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Alcoholism is a significant health crisis in the U.S., and problem drinking has caused issues for individuals, families, and society for centuries. While most people can drink without becoming addicted, others aren’t so lucky. Alcohol is something legal, ubiquitous, and a significant part of the broader culture in the U.S. People drink to celebrate, socialize, unwind, or complement a meal. Over 86% of people in the U.S. over the age of 18 have drunk alcohol, but 15 million U.S. adults struggle with an addiction to drinking. Problem drinking plays a role in the top three leading causes of death for young adults – violence, suicide, and accidents.
Because alcohol is such a socially-accepted part of the cultural fabric, it can be very difficult for individuals and loved ones to know when casual drinking becomes alcohol use disorder. Furthermore, it’s easy to obtain alcohol and extremely difficult to avoid its presence in society. For people who are in recovery for alcoholism, using medications to assist with withdrawals and the recovery period can be a godsend. Disulfiram, or Antabuse, is one medication that people in recovery for alcohol use disorder may find beneficial to maintaining their sobriety.
What is Disulfiram or Antabuse?
Disulfiram is a prescription medication used to treat alcoholism. Its brand name is Antabuse. When someone uses Disulfiram, they will not be able to drink even small amounts of alcohol without experiencing unpleasant side effects. The goal of using Antabuse is to associated alcohol with negative consequences, sickness, and to discourage someone from drinking and relapsing.
Antabuse will cause users to experience a range of side effects that can be very unpleasant and severe, even if they only ingest trace amounts of alcohol. After only a few minutes of drinking, a user will experience the following range of symptoms and side effects:
- Stomach upset
- Headache
- Sweating
- Impaired vision
- Weakness and dizziness
- Trouble breathing
- Confusion
- Anxiety
- Hypotension
- Tachycardia
What is the history of Disulfiram?
Disulfiram was the first prescription drug the FDA has ever approved for treating alcoholism. The origins of Antabuse or Disulfiram have nothing to do with treating alcohol dependency. In the 1930s, rubber industry workers who were handling a chemical compound called tetraethyl thiuram disulfide noticed they became sick after drinking alcohol. A decade later, Disulfiram was used in a research study on stomach issues, and anyone who drank also became ill during the experiments. After this coincidence, studies began to focus on Disulfiram and alcohol and confirmed that the two substances were opposed to each other. But it wasn’t until 1951 that the FDA approved the drug for treating alcohol dependency.
At first, Disulfiram was prescribed in large doses, some as high as 3,000 milligrams a day. But these high doses caused severe reactions in some people, which proved fatal in a few cases. These reactions caused the FDA to lower the dosing threshold, and the drug started to become widely known as an effective medication for promoting and supporting abstinence from alcohol. PLIVA manufactures the drug, and it is distributed by Odyssey Pharmaceuticals under the brand name Antabuse.
When Disulfiram was first used in the 1950s, doctors would often recommend that patients mix the drug with alcohol under a doctor’s supervision. This practice was supposed to help patients fully understand how powerful the effects of the drug were. This practice is no longer used, but it is critical that patients fully understand the impact of the medication before they start taking it.
Can people abuse Disulfiram?
Disulfiram or Antabuse won’t get someone high, and it’s not a drug that is typically abused. Unlike other medication-assisted treatments, Disulfiram won’t produce euphoric effects, but it is highly effective for producing unpleasant effects when mixed with alcohol.
How does Disulfiram work?
When someone drinks alcohol, the body converts the drink into a chemical compound called acetaldehyde, which is then converted into acetic acid. The primary mechanism by which Disulfiram works is that it blocks acetaldehyde from converting into acetic acid. This causes the body to experience a marked increase in acetaldehyde. Acetaldehyde is toxic and produces a range of unpleasant side effects.
A range of 80 to 95% of the medicine is absorbed in the gastrointestinal tract, then filtered slowly through the rest of the body. Up to 20% of the medication is eliminated. But the elimination and distribution of the medicine are prolonged, and the drug can linger in the body for up to two weeks. Although there are no withdrawal symptoms from Disulfiram, it has a half-life range of 60 to 120 hours. Also, any alcohol consumed during the withdrawal period from Disulfiram can produce ill effects. It is also critical that people wait to use Disulfiram at least twelve hours after having their last drink.
