Three pills to stop drinking exist: naltrexone, acamprosate, and disulfiram are all FDA-approved and all part of routine alcohol use disorder treatment. Here at Porch Light Health, people ask us about them almost every day, and the question underneath is usually how to actually get one.
The answer is simpler than most people expect. This guide covers how to get a prescription in Colorado or New Mexico and what happens at that first visit. It also covers what these medications cost on Medicaid, Medicare, or no coverage at all.
Three FDA-approved pills can help you drink less or stop drinking. Any licensed prescriber can write them, no special waiver required, and you can often start within a single outpatient visit. Which one fits depends on your goal, your liver and kidney health, whether you take opioids, and how recently you had your last drink.
Yes, though the name oversells it slightly.
None of these medications makes alcohol disappear from your life on its own. What they do is change the arithmetic.
That distinction matters, because it sets a realistic expectation. People who start medication alongside counseling do better than people who start medication alone, and we’d rather you hear that now than discover it three months in.
What about over-the-counter options? There aren’t any. Kudzu extract, L-glutamine, and milk thistle all rank well for this search. None carries FDA approval for alcohol use disorder, and none has the evidence base the prescription medications do.
For the full pharmacology and a head-to-head look at all three, start with our guide to medication for alcohol use disorder.
The National Institute on Alcohol Abuse and Alcoholism confirms that three medications are approved for alcohol use disorder. Its clinician guidance adds a point worth repeating to anyone who’s been putting off this conversation: prescribers don’t need specialized training or licensing to write them.
NIAAA calls them no more complicated to prescribe than medications for any other common condition.
In practice, that means your primary care doctor, a clinician at one of our clinics, or a telehealth provider can all start you on one.
| Medication | What It’s For | Form | Can You Start While Still Drinking? | Main Safety Check First |
| Naltrexone | Reducing heavy drinking and cravings | Daily pill or monthly injection | Yes | Liver enzymes; no current opioid use |
| Acamprosate | Staying abstinent after you’ve stopped | Tablets, three times daily | No, started after you stop | Kidney function |
| Disulfiram (Antabuse) | Creating a deterrent to any drinking | Daily pill | No, requires 12 to 24 hours alcohol-free | Liver health; not used in pregnancy |
Naltrexone is the one most people end up on.
One point keeps coming up in clinic. Naltrexone cannot be combined with opioid medication of any kind, including buprenorphine or methadone, because it blocks the same receptors. Taking it with opioids in your system can trigger immediate withdrawal, so tell your prescriber about everything you take.
Most people are surprised by how short the process is.
This is the detail almost nobody explains, and it’s the one that determines how fast you can begin. The SAMHSA and NIAAA clinical guide sets the timing: acamprosate is typically started five days after you stop drinking, while naltrexone doesn’t require you to stop first.
Disulfiram sits in between, needing 12 to 24 hours alcohol-free before the first dose. So if you’re still drinking today and want to start something today, naltrexone is usually the answer. If you’ve already stopped and you’re fighting the restlessness and insomnia that follow, acamprosate is built for that stretch.
| Bring This | Why It Matters |
| Photo ID and insurance card | Lets us confirm coverage before you leave |
| A list of every medication and supplement | Prevents interactions, especially with opioids and sedatives |
| Roughly when you last drank and how much | Determines which medication you can start and when |
| Any recent lab results you have | May save you a blood draw |
| A support contact | Useful for follow-up and for anyone helping you through the first weeks |
Most coverage of these medications assumes daily dosing. There’s a second approach that rarely gets mentioned: taking naltrexone only on days you plan to drink, about an hour beforehand.
This targeted approach is the basis of the Sinclair Method for alcoholism. It has drawn academic attention as a route for people whose goal is drinking less rather than quitting outright.
The logic is straightforward. Naltrexone blunts alcohol’s rewarding effect, so drinking while the medication is active gradually weakens the association between alcohol and reward. Researchers describe this as pharmacological extinction.
We’d frame it carefully. Targeted dosing isn’t the standard FDA-labeled approach, and the research base is smaller than it is for daily dosing.
It also asks a lot of a person in terms of planning and honesty about their own drinking. But for someone who has ruled out abstinence and would otherwise take nothing at all, it’s a legitimate conversation to have with a clinician.
