What medications can help me stop drinking?

Acamprosate (Campral®) decreases cravings to drink for people who have been dependent and want to completely stop drinking (abstinence).¹

• It comes as tablets – taken 3 times a day (often at mealtimes).
• It takes around 1 week to start working and you can continue for as long as needed (usually up to 12 months).

How does it work?

Acamprosate can reduce cravings for alcohol which also helps to prevent a lapse back to drinking.

• It won’t make you sick if you do drink.
• It won’t make you feel ‘high’ or sedated.
• It isn’t known to have a risk of dependence.

Who can be prescribed?

If you have a dependence on alcohol and want to stop drinking, you can talk to your doctor about getting a prescription for Acamprosate.

It is usually prescribed when you have stopped drinking, and after withdrawal symptoms have reduced (typically between 2-7 days).

What to keep in mind

• Acamprosate doesn’t help withdrawal symptoms, such as shakes.
• It’s subsidised by the Pharmaceutical Benefits Scheme (PBS), which means this medication is more affordable.
• For a doctor to prescribe, the person needs to have an alcohol dependence, want to stop drinking completely, and have a treatment program.
• The doctor can only prescribe 1-2 months of tablets at a time.
• Acamprosate in combination with counselling (from a general practitioner, psychiatrist, psychologist, or drug and alcohol counsellor) is generally most effective. Counselling can support you with cravings, lapsing, and help you make changes that support your goals.^1,2,3

*Not to be confused with Naloxone (Narcan) that temporarily reverses opioid overdose.

Naltrexone reduces cravings for alcohol and makes drinking less pleasurable for people who have been dependent and want to completely stop drinking (abstinence).¹

• It comes as tablets – taken once a day.
• It starts working within 1 hour and wears off within 72 hours of stopping, and you can continue for as long as needed (usually up to 12 months).

How does it work?

Naltrexone blocks the pleasurable effects of drinking alcohol and reduces cravings, which can help reduce the chance of lapsing/relapsing.

• It won’t make you sick if you do drink, but it can change the taste of alcohol.
• It won’t make you feel high and isn’t known to have risk of dependence.
• It can make you drowsy, so it’s best to avoid driving or operating heavy machinery.

Who can be prescribed?

If you have a dependence on alcohol and want to stop drinking, you can talk to your doctor about getting a prescription for Naltrexone.

• It is usually taken once you have stopped drinking, and after withdrawal symptoms have reduced (typically between 2-7 days).
• It can’t be taken for alcohol dependence by people who regularly use prescription opioids or are dependent on opioids (e.g. heroin, codeine, oxycodone), as it blocks their effects.

What to keep in mind

• Naltrexone doesn’t help withdrawal symptoms.
• It’s subsidised by the PBS which means it is more affordable, but only for the treatment of alcohol dependence, not opioid dependence.
• For a doctor to prescribe, the person needs to have an alcohol dependence, want to stop drinking completely, and have a treatment program.
• The doctor can only prescribe 1-2 months of tablets at a time.
• Naltrexone in combination with counselling is shown to be the most effective. Counselling can support you with cravings, lapsing, and help you make changes that support your goals.^1,4,5

In Australia, Naltrexone is usually available as an oral tablet. However, a few services provide Naltrexone implants, which can last several months.

A Naltrexone implant is a pellet inserted under the skin that slowly releases the drug, continuously for around 3-6 months so you don’t have to remember to take tablets daily.

Naltrexone implants are currently obtained through the TGA Special Access Scheme. This means that your doctor needs to get special authorisation to prescribe it and that makes the medication more costly.

But the safety and effectiveness of the Naltrexone implant hasn’t been well researched. More long-term research is needed to understand its effectiveness for alcohol dependence.^7,8

Disulfiram (Antabuse®) causes unpleasant effects if a person taking it drinks alcohol, discouraging them from drinking.¹

• It comes as tablets – taken once a day, dissolved in water.
• It starts working straight away, so you can’t drink any alcohol while taking it.
• You can continue for as long as needed (usually about 12 months).

How does it work?

Disulfiram impacts how your body metabolises alcohol. The intensity of the reaction varies depending on the amount of Disulfiram and alcohol consumed.

• The typical reaction begins with feeling flushed, hot, or sweating, followed by palpitations, headaches, chest pain, and shortness of breath. After this passes you may also experience stomach pain, vomiting, and drowsiness.
• The reaction usually lasts 2-4 hours, and up to several hours in more severe cases.
• Severe reactions can affect the heart and may cause fits, loss of consciousness and death. If this happens, the person needs immediate medical attention. In an emergency call triple zero (000).
• It doesn’t usually cause drowsiness, but it’s important to check your alertness before driving or operating heavy machinery.
• It can interact with other medications, food, and products that contain alcohol. Always check with your doctor or pharmacist for information on what to avoid when taking Disulfiram.

Who can be prescribed?

If you have a dependence on alcohol and want to stop drinking, you can talk to your doctor about getting a prescription for Disulfiram.

• You must wait at least 24 hours after your last alcoholic drink before taking Disulfiram so there’s no alcohol in the bloodstream.

What to keep in mind

• Disulfiram doesn’t help with withdrawal symptoms.
• It isn’t PBS subsidised – meaning it can be a more expensive option.
• It can be prescribed by any doctor, but often isn’t the first treatment option for alcohol dependence.
• Some people find it helpful to have a trusted friend, housemate, or family member watch them take their medication to make sure they continue with their treatment.^{1, 6}

1. SA Health. Medication assisted treatment for alcohol dependence: Government of South Australia; 2023 [cited 13 Nov 2023].
2. Drug and Alcohol Services South Australia. Acamprosate (Campral) Patient-client information 2020 [cited 13 Nov 2023].
3. NPS Medicine Wise. CAMPRAL® acamprosate calcium Consumer Medicine Information 2023 [cited 13 Nov 2023].
4. Drug and Alcohol Services South Australia. Naltrexone Patient-client information 2020 [cited  13 Nov 2023].
5. NPS Medicine Wise. NALTREXONE GH (naltrexone hydrochloride) film-coated tablet Consumer Medicine Information 2020 [cited 13 Nov 2023].
6. NPS Medicine Wise. ANTABUSE® Disulfiram Effervescent Tablets Consumer Medicine Information 2023 [cited 13 Nov 2023].
7. Drug and Alcohol Services South Australia. Naltrexone in heroin dependence 2023 [cited 2023 14 Nov].
8. Lobmaier PP, Kunøe N, Gossop M, Waal H. Naltrexone Depot Formulations for Opioid and Alcohol Dependence: A Systematic Review. CNS Neuroscience & Therapeutics [Internet]. 2011 2011/12/01 [cited 14 Nov 2023]; 17(6):[629-36 pp.].