Several licensed medications can support people who want to stop or cut down drinking alcohol, usually alongside counselling or other psychological support rather than instead of it. Acamprosate and naltrexone are typically offered first, after a successful withdrawal, to reduce cravings and lower the risk of relapse. Disulfiram works differently, acting as a deterrent, and is considered when someone specifically wants that approach. A GP or specialist decides which, if any, is appropriate.
Deciding to stop drinking is rarely just a matter of willpower, and for many people, medication becomes part of the conversation once detox is behind them. Knowing what these medications actually do, and what they cannot do, makes that conversation easier to have with a GP, and easier to understand once a prescription is in front of you.
At NOVEYA, understanding comes first, support follows, and change becomes possible once support is there.
What Medications Are Used to Treat Alcohol Dependence?
The three medications most commonly used in the UK for alcohol dependence are acamprosate, naltrexone and disulfiram. NICE guidance recommends acamprosate or naltrexone as first-line options after a successful withdrawal, usually alongside a psychological intervention. Disulfiram is considered a second-line option, used when acamprosate and naltrexone are not suitable, or when someone specifically prefers a deterrent-based approach.
How Does Acamprosate Help People Stop Drinking?
Acamprosate works by affecting levels of a brain chemical called GABA, which is thought to play a role in alcohol cravings. It is usually started as soon as withdrawal begins, is typically used alongside counselling, and does not cause a reaction if alcohol is drunk while taking it, unlike disulfiram. A Cochrane review of acamprosate trials found it supported continued abstinence more effectively than a placebo, without significant safety concerns (Rösner et al., 2010).
How Does Naltrexone Help Stop Alcohol Cravings?
Naltrexone blocks opioid receptors in the body, which stops alcohol producing its usual effects and can reduce the urge to keep drinking once someone has started. A course typically lasts up to six months, sometimes longer, as part of ongoing relapse prevention. Anyone taking naltrexone should tell their prescriber about any opioid-based painkillers, since naltrexone stops these working too. A separate Cochrane review of naltrexone and other opioid antagonists, covering more than 7,000 participants, found it reduced the risk of a return to heavy drinking compared with a placebo (Rösner et al., 2010).
What Is Disulfiram and How Does It Work?
Disulfiram does not reduce cravings. Instead, it causes unpleasant physical effects, including headache, nausea, a raised body temperature and heart palpitations, if alcohol is drunk while taking it, acting as a deterrent rather than a craving-reducer. NICE recommends it as an option for people with a clear goal of not drinking at all, when acamprosate or naltrexone are not suitable or not preferred, and clinicians are often advised to arrange for a supportive person to witness each dose. A meta-analysis of disulfiram trials found it was more effective at supporting abstinence in supervised, open-label use than in blinded studies (Skinner et al., 2014).
Is Medication Alone Enough, or Do You Need Alcohol Therapy Too?
Medication is rarely used on its own. NICE guidance recommends prescribing acamprosate, naltrexone or disulfiram as part of a wider psychosocial treatment and recovery plan, not as a stand-alone fix. A large meta-analysis of pharmacotherapy trials reached a similar conclusion: medication helps, but works best alongside alcohol therapy and ongoing support (Jonas et al., 2014). This fits with what NOVEYA sees in practice: medication can ease the physical pull of alcohol, while therapy and peer support address the habits and triggers behind it. If you are looking for the best way to quit drinking, the evidence points toward combining both rather than choosing one.
Who Can Prescribe Medication for Alcohol Addiction, and What Checks Are Needed First?
Acamprosate, naltrexone and disulfiram are all prescription-only medications in the UK. Before starting any of them, a GP or specialist will usually carry out a medical assessment, including blood tests to check liver and kidney function, since alcohol dependence can affect both. A GP, an addiction specialist or a local alcohol service can carry out this assessment, offer help quitting drinking more broadly, and work out which medication, if any, fits someone's situation.
What Does the Evidence Say About Medication for Alcohol Addiction?
