Medications can be an important part of treatment for alcohol use disorder (AUD). They can help some people reduce drinking, maintain abstinence, manage cravings, or make drinking less rewarding depending on the medication and treatment goal.
Three medications are currently approved by the U.S. Food and Drug Administration for AUD: naltrexone, acamprosate, and disulfiram. All three are nonaddictive, and they may be used alone or together with behavioral treatment and recovery support. NIAAA
Medication is not appropriate for everyone, and there is no single “best alcohol medication.” The choice depends on factors such as whether the goal is to stop drinking or reduce heavy drinking, current alcohol use, opioid use, kidney or liver health, other medications, and personal preference.
For a broader view of treatment beyond medication, see our alcohol addiction treatment guide.
The three FDA-approved medications for AUD work differently.
Naltrexone can reduce some of alcohol's rewarding effects and may help reduce urges to drink or heavy drinking. NIAAA notes that it can be started while a patient is still drinking, although individual medical circumstances still need to be assessed. NIAAA
Acamprosate is primarily used to help people maintain abstinence after they have stopped drinking. It is generally started after withdrawal when abstinence has been achieved. NIAAA
Disulfiram interferes with alcohol metabolism and can cause an unpleasant and potentially serious reaction if alcohol is consumed. It is intended to support abstinence rather than reduce cravings in the same way as some other options. NIAAA
Medication treatment remains significantly underused.
These figures come from SAMHSA's 2025 National Survey on Drug Use and Health. SAMHSA
That does not mean every person with AUD should take medication. It does show that medication is used by only a small proportion of people with a condition for which FDA-approved pharmacological treatments are available.
NIAAA recommends asking alcohol-treatment programs whether medication can be prescribed or coordinated when appropriate. Programs that reject AUD medications simply because they prefer “drug-free treatment” are not using the full range of current evidence-based options. NIAAA Alcohol Treatment Navigator
Naltrexone is an opioid-receptor antagonist.
For AUD, it works partly by blocking opioid receptors involved in alcohol's rewarding effects. This can help some people reduce urges to drink and reduce heavy drinking. Naltrexone is available in oral and extended-release injectable forms. NIAAA
One important consideration is opioid use.
Because naltrexone blocks opioid receptors, someone taking opioid pain medication or using opioids requires careful evaluation before starting it. People with opioid dependence may experience serious withdrawal if naltrexone is started inappropriately. Liver health can also matter when clinicians are deciding whether naltrexone is appropriate. NIAAA Alcohol Treatment Navigator
Naltrexone does not make someone sick merely because they drink alcohol, and it is not an alcohol-detox medication.
For more detailed information, readers can continue to our planned naltrexone for alcohol use disorder guide.
Acamprosate is generally used after someone has stopped drinking and is trying to maintain abstinence.
NIAAA describes it as helping address some of the anxiety, restlessness, dysphoria, and sleep-related discomfort that may occur while the brain adjusts to abstinence. NIAAA
It does not treat acute alcohol withdrawal, so it should not be confused with medications used during medically managed alcohol detox.
Kidney function is an important consideration because acamprosate is eliminated through the kidneys. Severe renal impairment can make it unsuitable, which is one reason medication selection requires medical assessment. ARCR
Our planned acamprosate for alcohol use disorder page can provide more medication-specific information.
Disulfiram uses a very different strategy.
It blocks an enzyme involved in alcohol metabolism. If alcohol is consumed while the medication is active, acetaldehyde can build up and cause unpleasant symptoms such as flushing, nausea, and other potentially serious effects. NIAAA
Because of this mechanism, disulfiram is generally intended for people whose goal is abstinence and who understand the importance of avoiding alcohol.
NIAAA states that disulfiram should not be administered until a person has abstained from alcohol for at least 12 hours. NIAAA
There is no single medication that is best for everyone with alcohol use disorder.
The treatment goal is one important consideration.
Naltrexone may be considered when reducing heavy drinking or alcohol reward is a major goal.
Acamprosate is particularly oriented toward maintaining abstinence once drinking has stopped.
Disulfiram may be considered for selected people who want to remain abstinent and can safely use an alcohol-deterrent medication.
Medical factors also matter. A clinician may need to consider opioid use before naltrexone, kidney function before acamprosate, and several health and medication factors before disulfiram. ARCR
Personal preference matters too. A medication that fits someone's lifestyle and treatment goals may be more practical than one they are unlikely to continue taking.
The decision should therefore be made with a qualified healthcare professional rather than through an online medication comparison alone.
No. These are different treatment purposes.
Naltrexone, acamprosate, and disulfiram are used as ongoing treatments for alcohol use disorder.
Medications used during alcohol withdrawal management have a different purpose: preventing or treating withdrawal complications while someone stops drinking.
This distinction matters because alcohol withdrawal can sometimes involve seizures, delirium, or other serious medical complications.
Someone who has been drinking heavily for a prolonged period should not assume that obtaining an AUD medication makes it safe to detox alone.
The drug detox programs guide explains medically supported withdrawal care in more detail.
