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 decrease the craving for alcohol. | 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 discourage alcohol use by producing adverse reactions when alcohol is consumed, such as nausea, dizziness, headache, flushing. | 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: Pharmacotherapy for Adults With AUD in Outpatient Settings – AHRQ
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 | Only physicians (MDs); nurse practitioners; physician assistants; clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives can prescribe buprenorphine. They must get a federal waiver to do so, but are not required to complete the previous eight-hour training. |
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