Medication for alcohol use disorder

Alcohol use disorder (AUD) is a common, treatable medical condition, and medication is one of the most effective ways to treat it. About 27.9 million Americans have AUD, yet more than 9 in 10 who could benefit from a medication have never been offered one. If you want to drink less or stop, you have real, safe, non-addictive options, and most of them can be started from home.

This is not about willpower. AUD changes how the brain responds to alcohol, and the right medication can turn down cravings, cut heavy drinking days, and make change far easier. Below is a plain-language guide to every medication used for alcohol use disorder, how each one works, and how to get started.

What is alcohol use disorder?

Alcohol use disorder is the medical name for a pattern of drinking that is hard to control and keeps going even when it causes harm. Doctors used to call it alcohol abuse, alcohol dependence, or alcoholism. It runs on a scale from mild to moderate to severe, based on how many warning signs a person has, such as craving alcohol, needing more to feel the same effect, or being unable to cut back.

It is a real medical condition, not a character flaw. Long-term heavy drinking changes the brain’s reward and stress systems, which is why stopping by willpower alone is so hard for so many people. The good news is that those same brain systems can be treated. Medication, support, or both together can help the brain reset and make drinking easier to control.

Can medication help you stop drinking?

Yes. Several medications are proven to help people drink less or stop, and three of them are FDA approved specifically for alcohol use disorder. They work in different ways. Some remove the reward you get from drinking, some ease the discomfort of staying sober, and one makes you feel ill if you drink at all. None of them are addictive.

Medication works best when it is paired with some form of support, whether that is counseling, a recovery group, or regular check-ins with a provider. It is not a magic cure, but the evidence is strong and consistent. Major medical groups, including the American Psychiatric Association, recommend medication as a core part of treating moderate to severe AUD.

What medications treat alcohol use disorder?

There are three FDA-approved medications for alcohol use disorder and several others used off label, meaning they are approved for something else but shown to help with drinking. Here is how they compare.

Naltrexone: the most common first-line option

Naltrexone is the medication most people start with, and it is a first-line choice. It blocks the pleasant “buzz” that alcohol gives you, so drinking feels less rewarding and cravings fade over time. You can take it as a 50 mg daily pill or as a once-a-month injection called Vivitrol. It is not addictive and not a controlled substance.

One of its biggest advantages is flexibility. You do not have to quit before you start. Some people take naltrexone every day to support staying sober, and others take it only before they plan to drink, an approach called the Sinclair Method, to gradually cut back. A large review of many studies found that for every 12 people treated with naltrexone, one extra person avoids a return to heavy drinking. Learn more on our full naltrexone for alcohol guide.

Acamprosate (Campral)

Acamprosate helps people who have already stopped drinking stay stopped. It is thought to calm the ongoing brain changes that cause the restlessness, anxiety, and poor sleep that can linger for months after quitting, and that often drive people back to alcohol. It works best when you begin it a few days after your last drink.

It is taken as two pills three times a day, which is more often than the other options, but it is gentle and non-addictive. The most common side effect is diarrhea. Because it leaves the body through the kidneys, it is not a good fit for people with serious kidney problems. Like naltrexone, acamprosate is considered a first-line medication and works well alongside counseling or support.

Disulfiram (Antabuse)

Disulfiram is the oldest alcohol medication and works in a completely different way. It does not reduce cravings. Instead, it makes you feel sick if you drink, causing flushing, a pounding heart, nausea, and vomiting. That unpleasant reaction is the point: it acts as a strong deterrent for people who are committed to full abstinence.

Because it only works if you take it every day, disulfiram does best when someone helps supervise the daily dose, such as a partner or a clinic. It is usually a second-line choice, chosen by people whose goal is to quit completely and who understand the reaction.

Other medications used off label

Some medications approved for other conditions have good evidence for alcohol use disorder and are used off label. Topiramate can reduce heavy drinking days, though its dose has to be raised slowly and it can cause tingling, foggy thinking, or weight loss. Gabapentin can lower drinking and ease early withdrawal symptoms like anxiety and poor sleep, which makes it useful in the first weeks. Baclofen is often chosen for people who also have liver disease, because it is processed by the kidneys rather than the liver. A provider may suggest one of these if the first-line options are not a good fit.

Which medication is right for you?

The best medication depends on your goal and your health history. If your goal is to cut back rather than quit, naltrexone is usually the first choice. If you have already stopped and want to stay stopped, naltrexone or acamprosate both fit well. If you are fully committed to abstinence and want a strong guardrail, disulfiram may help. If you have liver disease, baclofen is often safer.

You do not have to figure this out alone, and you should not. A licensed provider will look at your drinking pattern, your goals, your other medications, and your medical history, then recommend the safest, most effective option for you. Many people also try one medication, and switch if it is not the right fit. That is normal and expected.

The Sinclair Method: drinking less without quitting first

The Sinclair Method is a specific way of using naltrexone that has a devoted following. Instead of quitting first, you keep living your life and take one naltrexone pill about an hour before you drink. Because the medication blocks alcohol’s reward, each drink becomes less satisfying, and over weeks and months the urge to drink slowly fades. It is a gentler, more gradual path that many people find easier to stick with. Read our full Sinclair Method guide to see how it works.

How to start alcohol treatment from home

Starting is simpler than most people expect. You do not need to hit rock bottom, check into a facility, or even leave your house. A typical telehealth path looks like this: you answer a few questions about your drinking and health, you meet a licensed provider by video or by secure message, and if a medication is right for you, it is prescribed and mailed to your door. Follow-up check-ins keep you supported along the way. The whole point is to remove the friction and the stigma that keep people from getting help, so that starting treatment is as easy as ordering anything else online.

The bottom line

Alcohol use disorder is common, it is a medical condition, and it responds to treatment. Safe, non-addictive medications can reduce cravings and heavy drinking, whether your goal is to quit or just to drink less. Naltrexone and acamprosate lead the list, with several more options for specific needs. The evidence has been clear for years. The real gap is access, since more than 9 in 10 people who could benefit are never offered these medications. If drinking is something you want to change, talking to a provider about medication is one of the most effective first steps you can take.

Alcohol treatment is coming to Recovery Delivered

We are bringing medication for alcohol use disorder online, the way it should be: no waiting rooms, no judgment, and your medication mailed to your door. See a provider by video, or handle everything by secure message. Join the waitlist to be first in line when we open.

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Frequently asked questions

• National Institute on Alcohol Abuse and Alcoholism (NIAAA). Alcohol Use Disorder in the United States. 2024 National Survey on Drug Use and Health (about 27.9 million people ages 12 and older).
• Substance Abuse and Mental Health Services Administration (SAMHSA). 2024 National Survey on Drug Use and Health (NSDUH), National Report.
• American Academy of Family Physicians. Alcohol Use Disorder: Medication Options. American Family Physician, 2024 (medication doses, goals, and numbers needed to treat).
• Jonas DE, et al. Pharmacotherapy for Adults With Alcohol Use Disorders in Outpatient Settings: A Systematic Review and Meta-analysis. JAMA. 2014;311(18):1889-1900.
• American Psychiatric Association. Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder (naltrexone and acamprosate as first-line).
• U.S. Food and Drug Administration. Prescribing information for naltrexone, acamprosate, and disulfiram.

This page is for education only and is not medical advice. These are prescription medications. Talk with a licensed provider about which option, if any, is right for you.