For more information call: (614) 448-4055 or email

Medications for Alcohol and Substance Abuse Symptom and Relapse Reduction

Mark Dombeck, Ph.D.

Medication (Symptom Reduction)

Recovering drug or alcohol dependent persons often complain of mood and anxiety problems. The origin of these problems is not clear in many cases. People's mood and anxiety problems may have preceded their drug or alcohol dependence (and may have been a partial cause of the drug or alcohol dependence). Mood and anxiety problems may also have been caused by drugs or alcohol. In either case, the continuing presence of mood and anxiety problems is a considerable stressor to the recovering person. Left untreated, such symptoms can provoke the recovering person to return to substance abuse. For these reasons, a physician may prescribe medication to reduce symptoms of depression, anxiety, and other concerns. Anti-depressant, anti-anxiety and even anti-psychotic medications may be used for these purposes.

Some drug and alcohol dependent persons are known to have a mental health diagnosis that preceded their substance dependence (and cannot be accounted for by the effects of the drug), or that remains a significant problem for them despite sustained recovery from substances. Such persons are known as "dual diagnosis" patients. Dually diagnosed patients may require psychiatric medication to treat their mental illnesses.

A general warning about medication treatment for anxiety is appropriate. Some of the most effective anti-anxiety drugs are also themselves highly addicting. Drug and alcohol dependent people aren't stupid - they tend to abuse those drugs that help them to feel better (at least in the short run). For example, anxious addicts often gravitate towards alcohol abuse, as alcohol has anti-anxiety properties. Some physicians will treat their recovering patients' underlying anxiety with benzodaizapines (a class of medicines that includes Valium, Ativan, Klonopin and Xanax) which are themselves addicting! This sort of 'treatment' can result in the trading in of one sort of addiction for another, if both the patient and the physican are not careful. Not all physicians are thoughtful about this problem! There are several anti-anxiety medications that are non-addicting. Consult with your doctor to find out if one of these medications is most appropriate for you.

Medication (Relapse Reduction)

Detoxified drug and alcohol dependent people are at significant risk for relapsing back to using their drugs of choice, particularly in the early hours, days, weeks and months of their recovery. There are several medications that physicians can prescribe for their recovering patients which can help to minimize their chances of relapsing.

Administration of Antabuse (generic: Disulfiram) blocks alcohol from being metabolized (detoxified) by the liver, resulting in an extremely unpleasant reaction when alcohol is consumed. Patients who drink while taking disulfiram will turn purple, become severely ill for 30 to 60 minutes (or longer) and often vomit. Patients on disulfiram may also have this same response to alcohol ingested in mouthwash, wine sauces or vinegars, or even to inhaled alcohol vapors from aftershave lotions. Giving alcoholic patients Antabuse can provide them with a strong motivation to not relapse.

Naltrexone is a drug that blocks the action of heroin, codine, morphine and other opioid compounds. Naltrexone binds with but does not activate opioid endorphin receptors, thus reducing or blocking entirely the effects of opioid consumption. In essence, an opioid addict can take opioids (heroin, codine, etc.) while on Naltrexone, but it won't get them all that high. Being on Naltrexone then, can help discourage an opioid dependent person from relapsing. Naltrexone is also administered to alcoholics as a way to help them remain sober. The exact way in which Naltrexone compounds are able to help prevent relapse to alcohol is not well known. Unlike Disulfiram, consumption of alcohol while on Naltrexone does not produce sickness; rather it seems to make the alcoholic less interested in the effects of alcohol.

A new alternative to Naltrexone has become available in the last few years. Like Naltrexone, Suboxone is a partial agonist for opioid receptors, meaning that it fills up many of the the receptor spaces on nerons where opioid drugs would normally bind to produce their effect.

Reader Comments

Nerve Medications and Anti-depressants used in post-detox treatment of addiction - - Dec 12th 2016

December 2016

Since returning home from a treatment program I have not been so much fighting relapse as I have been fighting to regain my body's homeostasis.  This due in large measure to the medications issued by the handsfull in Rx centers today.

Rx centers love to prescribe the following:  Neurontin (Gabepentin), Cymbalta (Duloxetine), and, among others, Clonodine.  All of these medications in and of themselves may in fact be greatly paliative when used in isolation.  When combined and at high doseages these medications corporately produced disasterous physiological harm, weakening my ability to both cope and settle back into a daily routine upon returning home.

A literature review of the side-effects of Neurontin alone should cause those in charge of Rx medical personnel to quickly and thoroughly examine and retool the use of these dangerous medications for such a vulnerable population.  

I pray that those in this Rx pathway to examine this issue, without delay.  

Nutrition and Eating your way back...... - - Sep 20th 2010

Never is there much said about addiction, but being a gateway to something predisposed , or by-polor or misunderstood really!

Why are so many intelligent , artistic , musical , or creative minds seemingly falling into the world of addiction?

If there is a predisposition, then there is a way to find what that chemical imbalance is, and with the right nutrients the body lacks to begin with...

Anti-anxiety and Anti-depressants and all the bandages of temporary resources already prove not only unsuccessful but damaging . Many addicts have commit suicide after a relapse.

That's what should be in question, not a 12 step program.

If there is ever a more complicated, misinformed, undiagnosed , misunderstood , disease out there....

it would be addiction...

Addiction meaning everything compulsive and not just the ugly , obvious ones!

Please help US............

