“I heard there's a pill that if we put it in his food he'll hate alcohol.” This idea is passed around by many families out of fear and love, but it is one of the most dangerous things that can be done with disulfiram. This medication works when the patient is a partner in the decision, and becomes a danger when it is given secretly.
What is disulfiram (Antabuse)?
Disulfiram is a medication approved by the US Food and Drug Administration for treating alcohol dependence, according to the StatPearls reference, and its best-known international brand name is Antabuse. The US National Library of Medicine (MedlinePlus) classes it among “alcohol deterrents” and stresses that it is not a cure for addiction but discourages drinking. Its availability varies from country to country, so ask your doctor what is available.
How does disulfiram work?
Alcohol is broken down in the body in two stages, and disulfiram blocks the second, so a toxic intermediate substance builds up and causes unpleasant symptoms. The US National Library of Medicine notes that these symptoms begin about 10 minutes after alcohol enters the body and last an hour or more, and include flushing, headache, nausea, vomiting, chest pain, weakness, blurred vision, confusion, sweating, difficulty breathing and anxiety.
The US label adds that in severe cases the reaction can go as far as respiratory depression, circulatory collapse, heart rhythm disturbance, heart attack, loss of consciousness, seizures and death, and that its severity generally corresponds to the amount of the drug and the alcohol.
Is disulfiram effective?
An analysis published in PLoS One in 2014 pooled the results of 22 trials and found that disulfiram was generally better than the comparison. But the advantage appeared only in open-label trials, that is, when the patient knows they are taking the medication, while no benefit appeared in blinded trials. The logical explanation is that its effect depends on the patient knowing the consequence. The researchers noted that 89% of participants were men and that the studies varied widely. That is why the medication works best with a motivated patient and under supervision, for example by taking it in front of a family member by prior agreement.
Side effects of disulfiram
- Skin rash or acne.
- Mild headache.
- Drowsiness and tiredness.
- A metallic or garlic-like taste in the mouth.
- Sexual dysfunction.
Serious symptoms that call for a doctor immediately, according to the US National Library of Medicine, are signs of liver injury: severe tiredness, loss of appetite, vomiting, yellowing of the skin or eyes, dark urine and pale stools. It is usually not suitable for people with severe heart disease, and caution is needed with diabetes, thyroid disease, epilepsy, and kidney and liver disease.
Where disulfiram fits in treating alcohol addiction
Disulfiram does not reduce craving, and it does not treat alcohol withdrawal, which can be dangerous and needs medical supervision. So it comes after detox, within a plan that includes psychological therapy and family support. There are alternatives that work in a different way, such as naltrexone, which reduces the reward from drinking, and the doctor chooses according to the patient's condition and preference, as the guide to addiction treatment medications explains.
Alcohol addiction treatment at Eradah
If your relative refuses treatment, the safe alternative to the “pill in the food” is the proven persuasion approaches in the guide to persuading a person with addiction to accept treatment. At Eradah, treatment begins with detox under medical supervision, followed by the residential program for men, and the doctor decides with the patient on the medications suitable for preventing relapse. The first consultation is free and confidential on 01122220495.