Medications That Help Stop Drinking: A Complete Guide

Medications can be a helpful, evidence-based part of treatment for alcohol use disorder (AUD). They are designed to reduce cravings, lower the reward effect of alcohol, or support abstinence after someone stops drinking. These medications are not a substitute for therapy or support, but they can make recovery feel more manageable, especially when cravings and relapse triggers are strong.

This guide walks through the most commonly used medications, what they do, who they may be best for, and practical questions to ask a provider.

First, A Safety Note About Stopping Alcohol

If you have been drinking heavily every day or have had withdrawal symptoms before, do not stop suddenly without medical guidance. Alcohol withdrawal can be dangerous for some people. A clinician can help you decide whether you need supervised detox or a safer taper plan before starting medication.

What Medications For Alcohol Use Disorder Can Help With

Most AUD medications target one or more of these challenges:

• Cravings and mental preoccupation with drinking
  
   
• Loss of control once drinking starts
  
   
• Relapse risk, especially during high-stress periods
  
   
• Post-acute symptoms like sleep disruption, anxiety, and irritability that can linger after quitting 
  
   

FDA-Approved Medications For Alcohol Use Disorder

In the U.S., the FDA-approved options include acamprosate, disulfiram, oral naltrexone, and extended-release injectable naltrexone. Some sources describe this as three medications (disulfiram, acamprosate, naltrexone) because naltrexone has two FDA-approved forms. 

Naltrexone (Oral Tablet Or Monthly Injection)

What it does: Naltrexone is an opioid receptor antagonist. For many people, it reduces cravings and can reduce heavy drinking by making alcohol feel less rewarding. 

Who it may be a good fit for:

• People who struggle with “once I start, I cannot stop”
  
   
• People whose goal is abstinence or reducing heavy drinking (a clinician can tailor the goal and plan)
  
   

Important safety considerations:

• You generally cannot use naltrexone if you are currently using opioids, because it can trigger withdrawal and blocks opioid pain medications.
  
   
• Liver health matters. Providers often review liver history and may check labs before and during treatment.

Oral vs. injection: Oral naltrexone is taken daily. Extended-release injectable naltrexone is typically given once monthly by a clinician, which can help with adherence for some people. 

Acamprosate

What it does: Acamprosate helps support brain stability after someone stops drinking. It is often used to help maintain abstinence, especially when early recovery feels emotionally or physically unsettled.

Who it may be a good fit for:

• People who have already stopped drinking and want support staying abstinent
  
   
• People who experience lingering discomfort after quitting, such as restlessness or sleep disruption
  
   

Important safety considerations:

• Kidney function matters. Acamprosate is not appropriate for some people with significant kidney impairment
  
   

What to know about dosing: It is typically taken multiple times per day, so consistency and routine can be important for success.

Disulfiram (Antabuse)

What it does: Disulfiram is a deterrent medication. If you drink alcohol while taking it, it can cause an unpleasant reaction (flushing, nausea, headache, and more serious symptoms in some cases). This is meant to create a strong external “stop sign.”

Who it may be a good fit for:

• People who are committed to abstinence and want a clear deterrent
  
   
• People who do best with structure, accountability, or supervised dosing
  
   

Important safety considerations:

• You must avoid alcohol in all forms, including some mouthwashes, cooking extracts, and certain over-the-counter products.
  
   
• It is not a great fit for someone who expects they may drink impulsively, because the reaction can be severe.
  
   

Off-Label Medications Sometimes Used

If first-line options are not effective, not tolerated, or not appropriate due to medical history, clinicians may consider certain medications “off-label.” Evidence varies by medication and by the person’s symptom profile, so this is a conversation to have with a prescriber.

Commonly discussed options include:

Topiramate

May help reduce heavy drinking for some people, but side effects and tolerability can be limiting for others.

Gabapentin

Sometimes used to support symptoms that can drive relapse, such as sleep problems, anxiety, and post-acute withdrawal discomfort.

Baclofen

Discussed in some clinical literature as an option in specific situations, though practice varies and it is not universally preferred.

How To Choose The Right Medication

There is no single best medication for everyone. Providers typically match medication choice to:

• Your goal (abstinence vs. reducing heavy drinking)
  
   
• Whether cravings or loss of control is the main problem
  
   
• Co-occurring mental health symptoms (anxiety, insomnia, depression)
  
   
• Liver and kidney health
  
   
• Whether you use opioids or may need opioid pain medication
  
   

A practical way to think about it:

• If cravings and heavy-drinking episodes are the main issue, naltrexone is often discussed early.
• If you are already abstinent and want reinforcement to stay that way, acamprosate may be a stronger fit.
• If you want a strong deterrent and can reliably avoid alcohol, disulfiram may be considered, often with added structure.
  
   

Do You Still Need Therapy Or Support?

Medication tends to work best as part of a broader plan that includes counseling, skills-based therapy, and recovery support. SAMHSA’s clinical guidance emphasizes that these medications are effective and can be prescribed broadly, particularly when paired with evidence-based counseling and support.

Many people combine medication with:

• CBT or relapse prevention therapy
  
   
• IOP or outpatient counseling
  
   
• Peer support groups (12-step, SMART Recovery, or other communities)
  
   

What To Ask A Provider

If you are considering medication, these questions can make the appointment more productive:

• Which medication best matches my goal right now, abstinence or cutting back?
• Do I need detox or medical monitoring before I stop drinking?
• Are there any interactions with my current medications?
• Do I need labs for liver or kidney function?
• What side effects should I expect, and when should I call you?
• How will we measure progress, fewer heavy drinking days, full abstinence, cravings reduction, or all of the above?

Summary

Medications can help people stop drinking or reduce harmful alcohol use by lowering cravings, reducing alcohol’s rewarding effects, or supporting abstinence. The FDA-approved options include naltrexone (oral or monthly injection), acamprosate, and disulfiram, with some resources counting the two naltrexone forms separately. Off-label options like topiramate and gabapentin may be considered in specific cases. The best results usually come from combining medication with therapy and a realistic recovery plan.

If you or someone you love is looking for drugs to stop drinking. Treatment Solutions is a leading source for addiction and mental health information and treatment.