Put simply: acamprosate, naltrexone and disulfiram each have evidence supporting their use in alcohol dependence, but none of them replace psychological support or address why someone drinks in the first place (Jonas et al., 2014). NICE guidance and the wider evidence base agree that medication works best as one part of a combined treatment plan, not as a solution on its own.
If you are earlier in the process and want to understand what happens physically when drinking stops, our article on detoxification from alcohol (https://www.noveya.co.uk/blog/what-is-detoxification-from-alcohol) covers withdrawal and what support looks like. And if you want to understand alcohol addiction more broadly first, our article on what alcohol addiction is (https://www.noveya.co.uk/blog/what-is-alcohol-addiction) covers the signs and how it develops.
In Short
Acamprosate, naltrexone and disulfiram are the three medications most commonly used to help people stop or cut down drinking in the UK, and each works differently: acamprosate eases post-withdrawal cravings, naltrexone helps stop alcohol cravings by blunting alcohol's effects, and disulfiram acts as a deterrent. None of them work well in isolation. NICE guidance and the wider evidence base both point to medication as one part of a combined plan that includes psychological support, not a replacement for it. At NOVEYA, understanding comes first, support follows, and change becomes possible once support is there.
Frequently Asked Questions
Can you buy medication to stop drinking alcohol without a prescription?
No. Acamprosate, naltrexone and disulfiram are all prescription-only medications in the UK, and each requires a medical assessment before it is prescribed.
How long do you need to take medication for alcohol dependence?
This varies by person, but a typical course of acamprosate or naltrexone lasts up to six months, sometimes extended if it continues to help. A GP or specialist reviews this along the way.
Are there side effects to alcohol dependence medication?
Yes, as with any medication. Disulfiram is designed to cause an unpleasant reaction if alcohol is drunk while taking it, and naltrexone can affect how opioid-based painkillers work. A GP or specialist explains the specific risks for each medication before prescribing it.
Can medication be used alongside detox?
Yes. Acamprosate and naltrexone are typically started once withdrawal from alcohol is underway or complete, as part of ongoing relapse prevention rather than during the acute withdrawal period itself.
Does medication work without therapy?
It can help on its own, but the evidence consistently shows better outcomes when medication is combined with counselling or another psychological intervention, rather than used alone.
About This Article
Barbara Zadworna is the Founder of NOVEYA, bringing together a Bachelor's degree in Psychology and Criminology, professional experience supporting people in a psychiatric hospital setting, specialist training in Addiction Therapy and Psychological First Aid (2026), and personal lived experience of addiction and recovery.
If you would like to talk to someone or find out more about the support NOVEYA offers, get in touch (support@noveya.co.uk).
Sources
NHS guidance on alcohol misuse treatment: https://www.nhs.uk/conditions/alcohol-misuse/treatment/
NICE, CG115: Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence: https://www.nice.org.uk/guidance/cg115
Department of Health and Social Care, Clinical guidelines for alcohol treatment: pharmacological interventions: https://www.gov.uk/guidance/clinical-guidelines-for-alcohol-treatment/10-pharmacological-interventions
Jonas, D.E., Amick, H.R., Feltner, C. et al. (2014) 'Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis', JAMA, 311(18), pp. 1889-1900. doi:10.1001/jama.2014.3628.
Rösner, S., Hackl-Herrwerth, A., Leucht, S., Lehert, P., Vecchi, S. and Soyka, M. (2010) 'Acamprosate for alcohol dependence', Cochrane Database of Systematic Reviews, Issue 9, Art. No.: CD004332. doi:10.1002/14651858.CD004332.pub2.
Rösner, S., Hackl-Herrwerth, A., Leucht, S., Vecchi, S., Srisurapanont, M. and Soyka, M. (2010) 'Opioid antagonists for alcohol dependence', Cochrane Database of Systematic Reviews, Issue 12, Art. No.: CD001867. doi:10.1002/14651858.CD001867.pub3.
Skinner, M.D., Lahmek, P., Pham, H. and Aubin, H.J. (2014) 'Disulfiram efficacy in the treatment of alcohol dependence: a meta-analysis', PLOS ONE, 9(2), e87366. doi:10.1371/journal.pone.0087366.