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Acamprosate vs. Naltrexone

Clinically Reviewed By Dr. Jeremy Dubin

The journey to recovery from alcohol use disorder (AUD) is filled with challenges but also hope. With various options for treatment, choosing the right path can sometimes seem daunting. In addition to behavioral treatments, medications for addiction treatment (MAT) for AUD also offer various options. Acamprosate and Naltrexone stand out as two of those choices, each offering a path to healing in distinct ways. 

At Porch Light Health, we are dedicated to providing accessible MAT solutions and comprehensive care across Colorado and New Mexico. We believe that understanding the different treatments available to treat alcohol addiction can empower individuals to make informed decisions in their recovery journey. 

What is Acamprosate?

Acamprosate, known by the brand name Campral, is a medication that aids in the recovery process for those battling AUD. Specifically, acamprosate helps curb alcohol cravings, supporting individuals in their commitment to sobriety. This medication can be used after an individual has fully completed alcohol detoxification as a treatment to help them maintain sobriety and lasting recovery.

Administered orally and typically recommended to be taken three times daily, Acamprosate requires a disciplined approach to medication adherence. This disciplined approach is important for maintaining effective medication levels in the body, which is required to support its therapeutic goals. The consistent regimen required when taking this medication highlights the commitment required in the recovery journey, reinforcing the daily choice of sobriety.

How does Acamprosate work?

Acamprosate addresses the chemical imbalances in the brain that are a consequence of long-term alcohol abuse. Alcohol misuse can lead to a disruption in the balance between neurotransmitters such as GABA and glutamate, which, in turn, can fuel cravings and elevate the risk of relapse. Acamprosate’s action is believed to rebalance these neurotransmitters, thereby mitigating the psychological cravings for alcohol.

Acamprosate helps individuals sustain their sobriety by normalizing the brain’s chemical environment. It’s an important component of a broader treatment plan that often includes counseling and support groups, providing a multifaceted approach to recovery.

What is Naltrexone?

Naltrexone is an FDA-approved medication designed to combat alcohol addiction and opioid dependence. Classified as an opioid antagonist, it works by blocking opioid receptors in the brain. This blocking action is critical for individuals with AUD as it reduces the pleasurable effects of alcohol, thereby lessening the desire to drink.

Naltrexone is available in two forms: an oral tablet and an extended-release injectable known as Vivitrol. The oral form, intended for daily use, offers flexibility and simplifies adherence to the treatment regimen. The injectable form, Vivitrol, administered once a month by a healthcare professional, is an option for those who prefer or require less frequent dosing.

How does Naltrexone work?

Naltrexone plays a critical role in AUD treatment through its ability to block the euphoric and sedative effects of alcohol. This action significantly reduces the desire to consume alcohol, aiding individuals in their efforts to maintain sobriety. The medication is particularly valuable in supporting those in recovery, helping to prevent relapse by diminishing alcohol cravings.

Incorporating Naltrexone into a comprehensive treatment plan, which includes psychological support and counseling, enhances its effectiveness. Such an integrated approach not only addresses the physical aspects of dependence but also tackles the psychological challenges, enabling individuals to gain control over their cravings and progress in their recovery. Naltrexone stands as a testament to the advancements in addiction treatment, providing effective support for those dedicated to overcoming alcohol dependence.

Acamprosate vs. Naltrexone

When considering MAT options for alcohol addiction, acamprosate and naltrexone both stand out for their distinct approaches and efficacy. Here’s a deeper look at the two medications to aid decision-making:

How It Works

  • Acamprosate: Works by restoring the balance of neurotransmitters in the brain, such as GABA and glutamate, often disrupted by excessive alcohol consumption. This action helps reduce cravings for alcohol.
  • Naltrexone: Acts as an opioid antagonist, blocking opioid receptors that contribute to the rewarding effects of alcohol. This reduces the pleasure derived from drinking and helps diminish cravings.

How To Take It

  • Acamprosate: Available in oral tablet form, typically taken three times a day.
  • Naltrexone: Offered as an oral tablet for daily intake or as an extended-release injectable (Vivitrol), administered once a month.

Deciding Factors

When deciding between Acamprosate and Naltrexone for treating alcohol use disorder (AUD), it’s crucial to consider a few key elements. Here’s a closer look at some of the most important variables to consider: 

  • Treatment Objective: Both aim to support individuals with AUD in either reducing alcohol consumption or maintaining abstinence as part of a comprehensive treatment plan, which includes psychological support and counseling.
  • Efficacy: Research indicates both medications are effective in treating AUD, with their specific benefits varying from individual to individual.
  • Safety and Tolerability: These medications are generally well-tolerated and have different side effect profiles. Serious side effects are rare, and many find that the benefits outweigh the potential risks.

Which Medication is Better for Getting Rid of Alcohol Cravings?

Both acamprosate and naltrexone have been proven to be effective in reducing alcohol cravings in individuals with alcohol use disorder. However, the way this is achieved looks different for each medication. 

  • Acamprosate–this medication works to reduce alcohol cravings and maintain abstinence by restoring the brain’s chemical balance. 
  • Naltrexone–this medication works by blocking the euphoric effects of alcohol, thereby reducing the incentive for alcohol consumption and the likelihood of relapse. 

Multiple clinical trials and studies have demonstrated the effectiveness of these medications, highlighting their role in comprehensive treatment plans that include other forms of support, such as therapy​​.

How Long Does It Take Campral & Naltrexone to Work?

Understanding how long acamprosate and naltrexone take to work is crucial for those embarking on the path to recovery from AUD.

  • Acamprosate (Campral): Typically starts to show effects within the first week of use, around five to seven days, but achieving full benefits might take longer due to its gradual action on the brain’s chemical balance.
  • Naltrexone: Can start working within an hour after taking it, though its long-term effectiveness, particularly in curbing cravings and maintaining sobriety, builds with continued use.

Both medications necessitate a commitment to the prescribed regimen and ongoing communication with addiction specialists and providers to optimize recovery outcomes.

What Happens if You Drink on Naltrexone or Acamprosate?

Drinking alcohol while taking acamprosate or naltrexone has different implications for each medication. These implications differ from Antabuse, or disulfiram, a medication that causes individuals to become physically ill if they consume alcohol. This medication is a physical deterrent, while naltrexone and acamprosate are designed to help with cravings. Here’s a closer look at what happens if alcohol is consumed while on either of these medications:

  • Acamprosate: Consuming alcohol doesn’t trigger severe adverse reactions but it undermines the therapeutic effect aimed at supporting abstinence and may impede recovery efforts. Its effectiveness is maximized within a comprehensive treatment plan that includes psychological support.
  • Naltrexone: This medication also does not cause severe reactions when alcohol is consumed. However, it works by reducing the pleasure derived from alcohol, aiding individuals in drinking less or maintaining abstinence. Drinking while taking naltrexone can still lead to intoxication but without the associated reward or positive effects. This can potentially help in reducing alcohol dependency.

Open dialogue with your healthcare provider about any drinking episodes while on acamprosate or naltrexone is paramount for ensuring your treatment is designed to support your journey to lasting sobriety. 

Begin Healing With Porch Light Health

At Porch Light Health, we’re known for our holistic and tailored approach to addiction recovery. We offer comprehensive care that nurtures physical, mental, and emotional health, utilizing the latest in MAT within our network of state-of-the-art facilities across Colorado and New Mexico. Our commitment ensures patients embark on a path to lasting wellness with the highest standard of care.

Discover a path to recovery designed just for you with Porch Light Health. Reach out today to begin your journey towards wellness.

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