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Treating Alcohol Abuse And Addiction With Disulfiram

Joseph Sitarik, DO

Medically reviewed by

Joseph Sitarik, DO

March 12, 2019

Struggling with alcohol abuse or addiction can be a very difficult journey for an individual. Many people may struggle with obtaining or maintaining their sobriety and may try a variety of treatment methods to no avail. In these circumstances, disulfiram, or Antabuse, may help aid a person in maintaining sobriety by deterring them from the use of alcohol.

What Is Disulfiram?

The National Library of Medicine defines disulfiram as “an alcohol deterrent used as an adjunct to treatment of chronic alcoholism, based upon its ability to cause an adverse reaction when taken with alcohol.” It was approved by the FDA for this purpose in 1951.

Medscape reports that roughly 200,000 people take it on a regular basis within the United States. The purpose of this medicine is to prevent a person from consuming any alcohol due to fairly immediate and uncomfortable interactions between alcohol and disulfiram.

When you consume alcohol it is converted to acetaldehyde and your body works towards rapidly removing it from your system. Disulfiram works by binding itself to the sites where coenzymes that aid in this metabolic process reside. This blocks the oxidation of acetaldehyde to acetate to inhibit your body’s metabolism of alcohol.

As a result, the concentration of acetaldehyde increases to levels according to Medscape that are “five- to ten-times the concentration found in blood during metabolism of the same amount of alcohol alone.” These accumulations are responsible for creating the unpleasant reactions which occur within 10 minutes of having a drink while taking disulfiram.

Some research suggests that it is not only the aversion caused by disulfiram that can aid in treatment, but also a physiological change that results from the medication itself. Medscape suggests that “the secondary CNS actions, through modulation of catecholamine neurotransmission, may be the effect most closely related to the clinical efficacy of disulfiram in reducing craving and preventing relapse to drinking.”

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How Is It Used To Help With Alcoholism Treatment?

The National Library of Medicine cites that “the recommended starting dose is 500 mg once daily for 1 to 2 weeks, followed by a maintenance dose of 125 to 500 mg daily.” The exact dosing requirements will vary person to person and will be specified by your doctor after an extensive examination.

Medline Plus states, “disulfiram is not a cure for alcoholism, but discourages drinking.” For this reason, it is ideally used in combination with other forms of treatment and supportive care and, if used properly, deters a person from consuming alcohol. However, it does not address the underlying problems or circumstances that might push a person towards drinking in the first place.

If you want your sobriety and recovery to last you should integrate other avenues of care and treatment into your protocol. These can include cognitive behavioral therapy, recovery facilities and support groups, including AA or non-12 step programs.

What Symptoms Occur If You Drink While Taking Disulfiram

If a person drinks while they are taking this medication, they will experience physical and mental reactions which may add up to several hours. The severity of the reaction increases as you drink more alcohol. According to Medline Plus, if you consume alcohol while taking disulfiram, you may experience the following:

  • Flushing of the face
  • Headache
  • Nausea
  • Vomiting
  • Chest pain
  • Weakness
  • Blurred vision
  • Mental confusion
  • Sweating
  • Choking
  • Breathing difficulty
  • Anxiety

Special Health Considerations When Taking This Medicine

As with any medication, you should have a thorough discussion with your doctor about your health and medical history. It is recommended that you carry a card stating that you take disulfiram, along with the symptoms of its reactions with alcohol and how to contact your doctor in emergency situations.

If you are scheduled for a surgical procedure, including any dental procedures, it is important that you inform the medical team that you are taking disulfiram. Do not take this medicine within twelve hours after drinking as it can remain in your system for up to two weeks.

Also avoid any other products that may contain alcohol, even food products such as vinegar or sauces or medicines like cough syrups. You must take care to avoid breathing household products that contain alcohol and may emit fumes, including stains, solvents, and paint thinners.

Even products that are intended for personal care can be problematic, such as perfume or cologne, aftershave, muscle ointments, mouthwash, hand sanitizer or antiseptics. If you have any doubt about a product or its alcohol content, speak to your doctor or pharmacist before using it.

What Are The Risks And Side Effects Of Taking This Medicine?

Though disulfiram has been used for many years as treatment for alcoholism, in recent years its use has declined because of its side effects. This medication may cause drowsiness, especially when used concurrently with other medications may enhance this effect, especially ones that depress the central nervous system.

According to Mayo Clinic, these include: “antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics.” Blood thinners can also interfere with disulfiram.

If you are pregnant or breast feeding, have epilepsy, cerebral damage, thyroid issues, kidney disease, diabetes, liver disease, or any mental illness, you should speak to your medical provider before beginning treatment with this medication.

Individuals that have liver concerns need to be especially careful about using this medicine. If you develop jaundice or jaundice-like symptoms, you need to seek medical attention immediately as this could be indicative of complications.

If you notice any of the following mild side effects, speak to your doctor.

  • Itching skin accompanied by a rash
  • Slight headache
  • Complications during sex, including impotence
  • Slight drowsiness or tiredness
  • Strange or metallic taste in your mouth

If you encounter any other side effects that you feel may be related to your use of this medication, contact your doctor.

Remember That Recovery, Help, and Treatment Is An Ongoing Process

True recovery from alcohol abuse is a multi-facet journey. Just as the circumstances surrounding your alcohol abuse or addiction are unique to your life and circumstances, so are the elements of your recovery. Knowledge is power and you need to know all you can about all your options. So contact us at today. Our caring and supportive team is standing by to answer any questions you might have about substance abuse, addiction, or treatment.

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