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Should Disulfiram Be Used to Stop Drinking?

Disulfiram makes drinking alcohol very uncomfortable, causing nausea, headaches, and more if alcohol is consumed. This can help people addicted to alcohol if they are at a point where such obstacles are enough to limit their drinking.

DISULFIRAM

Disulfiram, often sold under the brand name Antabuse, is an alcohol antagonist. It treats alcohol addiction through deterrence.

If you drink alcohol while disulfiram is in your system, you will begin to feel seriously ill within about 10 minutes; you likely will feel sick for about one hour. It could last longer, depending on the amount of alcohol consumed and how much disulfiram is in the body.

This alcohol-disulfiram reaction can make a person feel the following:

Alcohol should be avoided 12 hours before taking disulfiram and for at least a few weeks after you stop the treatment course.

DRAWBACKS OF DISULFIRAM

Disulfiram use is only a viable option for those ready to commit to alcohol abstinence. For those who can’t resist the draw of alcohol while on disulfiram, it may cause a person serious problems, including abusing alcohol despite the serious alcohol-disulfiram reaction or otherwise acting dangerously or impulsively.

Disulfiram can react negatively to some medications and conditions, including diabetes, thyroid disease, epilepsy, brain damage, kidney and liver disease, and pregnancy. Talk to your doctor about potential issues and interactions before taking disulfiram.

Disulfiram can have the following side effects (in addition to those caused by the alcohol-disulfiram reaction):

  •  Impotence
  •  Skin rash
  •  Acne
  •  Drowsiness
  •  Mild headache
  •  Metallic or garlic taste in mouth

It should be noted that these conditions tend to go away within the first two weeks of taking disulfiram or after a reduction in dose.

If you experience any of the following symptoms, call a doctor immediately:

  • Dark urine
  • Yellowing of skin or eyes
  • Vomiting
  • Weakness
  • Extreme Tiredness

Disulfiram can tax the liver, although it will usually only cause problems for those with a prior liver condition. If you have problems with your liver, make sure this information is included in any discussion of disulfiram use.

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THE IMPORTANCE OF INFORMED CONSENT

There is an ongoing problem within the medical community about how to keep patients, who are generally not medically literate, informed about medical choices. While sometimes difficult, it is very important that patients understand disulfiram before taking it.

Disulfiram makes a person violently ill if they drink alcohol. People who have a problem with alcohol abuse must understand this before being given disulfiram. It is not meant as a punishment for relapsing nor as a trick to force people who abuse alcohol into stopping.

If you are considering disulfiram, ensure that you and people in your household are fully informed about the drug. Even mild amounts of alcohol can sometimes cause quite serious reactions, so you must research common food items with trace amounts of alcohol, like vinegar and some sauces, to avoid a reaction.

Never administer disulfiram without a person’s knowledge or consent. If a person is unaware of its effects, they can become extremely ill if they drink while on the drug.

A doctor should always be involved in the process. Never take disulfiram without first talking to a medical professional.

IS DISULFIRAM FOR ME?

Disulfiram use requires that a person look inward before starting it. You should have a serious conversation with a qualified medical professional if you think the drug might help you. It certainly might. It is just very important to be fully informed about choosing to take it.

Disulfiram essentially removes alcohol as an option for abuse.

Alcohol addiction is different for everyone. Some people who are addicted to alcohol are not yet at a stage where disulfiram is a healthy choice. Consider the nature of the alcohol-disulfiram reaction carefully.

By the drug’s nature, people who are considering disulfiram feel drawn to abuse alcohol for one reason or another. While the goal of alcohol abuse treatment programs is to overcome that urge, getting to a level where you can resist it for long periods can take time.

Disulfiram should not be taken if you do not feel you can resist the draw of alcohol for relatively prolonged periods.

Woman with a pill and a glass of water in her hand

RESEARCH ON ITS EFFECTIVENESS

For those ready to take it, disulfiram was shown in a 2014 meta-analysis to be a generally safe and effective treatment compared to other alcohol abstinence programs or no program at all. Its biggest downside is that it is essentially a medicinally enforced commitment to alcohol abstinence that can be underestimated by those considering it.

The effectiveness of disulfiram is up for debate, with many of the studies discussed in the meta-analysis showing different results. As a group, however, nearly all showed disulfiram better than the control (a treatment option without disulfiram).

Generally, it was at least 5 percent more effective. In some cases, it was reportedly as high as 40 percent more effective than a non-disulfiram option.

THE RIGHT CHOICE

It should be noted that appropriate treatment for alcohol abuse varies from person to person. Disulfiram does not simply increase your specific odds of beating alcohol abuse. It is more complex than that, but it is still worth considering for many people who struggle with alcohol.

It is OK if you’re not ready for disulfiram or even if you don’t need it as part of your alcohol treatment program. Every person is different, and addressing addiction is a multistep process.

Disulfiram can be a bad option for you today but a better one tomorrow. Talk to your doctor if you think you are in a place where it may help even if previously you were not.

Sources

(January 2019). Antabuse. RxList. Retrieved February 2019 from https://www.rxlist.com/antabuse-drug.htm

https://medlineplus.gov/druginfo/meds/a682602.html from https://medlineplus.gov/druginfo/meds/a682602.html

(February 2014). Disulfiram Efficacy in the Treatment of Alcohol Dependence: A Meta-Analysis. PLoS One. Retrieved February 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3919718/

(1997). A Guide to Substance Abuse Services for Primary Care Clinicians. Substance Abuse and Mental Health Services Administration (SAMHSA). Retrieved February 2019 from https://www.ncbi.nlm.nih.gov/books/NBK64825/

Definition of Hepatitis. RxList. Retrieved February 2019 from https://www.rxlist.com/script/main/art.asp?articlekey=3705

(August 2017). Campral. RxList. Retrieved February 2019 from https://www.rxlist.com/campral-drug.htm#description

(June 2014). Treatment for Problem Drinking: What Are the Options? National Institute on Alcohol Abuse and Alcoholism (NIAAA). Retrieved February 2019 from https://www.spectrum.niaaa.nih.gov/archives/V6I2Jun2014/features/options.html

https://findtreatment.samhsa.gov/ from https://findtreatment.samhsa.gov/

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