Dr. Charles Sophy, who has appeared on Channel VH1’s Celebrity Rehab and Sober House, discusses the use of the drug Antabuse to help treat alcohol addiction. Antabuse, also known as Disulfiram, acts by preventing the body breaking down the alcohol in the bloodstream. The body is therefore unable to deal with alcohol in the normal way.

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Antabuse as Therapy

For the patient, this results in an unpleasant reaction that includes nausea, vomiting, high blood pressure and palpitations. Antabuse is thus a behavioral intervention, in that it aims to modify the behavior of the user. The user must take the tablet every day for it to be effective.

While not used extensively in the USA, it has been used with some success in other countries, with up to 50% rates of success. The one major problem with its use is that it is possible to have users who are undeterred by the unpleasant effects of the drug, such that they have a very severe reaction. This could, in some cases, lead to their death.

Disulfiram is a medication sold under the brand name Antabuse that is meant to treat alcoholism by producing extreme sensitivity to the consumption of ethanol. Disulfiram was the first medicine approved to treat alcohol abuse and dependence by the Food and Drug Administration (FDA). It has been effective in the treatment of alcohol addiction by causing a very unpleasant reaction in a person if they consume alcohol while taking the medication.

How Disulfiram Works

Disulfiram works by creating an extremely unpleasant reaction in a person who drinks alcohol while taking the medication. Normally, alcohol is metabolized into acetaldehyde, a toxin that leads to various hangover symptoms people experience after a night of heavy drinking. The body continues to oxidize acetaldehyde into acetic acid; however, disulfiram interferes with the metabolization of alcohol. It inhibits the oxidation of acetaldehyde into acetic acid, leading to a build-up of acetaldehyde that is significantly greater (five to 10 times) than would normally be present in the body after consuming alcohol.

Effects of Disulfiram

When a person takes disulfiram and drinks alcohol, it triggers the build-up of a high concentration of acetaldehyde. This, in turn, triggers an extremely unpleasant slew of symptoms within the person who has taken the medication and alcohol together. The symptoms can be triggered as quickly as 10 minutes after a person consumes alcohol and may last for an hour or longer. These symptoms (which may range in severity) include:

  • Nausea and vomiting
  • Flushing and sweating
  • Extreme thirst
  • Heart palpitations
  • Headache
  • Difficulty breathing
  • Hyperventilation
  • Rapid heart rate
  • Low blood pressure
  • Confusion
  • Loss of consciousness

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