Medications to treat opioid and alcohol use disorders can be integrated into primary care settings effectively and play an important role in helping patients recover from addiction.

Medications to treat alcohol use disorder

Medication
(Brand name)
Route Effect Most common adverse effects Notes
Acamprosate
(Campral)
Oral Can decrease the craving for alcohol. Anxiety
Diarrhea
Vomiting
Non habit-forming. Safe to take with alcohol and opiates. In event of relapse, will not cause an adverse reaction or exacerbate withdrawal symptoms.
Naltrexone
(Vivitrol)
Oral, injection Can discourage alcohol use by producing adverse reactions when alcohol is consumed, such as nausea, dizziness, headache, flushing. Dizziness
Nausea
Vomiting
Non habit-forming. May reduce the feeling of intoxication and the desire to drink more, but it will not cause a severe physical response to drinking.
Disulfiram
(Antabuse)
Oral Can decrease the craving for alcohol. Drowsiness Non habit-forming. Should not be administered until patient has abstained from alcohol for at least 12 hours. If discontinued it can be restarted, even briefly, to ensure success in high-risk relapse situations.
Topiramate
(Topamax)
Oral Can decrease the craving for alcohol. Loss of appetite
Drowsiness
Hair loss
Non habit-forming. An anti-seizure medication used off-label for the treatment of alcohol use disorders (not FDA approved for this purpose).

More information: Medication for the Treatment of Alcohol Use Disorder, SAMHSA

Medications to treat opioid use disorder

Medication
(Brand name)
Route Effect Most common adverse effects Notes
Methadone Oral An opioid agonist that eliminates withdrawal symptoms and relieves drug cravings. Constipation, hyperhidrosis, respiratory depression, sedation Only federally certified, accredited opioid treatment programs can dispense methadone.
Buprenorphine
(Suboxone)
Tablet, Injection, implant A partial opioid agonist that reduces cravings and withdrawal symptoms without producing euphoria. Constipation, nausea, withdrawal, excessive sweating, insomnia Usually tolerated well by patients. Only physicians, nurse practitioners, and physician assistants can prescribe buprenorphine for OUD and must get a federal waiver to do so.
Naltrexone
(Vivitrol)
Oral, injection Blocks the euphoric and sedative effects, prevents feelings of euphoria Nausea, anxiety, insomnia, depression, dizziness Any prescriber can offer naltrexone

More information: Treatment Improvement Protocol 63, SAMHSA