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Does Medication-Assisted Treatment (MAT) for Alcohol Use Disorder (AUD) Work?

July 6, 2022

Table of Contents

Medication-Assisted Treatment (MAT) for alcohol use disorder (AUD) is effective.

There are 4 medications approved by the U.S. Food and Drug Administration proven to reduce alcohol consumption and increase abstinence.[1] Others have more modest track records, but they are very helpful for some people who are trying to quit drinking. Your doctor can help you choose the right medication for you. 

How Does MAT for Alcohol Use Disorder Work?

Despite the proven effectiveness of Medication for Addiction Treatment, less than 4% of people with alcohol use disorder get medications to help them abstain from use.[2] This is a shame because, nowadays, there are several very effective medications to help reduce the cravings for alcohol in patients trying to abstain.

The more you know about how these therapies work, the more likely you will be to ask your doctor to help.

Each medication approved for AUD treatment works differently, but in general, they do one or multiple of the following:

  • Reduce cravings
  • Lower relapse risks
  • Make drinking alcohol unpleasant or less rewarding

These medications can't cure your AUD since there is no cure for the disorder, but they can help you focus on your recovery.

In a MAT program, you will also take advantage of conventional addiction therapies such as these:

  • Group counseling
  • Individual counseling
  • Family therapy
  • Support group meetings

Medications support but don't replace the work of therapy. However, medications can help ease cravings and help you physically be more comfortable as you work on behavioral therapy that supports long term recovery.

AUD is a chronic condition, and many people relapse while in therapy.[3] Your relapse is a temporary setback, not proof that your medications don't work or can’t be helpful in the future. 

Who Is a Candidate for MAT?

Anyone with alcohol use disorder can consider MAT. But people who are successful in treatment share a few core characteristics. However, the people who have the most success are people that are really ready to make a change and are highly committed to decreasing and/or discontinuing alcohol use.[4]

In addition, certain medical conditions may preclude you from using certain medications for AUD, or may make one medication preferable to another. Talk to your doctor before starting a medication for AUD about which would be right for you.

Remember, using medication to help treat alcohol dependence isn't substituting one addiction for another [5] It is an evidence based method to reduce overall harm to your health and keep you on the road to recovery. 

MAT Pharmaceutical Options Explained

The U.S. Food and Drug Administration recognizes four medications for the treatment of alcoholism. Your doctor will help you decide which is right for you.

These are the four options:[6]

  1. Acamprosate: This medication can ease cravings for alcohol and makes it easier to stick to sobriety. 
  2. Disulfiram: This medication makes you sick when you drink alcohol. This makes the prospect of drinking less appealing. Enforced sobriety could make relapse less likely. 
  3. Oral naltrexone: This medication eases cravings for alcohol and helps you stay sober. 
  4. “Extended-release” naltrexone: This medication is delivered via a shot, ensuring that it stays in your body for a month at a time. You won’t have the option to skip doses once it is in your body, which some people find helpful to ensure they don’t miss doses and are able to stick to the treatment plan.

No single medication is right for everyone. Your doctor can help you discover which is best for you and your alcohol use disorder.

MAT for Alcohol Use Disorder FAQs

Is MAT available for alcohol use disorder?

Yes: acamprosate, disulfiram, and naltrexone (in both pill and injectable form) are all used to treat alcohol use disorder. They are FDA approved to help treat AUD. They can be obtained by a prescription from any licensed medical professional. 

Is MAT recommended for alcohol use disorder?

Yes. MAT can lessen cravings for alcohol and ease withdrawal symptoms, helping people to maintain abstinence. 

Does Medication-Assisted Treatment work?

Success rates for MAT are high. People are much more likely to maintain treatment compliance with MAT than with other treatment approaches alone. The combination of both medications and behavioral therapy together tend to have the best long-term success rates for abstaining from alcohol. 

Can medication “cure” alcoholism?

It depends on how you define “cure”. Some people consider AUD a life long condition that can be “in remission” but never “cured”. Other people who have been abstinent for a long time without any concern for relapse would consider themselves “cured”. Regardless of how you prefer to identify, medications can help you maintain long term abstinence, which some people would consider “cured”, or at least in long term remission. Be aware, however, that some people who discontinue medication may have cravings return and increase their risk of relapse. Some people prefer to stay on medication lifelong to prevent relapse. Talk to your doctor about what length of therapy is best for you. Some people do stay on medications lifelong to prevent relapse.

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. Medications for Alcohol Use Disorder. American Family Physician. https://www.aafp.org/pubs/afp/issues/2016/0315/p457.html. March 2016. Accessed June 2022.
  2. Medications to Treat Alcohol Use Disorder: Targeting the Dark Side. American Journal of Psychiatry. https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2021.21030286. May 2021. Accessed June 2022.
  3. Alcohol Use Disorder (AUD) Treatment. U.S. National Library of Medicine. https://medlineplus.gov/alcoholusedisorderaudtreatment.html. September 2017. Accessed June 2022.
  4. Medicines to Treat Alcohol Use Disorder. Agency for Healthcare Research and Quality. https://effectivehealthcare.ahrq.gov/products/alcohol-misuse-drug-therapy/consumer. February 2016. Accessed June 2022.
  5. Medications for the Treatment of Alcohol Use Disorder. Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury. https://www.healthquality.va.gov/guidelines/MH/sud/MedicationsForTheTreatmentOfAlcoholUseDisorderBrochure92816.pdf. September 2016. Accessed June 2022. 
  6. Medication for the Treatment of Alcohol Use Disorder: A Brief Guide. National Institute on Alcohol Abuse and Alcoholism. https://store.samhsa.gov/sites/default/files/d7/priv/sma15-4907.pdf. 2015. Accessed June 2022.

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