Disulfiram as a Medication for Addiction Treatment (MAT)

Disulfiram is an FDA-approved medication used to treat alcohol use disorder (AUD).¹ It works by interfering with the metabolic processing of alcohol, which leads to a buildup of acetaldehyde—a toxic alcohol-related metabolite that causes people taking the medication to become very sick if they drink alcohol.¹ As such, disulfiram can help those who are highly determined to stay sober maintain recovery. Understanding what exactly disulfiram is, how it can be used alongside behavioral therapy in MAT, and how programs that offer disulfiram and other pharmacological treatment for AUD can help with achieving and maintaining recovery.

What Is Disulfiram?

Disulfiram is sometimes referred to as an aversive or alcohol-sensitizing agent that causes a toxic physical reaction when mixed with alcohol.³ It was the first FDA-approved medication to treat chronic alcohol dependence, and was originally marketed under the trade name Antabuse.³

If someone consumes alcohol after taking disulfiram, they will become extremely sick.¹ The goal of use is to create a situation of enforced sobriety that, in turn, provides a space where a person might be more receptive to psychotherapeutic treatment.⁴

How Does Disulfiram Work?

Disulfiram is most effective for people who have already detoxed from alcohol and are in the early stages of abstinence.² Its mechanism of action is quite different from other medications used in the treatment of AUD like naltrexone or acamprosate.

While naltrexone helps to decrease continued drinking by blocking some of the reinforcing euphoric effects of alcohol, disulfiram works by inhibiting a step in our body’s metabolic processing of alcohol, resulting in a buildup of a toxic metabolite that can lead to uncomfortable side effects such as vomiting, flushing , and heart palpitations should a person drink while taking the medication.⁴ Disulfiram acts as a deterrent to alcohol use since once a person takes it, they know they will become extremely ill if they drink alcohol.⁴ It can provide an extra layer of protection, so to speak, for people struggling with cravings for alcohol in early sobriety.

While typical side effects of consuming alcohol while taking disulfiram include nausea and vomiting, if a person consumes higher amounts of alcohol, more serious side effects may occur, including respiratory depression, myocardial infarction, acute congestive heart failure, cardiovascular collapse, convulsions, unconsciousness, and in rare cases death.⁴

What Are the Side Effects of Disulfiram?

As with most medications, even when taken as directed, there are potential side effects. Some potential side effects of disulfiram may include:¹

• Drowsiness.
• Headaches.
• Acne.
• Metallic aftertaste.

Disulfiram Interactions and Contraindications

It is important to abstain from drinking alcohol while taking disulfiram and avoid exposure to any product containing alcohol, even those you might not immediately associate with alcohol. Products such as mouthwashes, aftershaves, hand sanitizers, cough syrups, certain kinds of vinegar, and kombucha may contain alcohol, and as such should be avoided if one is undergoing disulfiram treatment.¹

Disulfiram for Alcohol Abuse

Disulfiram can be quite useful for people struggling with alcohol use disorder, particularly once they have gone through the detox process.² Considering the intense reactions caused by drinking alcohol after taking disulfiram, it encourages people to avoid alcohol while taking the medication.¹ It can be a useful tool for people who have had trouble maintaining abstinence on their own.

How to Find MAT Programs

MAT programs can be beneficial for many people who are seeking help for alcohol addiction. The American Society of Addiction Medicine (ASAM) created multidimensional assessments to consider the unique needs of everyone entering treatment.^{5 What are the levels of care?} Accessing treatment can feel intimidating, but it doesn’t have to. The Substance Abuse and Mental Health Services Administration has a convenient treatment locator on their website to help you find available treatment options near you.

Addiction helplines can also assist people in finding treatment that includes the use of medication assistance with drugs like Disulfiram. Admissions navigators are available 24/7 to help you discuss your options for treatment at no cost and with no obligation. Call today to learn more about addiction treatment and disulfiram.