How to Treat Addiction & Withdrawal with Disulfiram

If you have a severe addiction to alcohol and are struggling to stay sober, you may be prescribed disulfiram. This is a medication that produces an acute sensitivity to alcohol, leading to unpleasant symptoms.

If you drink alcohol after taking disulfiram, you are likely to experience symptoms similar to a severe hangover. These symptoms manifest almost immediately and can make you feel quite unwell. Even a small amount of alcohol after taking disulfiram can cause symptoms that include a pounding headache, sweating, vomiting, and confusion.

Further to this, as disulfiram can help inhibit dopamine production by reacting with specific enzymes, studies into its efficacy for use as part of the treatment for cocaine addiction are being carried out. Research is also being conducted to determine if the medication could be used in the treatment of cancer and HIV.

What Addictions is Disulfiram Used to Treat

  • Alcohol addiction

Medications for Abuse and Addiction

Complete abstinence is generally accepted as the best way to overcome addiction to specific toxic substances. This is typically achieved through programmes of detoxification and rehabilitation. However, certain medications can help make the process of achieving abstinence easier.

For instance, some medications can help to ease the symptoms of withdrawal from specific substances. When used as replacement drugs, they can help make detox withdrawal symptoms less severe and can then themselves be withdrawn before the potential for an addiction to these develop.

Other medications can be used as a help for relapse prevention. Some react with other substances to cause unwanted side effects (think hangover-type symptoms) and can be used as a deterrent to help the addicted individual stay sober.

There are also medications that can be prescribed to ease the symptoms associated with co-occurring disorders; disorders that often go hand-in-hand with substance abuse and addiction. These include anxiety and depression.

How to Choose the Right Medication

Choosing the right medication during a detox and rehabilitation programme is the job of your doctor. When you start a detox or rehabilitation programme, you will likely be assessed by a doctor who will then decide if medication is appropriate for your circumstances.

This medical professional will need to look carefully at your medical history and will need to know about any medications currently being taken. This would include all prescription drugs, over-the-counter pills, and herbal products.

What is Disulfiram?

Disulfiram is an oral medication that is used for the prevention of drinking in those trying to overcome alcohol dependence and addiction. It works by blocking the oxidation of alcohol at the acetaldehyde stage during the process of alcohol metabolism. When this happens, acetaldehyde builds up in the blood, causing very unpleasant symptoms similar to a bad hangover when alcohol is consumed. Even a small amount of alcohol after taking disulfiram can cause these symptoms.

Brand Names for Disulfiram

Antabuse

Antabus

History of Disulfiram

The development of disulfiram came about by chance. It was originally used as a compound for vulcanising rubber tyres. Those working with this substance reported suffering adverse effects after drinking alcohol; however, the connection between the two was not made at the time.

It was only in 1948, when three researchers at Danish drug company Medicinalco were trying to test the substance to determine if it could be used as an anti-parasitic, that the connection was discovered. Jens Hald, Erik Jacobsen, and Kenneth Ferguson self-dosed with the chemical and found that they had a violent reaction upon consuming alcohol thereafter. This led to disulfiram eventually being developed as a medication for the treatment of alcohol addiction.

Is Disulfiram Addictive?

Disulfiram has a very low potential for abuse and is not currently classed as an addictive drug.

What is the Mechanism of Action?

When alcohol is consumed, the body eventually metabolises it to acetaldehyde. The acetaldehyde dehydrogenase enzyme then breaks down the acetaldehyde before it is expelled. Disulfiram works by inhibiting the acetaldehyde dehydrogenase enzyme, preventing it from breaking down the acetaldehyde, which leads to a build-up in the blood. This then causes a variety of unpleasant symptoms when alcohol is consumed.

How Long Does It Take for Disulfiram to Work?

Disulfiram begins to work immediately. It is recommended that alcohol is avoided for at least twelve hours before or after taking this medication to avoid becoming violently ill. As everyone reacts differently to disulfiram though, there is no way to tell which symptoms one will experience or indeed how severe these will be.

What are the Side Effects of Disulfiram?

  • Headache
  • Drowsiness
  • Mood swings
  • Fatigue
  • Skin rash
  • Metallic or garlic taste in the mouth
  • Numbness or tingling in the feet and hands
  • Abdominal pain
  • Yellowing of the skin and eyes

Facts/Statistics on Disulfiram

Fact #1

Disulfiram is not a toxic substance unless mixed with alcohol.

Fact #2

Disulfiram is available as 250mg or 500mg tablets.

Fact #3

It must be taken every day to achieve the full effects.

Fact #4

It does not prevent alcohol cravings from occurring.

Studies Done on Disulfiram

A study published in PLOS One in 2014 to determine the efficacy of disulfiram in the treatment of alcohol dependence concluded that ‘based on results with open-label studies, disulfiram is a safe and efficacious treatment compared to other abstinence supportive pharmacological treatments or to no disulfiram in supervised studies for problems of alcohol abuse or dependence’.

Studies are also currently being conducted by the National Cancer Institute to determine the efficacy of using disulfiram to treat various cancers. The four clinical trials taking place at the time of this writing are:

  1. Safety, Tolerability and Efficacy of Disulfiram and Copper Gluconate in Recurrent Glioblastoma.
  2. Copper Chloride, Disulfiram, and Copper Gluconate in Treating Patients with Metastatic Castration-Resistant Prostate Cancer.
  3. Disulfiram and Copper Gluconate with Radiation Therapy and Temozolomide in Treating Patients with Newly Diagnosed Glioblastoma That Can be Removed by Surgery.
  4. Disulfiram and Gemcitabine Hydrochloride in Treating Patients with Unresectable Solid Tumours or Metastatic Pancreatic Cancer.
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