Antabuse

Authored by Matthew Idle

Edited by Alexander Bentley

Reviewed by Dr Ruth Arenas

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What is Antabuse?

 

Disulfiram, more commonly known by the brand name Antabuse, is a medication designed to assist in the treatment of alcoholism and was the first of its kind to be licensed by the FDA for use in the USA it works by interrupting the process that breaks down alcohol in the body, therefore disrupting the body’s reliance on alcohol enough to help the patient heal.

 

It is important to note that Antabuse is not a cure for alcoholism, but a medicine to help deter dependence on it while an addict receives the psychological treatment and other techniques needed to break their addiction fully and allow them to lead a life of sobriety. Antabuse alone will not stop cravings or reduce withdrawal symptoms from alcohol. However, there are many reasons why it is a useful tool as part of rehabilitation treatments, even in the 21st century with so many other treatment options available.

 

Disulfiram was first discovered in the 1930s when workers in the rubber industry became unwell after drinking alcohol. As part of the work that they were doing, these workers were handling tetraethylthiuram disulfide – disulfiram.

 

Scientific experiments in the 1940s using disulfiram as a potential treatment to treat stomach illnesses found that those patients who drank alcohol got ill11.M. D. Skinner, P. Lahmek, H. Pham and H. J. Aubin, Disulfiram Efficacy in the Treatment of Alcohol Dependence: A Meta-Analysis – PMC, PubMed Central (PMC).; Retrieved September 27, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3919718/. By 1951 it had been developed as a medication to treat alcoholism and was finally approved by the FDA for prescriptive use in the USA.  It was branded as Antabuse, and doctors began to prescribe it to deter the heaviest of drinkers.

What Does Antabuse Do?

 

So, how exactly does Antabuse work? When alcohol enters the body it is converted into acetaldehyde, which then oxidizes into harmless acetic acid. Antabuse prevents acetaldehyde from converting into acetic acid. As acetaldehyde is toxic if it remains in the body at too high a dose, the user becomes ill, since the acetaldehyde does not convert and so is a 5 to 10 times higher dose than it is after drinking alcohol normally.

 

The user is deterred from drinking alcohol as it becomes associated with this feeling unwell. It is recommended that patients do not take Antabuse for at least 12 hours after drinking alcohol and that they do not drink for several weeks after they have stopped taking the medication. Someone taking Antabuse must not drink alcohol while they are prescribed the medication, including all foods that contain alcohol such as cooking wine, cough syrups, and mouthwash.

 

Antabuse Side Effects

 

If someone does drink alcohol while on Antabuse, then the drug will react as it is designed to, and cause the drinker unpleasant side effects, as predicted. Reactions to drinking alcohol while on Antabuse include flushing, nausea, vomiting, sweating, thirst, headache, respiratory difficulty, confusion, weakness, vertigo, hyperventilation, and palpitations. These reactive symptoms occur as the Antabuse impedes the oxidization of the acetaldehyde22.C. Brewer, E. Streel and M. Skinner, Supervised Disulfiram’s Superior Effectiveness in Alcoholism Treatment: Ethical, Methodological, and Psychological Aspects | Alcohol and Alcoholism | Oxford Academic, OUP Academic.; Retrieved September 27, 2022, from https://academic.oup.com/alcalc/article/52/2/213/2864434.

 

As a result, patients are advised only to take Antabuse if they are severely, chronically alcoholic, looking to stop drinking, and begin the medication fully aware of the risks and the effects that it causes. Long-term usage of Antabuse daily, as it is prescribed, has been proven in Europe as a very effective deterrent that encourages people to stop drinking and develop sobriety as a habit.

 Antabuse Reaction

 

Antabuse is effective, but it does not come without risks of reaction. While the symptoms outlined above are effective, there are further symptoms that are not part of the deterrent, and if someone begins experiencing any of these symptoms means that a doctor or 911 should be called immediately. Concerning symptoms include eye pain or vision loss, numbness or tingling, untypical behavior, and signs of liver problems such as jaundice (yellow skin), dark urine, or clay-colored stools.

 

Additional medications can also affect the way that Antabuse affects a patient. Seizure medications and blood-thinning medications such as warfarin, in particular, can have more of an impact on how Antabuse works. Additional medications should be disclosed to the responsible medical professional before a patient begins taking Antabuse, or,  at any point throughout their prescription period if their other prescriptions change.

Does Antabuse Cure Alcoholism?

 

Antabuse has been proven to be effective, but it is worth emphasizing that the effectiveness of the medication, as with any rehabilitation process, depends almost entirely on the patient and their dedication to their program and to taking the Antabuse daily as prescribed, all while being supported by their medical team. Antabuse both makes the idea and process of drinking alcohol distasteful and causes the body to react badly to it.

 

Antabuse and Rehab

 

An addict’s commitment to the rest of the treatment program and the other aspects involved is needed, for example, the psychological counseling aspect. Professionals help patients tackle the psychological issues that are the root cause of their alcohol abuse, and allow them to reconcile with being mentally deterred from drinking as the drug deters them physically from drinking. These two different aspects of the treatments working together mean that patients are able to gain a new focus with new sobriety, and start to rebuild their lives from the derailment that alcohol addiction and abuse typically causes.

 

Overall, the circumstances and situations that result in an alcoholic patient being prescribed Antabuse are specific3https://www.frontiersin.org/articles/10.3389/fphar.2022.826783/full. The medicine is only used with the complete understanding from the patient of the effects of Antabuse if they were to drink alcohol. Antabuse is a temporary measure to be used alongside counseling as patients undergo treatment. Patients are under continued medical guidance, and have support throughout their recovery.

 

Once patients are no longer taking the drug as part of a rehabilitation program, they are not allowed to continue taking the drug, and can only take it again if are thought to be extremely close to relapse, or have relapsed, and once again do so under close medical follow up.

 

Antabuse may seem drastic or questionable to some. Under careful prescription and as part of treatment for the most severe addictions, the drug has proved time and time again to be an effective tool part of alcoholism recovery when embraced by patients.

 

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  • 1
    1.M. D. Skinner, P. Lahmek, H. Pham and H. J. Aubin, Disulfiram Efficacy in the Treatment of Alcohol Dependence: A Meta-Analysis – PMC, PubMed Central (PMC).; Retrieved September 27, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3919718/
  • 2
    2.C. Brewer, E. Streel and M. Skinner, Supervised Disulfiram’s Superior Effectiveness in Alcoholism Treatment: Ethical, Methodological, and Psychological Aspects | Alcohol and Alcoholism | Oxford Academic, OUP Academic.; Retrieved September 27, 2022, from https://academic.oup.com/alcalc/article/52/2/213/2864434
  • 3
    https://www.frontiersin.org/articles/10.3389/fphar.2022.826783/full
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