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7 January 2010
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Medications to treat alcoholism

I've been a heavy drinker for years but now realise it has got out of hand. I want to get off alcohol but it seems impossible. Could my doctor prescribe any medicines to help me?

Stephen

Dr Trisha Macnair responds

Dr Trisha MacnairThere are various medications that can be used to help drinkers stop. However, these are by no means always used, and many people prefer to try other therapies such as psychological approaches.

None of the drug treatments offers anything like a miracle cure that, on its own, might enable you simply to stop drinking. Nor is there anything like the nicotine replacement therapies used to wean smokers off cigarettes, which could act as an alcohol substitute. However, there are medications that can help you to deal with some of the symptoms of withdrawal and the craving for alcohol.

Some of the best results are achieved by intensive and carefully structured rehabilitation programmes, in which these drug treatments play a specific but limited part. Talk to your GP to see if you can join one of these programmes locally.

Tranquillisers

Some tranquillisers, such as chlordiazepoxide (trade name Librium) may be useful to help you cope with the effects of withdrawal when you first stop drinking alcohol.

In the first week - often referred to as detoxification or detox - you may experience intense anxiety, shakes, tremors, cravings and even hallucinations. You may also have problems sleeping.

Usually, chlordiazepoxide is used only for this short period. Beta blockers such as propranolol may also be used to control these symptoms.

Drugs for alcohol cravings

Acamprosate (trade name Campral) has been developed specifically to help people deal with the intense craving for alcohol that may be experienced after giving up. It may double your chances of giving up successfully.

Drugs to put you off alcohol

Another medication often used to help people stop drinking is disulfiram (trade name Antabuse).

If you drink alcohol while taking this medication, you'll feel extremely unwell with intense nausea and flushing. This can help to put you off the idea of a drink, but you have to be diligent about taking it in the first place.

Occasionally, naltrexone (trade name Nalorex) is used. This is licensed in the UK for treatment of opiate addiction, not alcohol-related problems. However, under some circumstances it may be prescribed for heavy drinkers.

This article was last medically reviewed by Dr Trisha Macnair in October 2007

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