Medication-Assisted Therapies for Alcohol Use Disorder
Today’s presentation will be on Medication-Assisted Therapies for Alcohol Use Disorder. You will often hear these therapies referenced as just M.A.T.
After this presentation you will:
- Be able to name 3 medication-assisted therapies for alcohol use disorder
- Be familiar with some of the side effects of M.A.T. and
- Be encouraged to talk to a medical provider to see if M.A.T. is right for you.
There are many tools you have to remain sober from alcohol once you have been safely detoxed. In addition to medication-assisted therapy after a safe detox, it is recommended all patients continue to engage in treatment. This can include time spent in a residential level of care, partial hospitalization level of care, and/or an intensive outpatient level of care.
And while we do not officially endorse any particular one of the following groups, it is encouraged that you seek out support groups such as Alcoholics Anonymous or Celebrate Recovery. Evidence shows these support groups help patients with substance use disorders maintain sobriety.
Other activities that will help maintain sobriety include quitting smoking, not isolating, exercising as tolerated, maintaining a nutritious diet, getting adequate sleep, and taking all medications as prescribed.
Statistics show that the following medications can help you recover from alcohol use disorder, ultimately improve quality of life, improve your health by minimizing withdrawals and reduce or eliminate cravings.
Some of these medications include Acamprosate, Disulfiram and Naltrexone.
People who take acamprosate drink less and less frequently. The negative of this medication is that you have to take two tablets three times a day and you need to take it regularly so that it is effective. It takes 5–8 days to fully kick in and side effects include but are not limited to weakness, loss of appetite, dizziness, anxiety, depression and insomnia.
Good news is those side effects tend to go away in the first couple of weeks. If you have alcohol use disorder and want to go on a medication like Acamprosate, the time to start this medication is while you are in treatment. It does seem to act with the nervous system, by reducing the hyperactivity seen in alcohol withdrawal, including insomnia, anxiety and restlessness.
Disulfiram, also known as Antabuse, was the first medication approved by the FDA to treat chronic alcohol use disorder. It is alcohol aversive which means that if you are taking Antabuse or Disulfiram and you are exposed to or consume alcohol; you can have a toxic reaction. This can include nausea, vomiting, confusion, sweats, to name a few. It does not block alcohol. It blocks the metabolism of alcohol. And if you know that you may have a severe reaction to alcohol consumption, it is thought to increase your motivation to remain abstinent. Once a day dosing of pills is all and the side effects include but are not limited to alcohol reaction if you consume or are exposed to alcohol, drowsiness, dizziness and metallic taste. All of these go away in a couple of weeks. It is always good to start this medication before you leave a treatment program.
Naltrexone is the third medication I am going to talk about. This is also used in opioid use disorder. If you have both conditions, this would be a great drug choice for you. For alcohol, it decreases cravings and the pleasure from drinking. And so, by blocking the craving and blocking that pleasure from drinking, you are more likely to drink less or not drink at all. Naltrexone long-acting, which is the injectable form, seems to be even more effective than the pill form. And part of that could be due to the fact that you do not have to worry about compliance.
How do you choose which medication to take?
There is no data to indicate which patient will respond to which medication better. It really comes down to your choice and which medication you can access. Couple of the medications on the list are pills. One of them is an injection. And so, you have some choices there. And the advantage, again, of the injection really is compliance. You do not have to worry about taking the pill. You just have to show up at the doctor’s office or nurse practitioners office every 28 days or so to get another shot.
We do have programs that can help you. In addition to our treatment centers, we also offer an Office-Based Opioid Treatment (OBOT) Program. Our prescribers can continue to treat you after you complete your treatment with us. This can be done by telemedicine or face-to-face.
Evidence shows that if you are participating in a partial hospitalization, intensive outpatient, or outpatient services, in addition to seeing the medical provider for the medication-assisted therapy, your outcomes are better.
Evidence also shows that if you are participating in support meetings such as Alcoholic Anonymous or celebrate recovery, your outcomes are improved.
How does our Office-Based Opioid Treatment program work?
All patients sign a contract of expectations and conduct. We recommend that patients have weekly visits with the medical provider for the first 4 to 8 weeks and then bimonthly for the next 4–8 weeks and then monthly. Visit frequency will ultimately depend on how well you are doing and your ability to remain sober. All patients will need to participate in random Urine Drug Screening as well as Breathalyzer tests.
All patients will have their pharmacy drug monitoring profile (also referred to as PDMP) checked regularly to make sure that the medications they are receiving from their outside providers are consistent with your recovery plan.
We encourage all of you with Alcohol Use Disorder to take a medication to aid in your recovery. It will reduce cravings, reduce withdrawal and hopefully save your life.
Thank you for choosing The Recovery Village. If you or a loved one are struggling with mental health or substance abuse and would like to find out more about the programs we offer, please reach out to us directly at 855-387-3291.
