Medication for Alcohol Use Disorder in Illinois

How Medications Help With Alcohol Use Disorder

The medications can be used alone, but some people get better results when they combine the medication with counseling or other behavioral treatments.

If you decide that medication might be right for you, your provider will help you find the best combination of medications and behavioral treatments. Here are some common options:

• Naltrexone blocks some of the effects of alcohol and reduces the urge to drink.
• Acamprosate helps people avoid drinking by reducing the anxiety or nervousness that can occur during abstinence from alcohol.

Disulfiram works by making someone feel sick or ill if they consume alcohol while taking the medication.

Medications for alcohol use disorder are not a substitute for counseling and other behavioral therapies but may be used in combination with these treatments for the best results.

It is important to note that medications do not "cure" AUD. They are one tool in your recovery toolbox, to be used in combination with other forms of treatment like counseling.

There are three medications approved in the United States to treat alcohol use disorder (AUD). These include disulfiram, acamprosate, and naltrexone.

Naltrexone

Oral and extended-release injectable naltrexone both have been found to reduce heavy drinking, craving, and the likelihood of relapse among people with alcohol dependence.

Naltrexone is a pill or injection that reduces cravings for alcohol and makes drinking less enjoyable. It works by blocking some of the pleasurable effects of drinking alcohol.

Daily oral naltrexone and monthly Vivitrol both work on the brain's reward system to decrease craving for alcohol. They also make drinking feel less pleasurable, so you may want to drink less. Naltrexone is not a cure for AUD but it can help people with this condition cut back or stop drinking altogether.

Before naltrexone is started, opioids must be completely eliminated from your body. Otherwise you might experience withdrawal symptoms when the opioid is blocked.

By blocking alcohol reward pathways, naltrexone can be useful for many people who want to moderate or quit drinking.

Clinicians choose between the tablet and the injection based on patient needs, preferences, and medical issues. The injectable formulation of naltrexone (Vivitrol) is approved for alcohol dependence in combination with psychosocial support.

Acamprosate

After withdrawal ends, acamprosate can help prevent you from relapsing. Acamprosate works on multiple brain systems that may be affected by alcohol. This can make it easier for you to maintain abstinence after withdrawal ends.

Acamprosate is a pill you take after you have stopped drinking. It makes it easier to stay away from alcohol by reducing the cravings and other symptoms that make abstinence difficult for some people.

Acamprosate (Campral) has been shown to help reduce some people's craving for alcohol, but it does not prevent or minimize withdrawal symptoms. It does not cause physical dependence nor produce intoxication or sedation.

Clinical trials indicate that acamprosate can help you maintain abstinence from alcohol after detoxification or as an adjunct to psychosocial treatment. It is not effective for everyone. Not all people who take it will stop drinking, nor are they protected against relapse.

Disulfiram

Unlike naltrexone, disulfiram does not reduce alcohol craving. Instead it makes the drinker sick if he or she drinks while taking the drug.

Disulfiram interferes with the way the body breaks down alcohol and produces unpleasant effects when even small amounts of alcohol are consumed.

Three prescription drugs have been approved for treating alcohol dependence in adults: disulfiram (Antabuse), acamprosate (Campral), and naltrexone (ReVia).

Because disulfiram leaves craving unchanged, people who do not want to drink have the best chance for success with this medication. It is important to understand that disulfiram does not stop a person from wanting alcohol or even thinking about it. What it does, however, is make drinking while taking disulfiram very unpleasant. The idea of having an adverse reaction upon drinking can be an effective deterrent. This medicine should not be taken without the patient's full knowledge and agreement. It must be used along with behavioral support.

Supervised dosing and a clear plan to stay away from alcohol while taking the medication are essential for effective use of disulfiram. The medicine itself does not cause craving for alcohol, but it causes unpleasant symptoms whenever you drink alcohol.

Flushing and nausea appear if alcohol is drunk while on this medication.

Medications Combined With Counseling

Combining AUD medicines with counseling often gives a person the best chance of success.

Healthcare professionals may prescribe medications to treat alcohol use disorder. Medicines are used along with other forms of treatment and recovery support. They can help people stop drinking, reduce their cravings, and prevent a relapse.

Behavioral therapy plus medication addresses drinking and other problems related to alcohol use disorder. A doctor or counselor can recommend one of several options.

Behavioral therapies help change the person's attitudes and behaviors related to alcohol use. Examples include:

Cognitive-behavioral therapy teaches people how to identify thought patterns and beliefs that lead them to drink alcohol.

Motivational enhancement therapy helps build motivation to change alcohol-related behaviors.

Family counseling involves family members in the treatment process.

Medicines combined with behavioral treatment have been proven effective to help people stop drinking alcohol. The best results come when patients work with their health care provider to develop a comprehensive treatment plan for their AUD and are able to follow the program completely.

Naltrexone is an opioid antagonist that prevents the reinforcing effects of alcohol.

Acamprosate does not alter mental states or the way people feel at the time they drink.

If you have an alcohol use disorder, your doctor can help you choose a treatment option and provide support. Some people with an alcohol use disorder are able to achieve long-term sobriety without any treatment.

Getting a Prescription in Illinois

In Illinois, a primary care clinician can prescribe medication for AUD. You may need an initial assessment to determine which level of care is appropriate. Your provider may also refer you to counseling.

The clinician may be able to provide a prescription at your initial consultation or during follow-up visits. It is important for the clinician to have a clear understanding of the patient's goals for treatment and the degree to which the patient has been willing to make changes in his or her lifestyle, such as reducing alcohol use, before prescribing medication.

The Illinois Helpline can connect people seeking medication assisted treatment (MAT) with providers who offer these services. You may also ask your primary care provider about MAT for AUD.

If you do not have a primary care provider, ask the Illinois Helpline for suggestions on how to find one.

Talk to your doctor if you want to get treatment for AUD. Your doctor will need to prescribe the medication for you.

Your doctor may refer you to a mental health specialist, like a psychiatrist, psychologist, social worker, nurse practitioner, or physician assistant. They can provide specialized care and counseling.

Your provider will discuss what you can expect from each medication before prescribing it to you.

If your clinician thinks naltrexone is right for you, they'll write a prescription. You may be able to fill that prescription at your local pharmacy.

Insurance and Medicaid Coverage for AUD Medications

Illinois Medicaid may cover AUD prescription medicines. Check with Illinois Medicaid or a provider first before trying an AUD medication.

HFS Medical Programs list prescription drugs among the benefits covered by the program.

Mental health and substance use disorder services are covered for those who qualify for Medicaid.

The FDA-approved AUD medicines include naltrexone (oral tablets and an extended-release injection), acamprosate, and disulfiram.

The MHPAEA requires that mental health and substance use disorder benefits must be no more restrictive than a health plan's medical/surgical (M/S) benefits.

It's worth noting that some individuals with AUD may also be eligible for private insurance coverage through their employer-sponsored plan or an individual market health insurance plan. These plans may offer different levels of coverage and cost-sharing requirements for prescription medications.

When considering treatment options for AUD, it's essential to consult with a healthcare provider who can assess your individual needs and recommend the most appropriate course of treatment. This may include medication-assisted therapy in addition to other evidence-based treatments such as counseling and support groups.