Disulfiram (Antabuse) for Alcohol Treatment

People with an alcohol addiction, also called an alcohol use disorder, can benefit from certain types of evidence-based treatments including medications.¹ One of the three FDA-approved medications used in the treatment of alcohol use disorder (AUD) is disulfiram, also known by its brand name, Antabuse. Understanding what disulfiram is, how it can help you during treatment, and whether it is effective can help you begin your journey to recovery. The other forms of FDA-approved medications for alcohol use disorder include Naltrexone and Acamprosate.

What is Disulfiram (Antabuse)?

As stated, disulfiram is one of three medications that are FDA-approved for the treatment of alcohol use disorder.¹ Disulfiram interferes with the body’s ability to breakdown alcohol, causing unpleasant side effects ranging from facial flushing, nausea, vomiting, headaches, difficulty breathing, and an irregular heartbeat.^{1, 2} Medication for addiction treatment (MAT) may not be necessary for everyone, but they can help an individual meet their goals when used as part of a personalized treatment plan.

What is Disulfiram Used for?

Disulfiram is generally used as part of an individualized treatment plan for those receiving treatment for AUD.^{1, 3} Disulfiram will not be administered until a patient has been thoroughly screened, as disulfiram is not appropriate for everyone. Also, disulfiram cannot be given to someone who hasn’t gone at least 12 hours without consuming alcohol.^{1, 3} Those who do take disulfiram too soon may experience the aforementioned unpleasant effects and other types of illness.³ As such, disulfiram is largely prescribed to medically stable patients who are highly determined to avoid drinking and are fully aware that disulfiram is a type of aversion therapy that is used to support abstinence.²

How Long Does Disulfiram (Antabuse) Last?

How long disulfiram lasts largely depends on the dosages a person takes, how long they’re taken the dosages for, and other individual factors. In general, disulfiram’s effects can begin quite quickly, as soon as 10 minutes after a person drinks alcohol.⁵ The aversive effects of disulfiram or Antabuse can range from mild to severe, depending on the amount of alcohol consumed in association with the particular therapeutic dose of disulfiram that a person takes. A reaction lasts about 30 to 60 minutes in mild cases and can continue for several hours when reactions are more severe or prolonged.⁵ In some cases, severe reactions require supportive medical care, and it is recommended that prescribing physicians advise patients taking disulfiram carry a medical alert card that details their use of disulfiram as well as the symptoms of a disulfiram and alcohol reaction. Aversive symptoms can occur when a person consumes alcohol for up to 2 weeks after one has stopped taking the medication.³

Who Should Use Disulfiram?

It’s important to reach out to your doctor or a medical treatment team to determine if disulfiram is appropriate for you. Many MAT programs will be tailored to one’s unique needs, and whether disulfiram is prescribed will be dependent on where one is at in their treatment program, and the considerations of their treatment team. While studies on the effectiveness of disulfiram are mixed, it is suggested that those who are highly motivated not to drink may benefit most from taking the drug.⁴⁽⁶⁾ It’s also important that those who choose to take disulfiram are aware of the side effects that will emerge should they drink while taking the medication.⁵

Disulfiram Side Effects

The side effects of disulfiram may vary from person to person, but common side effects, which typically occur within the first 2 weeks of starting disulfiram may include: ³

• Drowsiness.
• Headache.
• Fatigue.
• Acne eruption and allergic dermatitis.
• Impotence.
• Metallic or garlic-like aftertaste.

Rare but serious side effects of disulfiram may include: ^{3, 4}

• Nerve pain or damage.
• Psychosis.
• Skin rash.
• Hepatitis and liver function changes, or liver failure.

It’s important to speak with your doctor or treatment team about any pre-existing conditions you may have before beginning disulfiram treatment.

How is Disulfiram Used in Alcohol Addiction Treatment

Treatment for AUD will vary depending on individual treatment goals a person has for reducing and managing symptoms as well as improving health and functioning. Medication is one component, and it is typically paired with counseling and other behavioral therapies.¹ Disulfiram does not directly treat AUD, nor will it resolve any lingering urges one feels to drink.¹ Instead, disulfiram causes unpleasant effects when alcohol is consumed. This can help discourage some individuals to avoid drinking alcohol.²

Finding AUD Treatment Near You

If you’re interested in receiving disulfiram, you will need to speak to your doctor or an addiction treatment provider about your drinking. Your doctor or another treatment provider determine if disulfiram is right for you. It’s also a good idea to check your insurance to see if alcohol rehab or disulfiram treatment is covered.

You may consider visiting the SAMHSA treatment locator. Additionally, you may contact an addiction helpline or some other addiction resource. Addiction helplines are 24/7 phone lines that can help answer questions you may have about alcohol addiction treatment. American Addiction Centers (AAC) operates a helpline that can answer questions about disulfiram, help you verify your insurance coverage, and possibly connect you with alcohol addiction treatment programs. Don’t delay in starting your recovery, reach out to us today at .