It seems a bit too good to be true, doesn’t it?
“Non est ad astra mollis e terris via.
That’s my philosophy. It’s a quote from the past. There is no easy way from the earth to the stars.” — Cecil Castellucci
While reading a few quit lit books giving advice on different ways to change your life forever and give up alcohol, one of the ways that has always interested me a bit has been the medicine route.
Some people won’t even mention it in their recommendations, as perhaps they see it a bit like cheating.
I would surmise that it’s a bit like a fitness trainer suggesting getting liposuction as a way to lose weight. It seems to be the easy way out and doesn’t appear to truly allow one to build the necessary mental and psychological fortitude and discipline for it to last long term.
While I do also fall into this category as it relates to losing weight, I can’t say I quite agree when it relates to breaking the hold alcohol has on you.
Much of what happens with our body’s physical connection to alcohol is somewhat physiological, and if we can break that connection and reduce or eliminate our urgings or cravings, we can then do the mental work that will allow us to understand that we don’t need it.
My thought process has always been to do whatever works for you (outside of hurting someone else) if it allows you to break free and then you can figure out how to remedy any other issues after you’re free from alcohol’s strong grip.
Therefore, I decided to do some research on the different types of alcohol-remedy medications available to share in the event this could be a viable avenue for some.
Disulfiram — FDA approved
Disulfiram (also known as Antabuse) was one of the first FDA-approved drugs used to treat alcohol use disorder.
How it works is that it changes the way your body breaks down alcohol by blocking one of the enzymes involved in alcohol metabolism. This blockage usually results in you getting sick while you drink it. The hope is this should deter you from drinking by not creating a very pleasant experience when you do it.
This usually results in alcohol causing some type of vomiting or headache that is somewhat similar to a really bad hangover.
One negative on this drug is that it is completely dependent on individuals taking it consistently and some just might stop taking it when they want to start drinking. One study showed that only 20% of individuals who take it are compliant without supervision.
Some of the potential side effects include bad breath, rash and acne, fatigue, headache, and sexual dysfunction.
Naltrexone — FDA approved
Naltrexone (also known as Vivitrol) is probably one of the more well-known drugs to help stop drinking. It is somewhat preferred because it doesn’t have to be taken as consistently as some of the others (if you get the shot) and can be taken while you are still drinking.
It is typically one of the first medical treatments considered. Naltrexone can be taken as a daily tablet or a monthly injection, however, and has been proven to be quite effective.
It works by blocking your opioid receptors that reinforces the positive feelings that alcohol creates. For this reason, they are not suggested to be taken with any kind of opioid medication, as it can cause severe withdrawal.
Research has shown that it is probably more effective to help people reduce their consumption of alcohol as opposed to stopping drinking altogether.
The major known side effects are sleepiness, dizziness, and headaches, but these have been known to dissipate over time. Also, only one out of nine people are known to reduce their drinking while taking it, and only one of out twenty are known to stop drinking completely from taking it.
Acamprosate — FDA approved
Acamprosate (also known as Campral) works on your brain’s neurotransmitters that alcohol targets when you drink.
Whereas naltrexone prevents the way your body normally functions by blocking the feeling of pleasure created by opioids, acamprosate works to help your body’s neurotransmitter system (particularly the interaction between glutamate and GABA) become stabilized again to repair the damage done to it by excessive drinking.
For this reason, this drug is mostly helpful for individuals who are having major withdrawal symptoms after they stop drinking. It can prevent the feeling of insomnia, restlessness, and anxiety that many heavy drinkers can feel for months after they stop drinking.
Treatment takes place once someone has been detoxed from alcohol (not before five days after the last drink) and involves taking up to three pills per day.
There are no major side effects (other than the occasional case of diarrhea), and the success rate is about one out of nine people will see a benefit from it.
Topiramate — Off label
Topiramate (also known as Topomax) is considered an off-label alcohol medication because it has not explicitly been approved for that function, but some doctors will still recommend it because there have been studies that show it could be effective.
It is (officially) an anti-seizure medication as well as an appetite suppressor, but similar to naltrexone, it alters the balance of chemicals in the brain to decrease the rewarding effect of alcohol.
There can be many physical and mental side effects of topiramate, including fatigue, dizziness, loss of coordination, speech/language problems, as well as the possible formation of kidney stones.
The dosage starts out with as little as 25 mg per day and can increase to a maximum of 75 mg. Studies have shown that it is as effective as naltrexone when it comes to keeping people abstinent after 4 to 8 weeks of treatment.
Gabapentin — Off label
And lastly, gabapentin, (also known as Neurontin) is used to treat epilepsy and something known as postherpetic neuralgia, a condition caused by shingles.
Studies have suggested that gabapentin can be effective to prevent a relapse by treating the symptoms of alcohol withdrawals. Similar to its FDA-approved counterpart, acamprosate, it helps stabilize the effects of the brain that have been damaged from excessive alcohol use.
It has had some promising results, as one study found that 41% of people with alcohol withdrawal symptoms before taking gabapentin were able to still remain abstinent after 16 weeks on the drug.
Gabapentin has a number of different side effects similar to the aforementioned medications, such as headache, fatigue, and insomnia, with the distinct additional side effect of potentially becoming addictive itself.
There is the fear that someone will potentially lose one addiction to only create a new one, so one must get their doctor’s permission before and be monitored closely while taking this.
The battle to quit or cut back on the amount one drinks is different for everyone. While some may look at taking medication as the get-rich-quick answer or easy way out, the truth is there are a number of major side effects and challenges that come with going this route.
Also, if one does make the decision to take medication to aid in this endeavor, this should generally be combined with some additional treatment that involves focusing on the mental and psychological side of the problem.
And while there is no one medication that will be the magic pill to make the journey easy for you, perhaps one of these five choices can make the ride a bit smoother along the way.