AA - Changing my thinking through Action - Bruce - May 5th 2009

I have been a long standing, sober member of AA. As part of my recovery i spend many hours counseling other alocholics and helping them to ahcieve long-term, happy, sobriety without mind or mood tranquilizing medications. The only cases in which i have seen success is where the participant is totally done doing things their "way." As I am sure many in the medical profession would agree, a sick mind cannot fix a sick mind. While my physical reaction to alcohol, where i cannot control and enjoy my drinking, is basic, my emotional/psychological reaction to alcohol was much more profound. Alcohol instantly changed my perception - it gave me the feeling of a job well done without ever having to do anything at all. It allowed me to escape any type of emotional growth or development from the time i picked it up.When i got sober, the vicious mood swings were almost unbearable. Feeling anything was painful. I would say that i didn't know what was wrong, and chalked up my emotional imbalance to something chemical. However, someone in the program made a bold statement to me that changed my life: you feel guilty, because you are guilty. Using the steps of the program i was able to look at, with someone's help, the behaviors that i was repeating that continued to make my life unbearable. Surely some of my emotional states were spawned by the chemical havoc i reaked on my body through drugs and alcohol, but a lot of my emotions were real reactions to behvior i wasn't comfortable with. All morals and ethics aside i had to accept that I was not happy with the way i had been living and needed to change - but in order to change i needed to scrap my ideas and my judgment about what i thought was good for me, and allow people in the program to guide me towards acting in a way that allows me to live with myself and who i am.My point is simple: as long as i thought i knew what was best for me, i coudn't accept help. As long as i thought i knew everything, i couldn't find a better way to live. In order to grow i had to go beyond my comfort zone.My advice to anyone who is struggling: find someone who has what you want (i.e. happy long term sobriety) and do what they do and you will find that little by little you will get what they got.  Very truly yours, Bruce

- - Mar 6th 2009
Smart Recovery is a good option.  The tools are rational/logical.  They are mostly based upon the work of Dr. Ellis.   The people there are kind and helpful.  I do not know about the face to face meetings, as I did not attend them. 

Giving AA a go. - JR - Oct 29th 2008

It may take more than 3 meetings for a newcomer to decide whether AA may work for them.  Better, perhaps, to give it a bit longer, approaching the Fellowship with an open mind (not just open to AA) and, as the mind clears, make an informed, considered decision as to whether the program is likely to help.  In the meantime, it would be better to avoid sponsors and handing around telephone numbers.  Better to know whether you like the prospect of advancing in the program before opening up to it to that extent.

On the other hand, some may take one look at the Steps, the prayers, "God as we understand Him" and all that, and decide that this approach is, for whatever reason, not for them.  I sometimes wish that I had been sufficiently confident and clear-headed to form such a decision after only three meetings. A decision that the Fellowship does not suit should be respected, at whatever stage it occurs and not - as is all too common among AAs and AA-orientated therapists - automatically derided as a symptom of denial.  It may simply be honesty. 

As to whether AA is a "sect" - no, I think not.  To be a "sect" a group has to be a "sect" of something, and it would be stretching current reality to suggest that the Fellowship is still in any sense a sect either of any recognised form of Christianity or of the Oxford Groups/Moral Rearmament/Initiatives of Change movement from which it sprang.  Whatever its origins, and however influential they may still be on its functioning, AA has long stood on its own.  This, of course, in no way means that AA is not religious, or that it is not religious in a very particular way.  The idea that the Fellowship is "spiritual, not religious" tends to fall down in the face of the prayers, penitential practices, "God as we understand Him", and so on.  There is, of course, nothing wrong with this.  Many people will find the particular religion of AA congenial and helpful or, at least, will be able to tolerate it in order to avail of the social support provided by the Fellowship in the often lonely world of addiction recovery.  However, many others - both believers and non-believers - will not find it so easy to "change" to this form of belief to the degree necessary to benefit from continued membership of the Fellowship.

It is a question of "horses for courses" and it is foolish, and flying in the face of reality, to suggest that every horse will run well on the course laid out by Bill W, Dr Bob and - dare I say ? - Frank Buchman.

Best regards,


Ellen Re: - HipMonkey - Oct 28th 2008

AA is not a sect. After only 3 meetings you don't know enough to make any such statement. AA does not align itself with any sect, religion, or organization. The only requirement for membership is the desire to stop drinking. At least give it 3-4 months, unless you prefer to drink. It really can help, and has helped millions, to stop drinking. But give it a fair chance.

Alcoholism - Ellen - Apr 16th 2008

I've been drinking a lot daily for decades. I went to an AA meeting (actually 3 of them). And it just doesn't work for me. It's too much like a sect for me.

I am finally admitting that I have this problem. But I want to get this taken care of. I'm sick of the blackouts and the injuries that I get when I'm drunk.

I will call my doctor tomorrow.

I cannot afford a clinic. How can I kick this demon that has had me in its grip for at least 30 years?

Thanks for any feedback that you can offer.


Editor's Note:  We've got a lot of people here who are negative on AA.  One of them has recently recommended Smart Recovery as a good secular alternative, and I can second that motion.


compral - bk - Nov 3rd 2007
i would like to ask how many days, weeks months, or years has your husband been doing fine after using this medication

HELP ME PLEASE!!!! - k.k. - Dec 5th 2006
I am very grateful for your website!!! I have suffered from alcoholism for 20 years... it's gotten worse & worse over the years. I KNOW that I am alcoholic . Both of my parents are and I am very afraid. I have been in program after program... but still crave alcohol everyday. I have shorter & shorter periods of sobriety as time goes by.... Please help me ... no financial means probably , to be able to afford the medication . Any advice? I have been in many rehabilitation programs,detox units and A.A. I'd appreciate Any suggestions, Sincerely, K.K.

non-abusive drug for alcoholism recovery - - Mar 25th 2006
when my husband left detox in Septemer, he asked for a new drug called Campral. It is a non-addictive, and non-abusive, drug that will not make you feel high. It demishes the craving, and it husband drank 16-20 beers daily, went thru 3 days of detox and is doing great! Good luck to anyone steping up to the challenge.