If severe confusion, seizures, loss of consciousness, or another medical emergency occurs, call 911 in the United States.
No.
Medication for alcohol use disorder does not require everyone to enter residential rehab.
No special addiction-prescribing license is required for the three FDA-approved AUD medications. NIAAA
The appropriate treatment setting depends on withdrawal risk, AUD severity, medical and mental-health needs, living environment, and other circumstances.
Readers comparing treatment settings can review the inpatient drug rehab and outpatient drug rehab guides.
Medication can be used alone in some circumstances, but behavioral treatment can provide additional support.
NIAAA states that FDA-approved AUD medications may be used alone or combined with behavioral therapies or mutual-support groups. NIAAA
Therapy may address drinking triggers, coping skills, motivation, relationships, mental health, and plans for responding to high-risk situations.
For someone with depression, anxiety, PTSD, bipolar disorder, or another co-occurring condition, coordinated care may be particularly important. Our dual diagnosis treatment guide explains this approach in more detail.
Medication should not be viewed as evidence that someone is “not really in recovery.” These are nonaddictive, evidence-based treatments for a recognized medical condition. NIAAA Alcohol Treatment Navigator
For a wider overview of medication-based addiction care, see medication-assisted treatment.
Naltrexone, acamprosate, and disulfiram are the three FDA-approved medications for AUD.
Other medications may sometimes be considered off-label by qualified clinicians.
NIAAA notes that American Psychiatric Association guidance suggests that gabapentin or topiramate may be considered as second-line options for certain patients who prefer them or have not responded to FDA-approved medications. NIAAA
“Off-label” does not mean a medication is automatically unsafe. It means the FDA has not specifically approved that medication for that particular use.
These decisions require individualized clinical judgment and should not be made from an online guide.
There is no universal medication duration for every person with AUD.
How long treatment continues can depend on the medication, response, drinking goals, side effects, risk of returning to heavy drinking, mental health, and personal preferences.
Follow-up matters because the first medication selected may not always be the best fit.
NIAAA notes that, similar to treatment for other health conditions, trying another medication may be appropriate when the first option does not produce a satisfactory response. NIAAA
Medication should not be stopped, started, or changed simply according to a generic timeline found online.
When comparing alcohol-treatment programs, ask directly whether medication is part of the treatment model.
NIAAA specifically recommends asking treatment programs whether they can arrange medication treatment and cautions against programs that reject medications outright. NIAAA Alcohol Treatment Navigator
Also ask how withdrawal risk is assessed, who prescribes medications, how progress is monitored, what behavioral treatments are available, and what happens after the initial treatment program ends.
Can the program provide or coordinate FDA-approved AUD medications?
Who prescribes, monitors, and adjusts medication?
How does the program evaluate alcohol withdrawal risk and medical safety?
What counseling, therapy, or recovery supports are available?
How are medication response, progress, and continuing care monitored?
Insurance coverage varies by health plan, medication, formulation, pharmacy benefit, provider, and treatment setting.
An oral generic medication may be covered differently from a long-acting injectable medication.
Physician appointments, counseling, detoxification, residential treatment, and pharmacy costs may fall under different benefits.
Readers can use the verify insurance for rehab resource to explore potential treatment benefits or review how much rehab costs for broader payment information.
Naltrexone, acamprosate, and disulfiram are the three FDA-approved AUD medications. NIAAA
The three FDA-approved medications are considered nonaddictive. NIAAA Alcohol Treatment Navigator
Naltrexone may help reduce alcohol reward, cravings, and heavy drinking for some people. Medication selection still requires individual medical assessment.
Acamprosate is used primarily to support continued abstinence after drinking has stopped. Disulfiram may also support abstinence through its alcohol-deterrent effect. NIAAA
Opioid use is an important consideration because naltrexone blocks opioid receptors and can precipitate withdrawal in someone who is opioid dependent. A clinician should assess opioid use before prescribing it. NIAAA Alcohol Treatment Navigator
No. Acamprosate is used to help maintain abstinence and is not a treatment for acute alcohol withdrawal. NIAAA
Alcohol can cause an unpleasant and potentially serious reaction while disulfiram is active. The medication should be used only under appropriate medical guidance. NIAAA
No. AUD medications can be prescribed in general healthcare and outpatient settings as well as incorporated into specialty addiction treatment. NIAAA
In 2025, only 2.6% of people aged 12 or older with past-year AUD—about 679,000 people—received MAUD. SAMHSA
Medication can be an important part of alcohol treatment, but the right option depends on individual goals, current drinking, withdrawal risk, medical history, other medications, and mental-health needs.
You do not need to determine which medication is appropriate before exploring treatment.
This page provides general educational information about medications for alcohol use disorder. It is not medical advice and should not be used to select a medication, determine a dose, stop medication, or manage alcohol withdrawal.
Alcohol withdrawal can sometimes become medically dangerous. Anyone concerned about withdrawal should seek guidance from an appropriately qualified healthcare professional rather than relying on a self-directed detox plan.
For a mental health, suicide, or substance-use crisis, call or text 988.
