The mostly ignored treatment for drinking too much

Americans are sipping less booze than before and having more open conversations about the health risks of drinking — but one piece of the puzzle remains largely ignored: treatment for alcohol use disorder. Despite decades of research and FDA approval, the three main medications — naltrexone, acamprosate, and disulfiram — remain underused, with only 2% of diagnosed Americans receiving them.

Naltrexone, originally for opioid addiction, blunts the pleasurable effects of alcohol, making heavy drinking less rewarding. Acamprosate restores brain balance and reduces cravings after prolonged drinking, while disulfiram causes unpleasant reactions if alcohol is consumed. These medications are safe, well-tolerated, affordable, and can be life-changing when paired with behavioral therapies.

So why aren’t they widely used? The stigma around addiction is a major barrier, as is lack of awareness among both patients and physicians. Many doctors receive little training in addiction medicine, and cultural attitudes still treat alcoholism as a moral failing rather than a chronic disease. As a result, people rarely hear about these treatments, and pharmaceutical companies invest little in marketing generic options.

Despite these obstacles, experts say medication-assisted treatment can be as effective as treatments for conditions like diabetes or depression. Newer drugs, such as GLP-1s like Ozempic, show promise in reducing alcohol consumption, but the real shift begins with recognizing that alcohol use disorder is a medical condition deserving proper treatment.

For millions struggling with drinking, these medications offer a way to take control and reduce harm — if only more people knew they existed. Treating addiction like any other disease, rather than a flaw in character, may finally give these underused tools the attention they deserve.