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Acamprosate in Alcohol Use Disorder (AUD) Treatment

July 6, 2022

Table of Contents

Acamprosate can support alcohol use disorder (AUD) treatment, helping people to stay sober and focus on recovery.

Long-term drinking changes your brain cells. Acamprosate is one of four medications that is FDA approved to treat alcohol use disorder.

Acamprosate (sold under the brand name Campral) helps normalize brain activity and prevent cravings for alcohol.[1] Take it properly, and it could reduce uncomfortable symptoms like insomnia, restlessness, and cravings, leaving you less likely to relapse. 

How Is Acamprosate Used?

Acamprosate is a prescription medication your doctor uses in conjunction with therapy to help soothe cravings and urges to consume alcohol. It is FDA-approved for this indication. Several studies show that acamprosate can help people reduce drinking days and stay sober.[5]

Most people start Acamprosate either when they are trying to slowly decrease their drinking, or when they have stopped drinking altogether. You do not have to be fully abstinent from drinking before starting acamprosate. It is safe to drink on Acamprosate. The point is to use the acamprosate to minimize the desire to drink. However, if you do “slip up”, and drink anyway, it is not dangerous to your health. This is desirable to some people who would like to reduce their drinking but are worried they will not yet be able to be totally abstinent. 

Benefits of Acamprosate

Why do you need to use medications to stop drinking? For some people, medications offer a special kind of help that just can't come from therapy alone. Medications can help reduce physical cravings for alcohol while you continue to work on behavior change, therapy and social support as other ways to help you maintain sobriety. For some people, medication alone may be enough to support abstinence. Others may not need medications, but simply a good support plan from their behaviorists/therapists and their family and friends. Overall, it is thought that a combination of both medication and behavioral interventions work best to really tackle AUD. 

Dosing of Acamprosate

Most people take acamprosate in pill form three times per day.[2] You must take your medication even if you feel you're not going to drink. It is used preventatively, not as needed. Therefore you should take it every day to prevent the urge to drink before it occurs. 

Some people find the three times a day dosing of Acamprosate burdensome. For this reason, it has fallen out of favor compared to drugs like Naltrexone that can be taken once a day only, or even monthly in an injectable form. If you think you will have trouble taking a pill 3 times a day, talk to your doctor about Naltrexone or other medications for alcohol cessation. 

Side Effects of Acamprosate

Many prescription medications cause side effects, and sometimes, they're mild or temporary. As your body grows accustomed to the medication and how it works, side effects tend to go away. Even so, it's always best to talk to your doctor about any side effects you experience. If they're severe enough to entice you to skip your doses, it's especially important for you to speak up.

Talk with your doctor if you notice any side effects with acamprosate that are significant or don't stop after a few weeks of therapy.[4]

How Long Should Someone Be on Acamprosate?

It depends on each individual. About half of people who use acamprosate stop using the medication within about a year.[3] Your doctor can help you decide how long you should stay on the medication. Quit too soon, and you run the risk of relapse. Some people take Acamprosate for many years, or even indefinitely, if they feel it will be helpful for them to prevent relapse.

If your withdrawal symptoms and cravings are under control and you would prefer to discontinue the medication, you can talk to your doctor about tapering off acamprosate. You can work together to come up with the best decision about medications for you and your unique needs as you continue to treat your AUD.

Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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Citations

  1. Substance Abuse Treatment Advisory. U.S. Department of Health and Human Services. https://pgdf.org/media/MS974.pdf. Fall 2005. Accessed June 2022.
  2. Alcohol Use Disorder: Pharmacologic Management. UpToDate. https://www.uptodate.com/contents/alcohol-use-disorder-pharmacologic-management. March 2022. Accessed June 2022.
  3. Acamprosate (Campral) for Treatment of Alcoholism. American Family Physician. https://www.aafp.org/pubs/afp/issues/2006/0815/p645.html. August 2006. Accessed June 2022.
  4. Acamprosate. U.S. National Library of Medicine. https://medlineplus.gov/druginfo/meds/a604028.html. May 2015. Accessed June 2022. 
  5. Incorporating Alcohol Pharmacotherapies Into Medical Practice. Substance Abuse and Mental Health Services Administration. https://www.ncbi.nlm.nih.gov/books/NBK64035/. 2009. Accessed June 2022.

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