thiuram-related chemicals, which are found in certain types of rubber and pesticides, are similar to certain compounds in disulfiram. Therefore, it is possible for a rare allergic reaction to occur.
Disulfiram is often recommended for patients who have tried to stop drinking already but who find themselves regularly relapsing. If you take disulfiram, you need to be able to commit to a long-term medical regimen. Remember that alcohol exists in certain medicines, mouthwashes, perfumes, kinds of vinegar, sauces, and flavorings, so you need to be willing to carefully check products for alcohol before using them. Each case of alcohol use disorder is different, so it is a good idea to consult carefully with your doctor and to see which medication is right for you.
We Offer the Latest in Medication-Assisted Treatment
At Granite Recovery Center, we are dedicated to offering evidence-based treatment options and medication-assisted treatment to our patients. Our custom care plans carefully consider each patient’s situation and then recommend a combination of therapy and medication for that person’s unique needs. At our facilities, we provide treatment options like cognitive behavioral therapy, grief counseling, and exercise therapy.
Granite Recovery Center provides substance use treatment in a private, relaxing setting. We provide a variety of inpatient, outpatient, and partial hospitalization treatment programs, so you can find the right treatment schedule for you. To schedule a consultation with us, call 855-712-7784.
