Medications That Help You Stop Drinking: What the Options Are
Quick answer: Three medications — naltrexone, acamprosate, and disulfiram — are FDA-approved to help people stop or reduce drinking. All three are prescription-only, so which one fits you is a decision for a prescriber rather than something to pick from a list. Medication doesn't replace the work, but it can make the work easier.
Medication for alcohol use disorder is one of the more useful tools available and one many people never hear about. A systematic review of the drug treatments found that acamprosate, disulfiram and oral naltrexone had the best evidence for improving abstinence and reducing heavy drinking — real effects, though not dramatic ones, and mostly measured over a few months rather than years.
That it goes unmentioned so often has little to do with whether it works. Stigma, limited awareness, and a lingering belief that quitting should be accomplished through willpower alone all play a part. None of those are good reasons to skip a tool that could genuinely help.
This is a plain-language guide to the main options and how they work, so you can have a more specific conversation with a doctor. It isn't a menu to choose from — the right medication depends on your history, your other prescriptions, and your goals, and only a prescriber can weigh those together.
One drug people now ask about is missing from the list below because it is not approved by the FDA for alcohol use disorder. Two randomized trials have tested semaglutide — the drug in Ozempic and Wegovy — against placebo in people with alcohol use disorder, and both found reductions in drinking and craving. Both were small by drug-approval standards. What the trials show about ozempic alcohol cravings sets out the numbers and the limits; the decision still belongs with a prescriber.
Naltrexone
Naltrexone is one of the most studied medications for alcohol use disorder. It belongs to a class called opiate antagonists, and it works by decreasing the craving for alcohol and blocking the effects of opioids — including the opioid receptors alcohol stimulates to produce the "reward" feeling.
The practical effect: the pull toward drinking can diminish because the brain doesn't get the expected reward. It's prescribed alongside counseling and social support rather than on its own.
Two forms:
- Daily oral pill (50 mg is the dose that a review of the trials found the best evidence for): taken once a day
- Long-acting injectable (Vivitrol): given by a healthcare provider every four weeks or once a month, removing the need to remember daily pills
The injection is often useful for people who struggle with medication adherence — when the shot is already in, there's no "should I take it today?" decision.
Who it's best for: People motivated to stop or significantly reduce drinking, working with a prescriber who knows their history.
Key consideration: Naltrexone must not be taken by anyone who is dependent on opioids or taking opioid pain medication — the tablet's US label lists both as reasons not to use it, because it can bring on opioid withdrawal. The two forms also differ on drinking. NIAAA notes that naltrexone can be started while a patient is still drinking, and the tablet label sets no condition about stopping first; the monthly injection's label is for people who can stop drinking before treatment starts and are not drinking at the first dose. That difference, and your other medicines, are among the reasons the starting point has to be a doctor rather than a decision you make alone.
Acamprosate (Campral)
Acamprosate works differently from naltrexone. Rather than blocking the reward of drinking, it helps stabilize the brain chemistry imbalance that develops after prolonged heavy drinking — reducing the anxiety, restlessness, and discomfort of early sobriety that drives many people back to drinking.
It doesn't affect the "high" from alcohol. Its main benefit is in making the absence of alcohol feel more tolerable, particularly in the first few months.
Dosing: Usually three times a day, which can be a challenge for adherence. It's generally started once you've already stopped drinking and any withdrawal has been managed — and if you drink heavily or daily, that part is worth doing with medical support, because withdrawal can progress unpredictably.
Who it's best for: People who've recently stopped drinking and are struggling with persistent anxiety, insomnia, and general dysphoria that doesn't improve quickly on its own.
Disulfiram (Antabuse)
Disulfiram is an older medication that works through a deterrence mechanism rather than reducing cravings. If you drink alcohol while taking it, you experience highly unpleasant physical reactions: flushing, nausea, vomiting, rapid heart rate.
It doesn't make drinking impossible — but it makes the consequences immediate and severe.
Who it's best for: People who are highly motivated to stop but want a hard chemical barrier against impulsive drinking. It's commonly used with someone else supervising the daily dose (a partner, a family member, a pharmacist), because the deterrence only works if you keep taking it.
Key consideration: Disulfiram requires strict avoidance of all alcohol, including in food, mouthwash, and certain medications. There are also significant drug interactions to be aware of — a conversation with a doctor is essential.
Topiramate and Gabapentin
These are used off-label (not FDA-approved specifically for alcohol use disorder; the American Psychiatric Association suggests them as second-line options):
Topiramate can reduce cravings for some people. It hasn't been shown to outperform naltrexone or acamprosate, and side effects — including cognitive ones — are the main limiting factor: about twice as many people stopped it because of side effects as stopped a placebo.
Gabapentin is sometimes used for insomnia, anxiety, and cravings in early sobriety, occasionally as a short-term bridge through withdrawal-related discomfort. In the same review, it improved abstinence but did not significantly reduce heavy drinking.
Both are prescription medications. They're worth raising with a doctor, not treating as self-help options.
How to Access Medication
The main barrier isn't the medications themselves — it's getting them prescribed. Options:
- Your primary care doctor can prescribe all of these. Many won't bring it up unless you do. Bring it up.
- Addiction medicine specialists or psychiatrists often have more experience with the nuances of these medications.
- Telehealth services can be an option in some places, which makes the access question simpler if getting to an appointment is the barrier.
You don't need to be at a crisis point to ask about these medications. Anyone who wants support for stopping or reducing drinking can raise it — the decision about which one, at what dose, and for how long belongs to you and your prescriber together. Our free alcohol addiction quiz gives you a screening band to bring to that appointment, and the withdrawal risk checker covers the safety question if you drink heavily every day.
Medication and Other Support
Medication works best as part of a broader approach. Medicines and behavioral therapies are both used to treat alcohol use disorder, and for many people using both gives the best results. Tracking your progress, building trigger awareness, and having social accountability all work alongside medication rather than being replaced by it.
Therapy for Stopping Drinking covers the therapy options that pair well with medication.
Frequently Asked Questions
Is medication for alcohol use disorder a sign of weakness?
No. It's a sign of using available tools intelligently. These are standard, non-addictive treatments that a doctor can prescribe like any other, and the stigma around them isn't medically justified.
Can I take naltrexone if I haven't quit yet?
That's a question for a prescriber, not one to settle yourself, and the answer depends on the form. NIAAA notes that naltrexone can be started while a patient is still drinking, and the tablet's US label sets no condition about stopping first. The monthly injection is different: its US label is for people who can stop drinking before treatment starts and are not drinking at the first dose. Some clinicians also use targeted or as-needed dosing regimens, so if that's what you're hoping for, ask directly — but do it with a doctor rather than on your own.
How long do people take these medications?
It varies. Some people use naltrexone for a few months through the highest-risk period. Others continue longer. There's no set timeline — it's a conversation with your doctor based on your situation and goals.
Are there side effects?
All medications have potential side effects. Nausea and headache are the most commonly reported ones with naltrexone in the alcohol trials. Disulfiram requires strict avoidance of alcohol to be used safely. Ask your prescriber or pharmacist to walk you through the specific side effect profile so you can weigh it against the benefit.