People who have been taking Disulfiram should not stop without speaking to their doctor first. Missing a dose of Disulfiram or quitting without doctor input can increase a person’s risk of relapse. Disulfiram can interact with some medications, supplements, and even OTC cough and cold medicines that contain minuscule amounts of alcohol. Patients should always talk to a doctor before trying anything new when they are on Disulfiram.
Who is most likely to use Disulfiram?
Disulfiram is used primarily to treat alcoholism and to help people maintain sobriety and avoid a relapse. The medication has been used for decades as a highly effective and safe medical treatment option for alcohol use disorder. The people most likely to use Disulfiram are those in recovery for alcoholism, and people who have already attempted to maintain sobriety but have relapsed.
Alcohol use disorder and problem drinking are prevalent among adults and adolescents alike. Addiction is also a chronic, lifelong disease that requires integrated care and ongoing maintenance and treatment to give patients the best chances of achieving and maintaining sobriety. An estimated 15 million U.S. adults struggle with alcohol dependency, but only 6% of those people will get treatment for their disorder. Over half a million adolescents have alcohol use disorder, but only 5% get treatment. Some of the signs and symptoms of alcohol use disorder include the following:
- Being unable to stop drinking despite the negative consequences
- Experiencing increasing tolerance levels to alcohol
- Getting unpleasant withdrawal symptoms when attempting to quit drinking
- Wanting to cut back or quit, but not being able to
- Neglecting responsibilities or hobbies to drink instead
Alcoholism is also associated with a range of other consequences and risk factors. Alcohol abuse can cause long-term heart damage, including irregular heartbeat, cardiomyopathy, stroke, and high blood pressure. Drinking also inflames the liver and can lead to hepatitis, or even liver failure. Pancreatitis, inflammation, and swelling of the pancreas, can also result from long-term, severe problem drinking. Alcoholics are also at increased risk of getting cancer. Fortunately, it’s never too late to get help for alcoholism and reverse the effects of problem drinking. Using medications like Disulfiram is one treatment option.
What is medication-assisted treatment?
Medication-assisted treatment, or MAT, is the practice of combining medications along with behavioral therapy to assist patients in recovery for drug and alcohol abuse. MAT is typically used to treat both opioid dependencies and alcohol dependency. These two types of addiction have FDA-approved medications specially formulated for treating the disorders. Other addictions, such as cocaine, may use medicines off-label to manage withdrawals and cravings for drugs.
How does Disulfiram fit in with treatment plans for recovery from alcoholism?
It’s critical for people to understand that medication alone is not the answer for treating addiction disorders like alcoholism. Disulfiram, in particular, does not address withdrawal symptoms, or the cravings users will get for alcohol once they attempt to achieve sobriety. This is one of the reasons why taking a holistic and integrated approach to addiction treatment is so critical. Therapy can address the other aspects of recovery that Disulfiram cannot.
When it comes to taking Disulfiram, most patients will take the drug in tablet form, once per day, at a range of 250 or 500 milligrams. 500 milligrams is the maximum recommended dosage for the medicine. Disulfiram or Antabuse should be taken regularly to reduce the desire to drink, avoid relapse, and to guarantee that the metabolic cycle continues. Certain drugs should not be taken with Disulfiram, including Elavil, Coumadin, Flagyl, and Dilantin. Disulfiram should also be avoided in patients who are pregnant or wish to become pregnant. The drug is thought to cross the placenta, and there have been instances of babies born to mothers who’ve taken Disulfiram experiencing malformations and congenital disabilities. It is unclear if these disabilities were due to Disulfiram directly or from alcohol abuse.
Medications like Disulfiram, when combined with comprehensive treatment plans for addiction, is incredibly useful for aiding in the recovery process. Taking Disulfiram requires a doctor’s supervision until patients stabilize and maintain long-term sobriety from alcohol. This can take as long as two years, but every patient is different.
If you or a loved one is struggling with alcohol dependency, please contact Mission Harbor Behavioral Health today. Representatives are standing by to answer your questions about rehab and recovery.
The facilities at Mission Harbor are staffed with trained experts to best assist patients with their mental health issues. We are capable of dealing with any and all cases with a licensed staff, equipment, and approved techniques. Our mission is to help those who want to help themselves, and we support your decision in seeking help.
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