Alcohol Cravings Medication: Practical Options That Work

Alcohol cravings can feel like a tug-of-war between your goals and the urge to drink. If you want to cut cravings, medication can be a real tool — not a cure, but a powerful aid when paired with counseling and support.

Three drugs are approved specifically for alcohol use disorder. Naltrexone reduces the rewarding effects of alcohol and helps many people drink less. It comes as a daily pill (50 mg) or a monthly injection (Vivitrol 380 mg). Acamprosate helps reduce the persistent physical feelings that make people want to drink again after detox; the usual dose is 666 mg three times a day. Disulfiram works differently: it creates a harsh reaction if you drink, so it’s more of a deterrent and needs strong commitment to be useful.

Other medications you might hear about

Several drugs are used off-label to tame cravings. Topiramate and gabapentin have solid evidence for lowering drinking in some people. Baclofen is another option, especially in Europe, and some clinicians use it for people who can’t take first-line drugs. These medicines can help, but benefits and risks vary — and dosing strategies differ from person to person.

What to expect and safety tips

None of these pills work by themselves. Expect better results when medication is combined with therapy, counseling, peer support, or mutual-aid groups. Side effects matter: naltrexone can cause nausea or liver problems, so liver tests are standard before starting. Acamprosate is generally well tolerated but needs kidney dosing checks. Disulfiram can cause severe reactions with alcohol and must be used cautiously. Off-label drugs like topiramate can cause numbness, cognitive fog, or weight loss.

Don’t try to self-prescribe. A doctor will screen for liver or kidney issues, review other meds you take, and pick the safest option. If you are pregnant or planning pregnancy, many of these drugs are not recommended. Also tell your provider about mental health issues; some medications affect mood or interact with antidepressants.

Practical tips: keep a simple daily routine, set small goals, use medication reminders, and pair drug treatment with therapy that teaches coping skills. If cravings spike, call your care team early — adjustments to dose or switching meds can help. If cost is a barrier, ask about generics, patient assistance, or community clinics that offer treatment on sliding scales.

If you’re not ready for medication, consider starting with behavioral tools and regular check-ins with a clinician. If you are ready, a shared decision with your provider will match treatment to your health, history, and goals. Medication isn’t a magic fix, but used correctly it can take the edge off cravings and make recovery more manageable.

Ready to start? Talk with your primary care doctor, addiction specialist, or local clinic. Ask about blood tests, medication options, likely side effects, and support programs in your area. If you have trouble accessing care, many regions offer telehealth and hotline referrals that can get you connected quickly. Start small, and steadily build from there.