If you’re reading about it online, be cautious about the success rates you’ll find. Many of the numbers circulating come from advocacy sites rather than peer-reviewed work, and we won’t repeat figures we can’t source.
Cost is where most people stall.
It’s usually a smaller obstacle than expected. Oral naltrexone, acamprosate, and disulfiram have all been available as generics for years, which keeps the medication itself among the cheaper parts of care.
We accept these plans and programs:
Because we’re a low-barrier outpatient provider rather than a private-pay program, coverage questions here work differently than people expect.
A few things worth knowing before you call:
Our staff can check your benefits and tell you what applies to you specifically. We can’t tell you in advance that a particular medication will be covered, because that depends on your plan.
For some people, stopping alcohol suddenly is medically dangerous, and that has to be sorted out before any of this applies. Heavy, long-term drinking can produce a withdrawal severe enough to require supervision.
Get emergency help immediately if you or someone you’re with has a seizure, severe shaking, hallucinations, serious confusion, or vomiting that won’t stop. These can signal delirium tremens, a withdrawal complication that can be life-threatening and needs treatment now rather than at an appointment next week.
Short of an emergency, some people need medical supervision to stop safely. Our ambulatory medically supervised withdrawal services handle this on an outpatient basis, meaning you’re monitored by clinicians while continuing to live at home. Medication for alcohol use disorder comes after that stabilization, not instead of it.
If you’re in crisis or thinking about harming yourself, call or text 988 to reach the Suicide and Crisis Lifeline.
You don’t need to have chosen a medication, or even decided whether you want to quit or cut back, before you call. Reach us at 866-839-8868 or through our contact us page, and a clinician will work through the rest with you.
Do I have to stop drinking before I can get a prescription?
Not for naltrexone. It can be started while you’re still drinking, which is often the reason it’s chosen first. Acamprosate is started about five days after your last drink, and disulfiram requires 12 to 24 hours alcohol-free.
How long will I need to take it?
That’s a clinical decision made with your prescriber based on how you respond and what your goals are. Many people stay on medication for months rather than weeks, and stopping is a conversation, not something to do on your own.
Which one works best?
Direct comparisons between naltrexone and acamprosate haven’t consistently shown one to be superior, so the choice comes down to fit. Your goal, your liver and kidney health, whether you take opioids, and how recently you drank all steer the decision more than any ranking would.
Can I take these if I’m on Suboxone or methadone?
Not naltrexone. It blocks opioid receptors and can trigger immediate withdrawal in anyone with opioids in their system. Acamprosate and counseling-based approaches are the usual alternatives, and your prescriber needs to know about every medication you take.
Is there a pill I can buy over the counter?
No. Kudzu, L-glutamine, and milk thistle come up often in searches, but none is FDA-approved for alcohol use disorder. The three medications with real evidence behind them all require a prescription.
Are these medications addictive?
NIAAA describes the FDA-approved medications for alcohol use disorder as non-addicting. They don’t produce a high and they aren’t controlled substances, which is part of why prescribers can write them without special authorization.
Does Ozempic help with drinking?
GLP-1 medications aren’t FDA-approved for alcohol use disorder, and the research is early. We don’t prescribe them for drinking, and we’d steer you toward the approved options rather than an off-label bet.
Can I do all of this through telehealth?
Often, yes. Many people complete the visit by video and pick up a prescription locally, though labs and the monthly injection require an in-person stop. Our mobile units cover rural and frontier communities where getting to a clinic is the hard part.
What if the medication doesn’t seem to be working?
Talk to your prescriber before changing anything. Adherence, drug interactions, and dosing are the usual culprits. Switching medications or adding behavioral health counseling are both normal next steps rather than signs of failure.
Starting a medication for alcohol use disorder is a shorter conversation than most people expect, and you don’t need to have it figured out before you call. Our clinicians will review your history, run the labs that apply, and walk you through the options that are safe for you.
Call 866-839-8868 or contact Porch Light Health to get started. We offer care in person, through mobile medical units, and by telehealth across Colorado and New Mexico, and we accept Medicaid, Medicare, and major commercial insurance.
This content is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are in crisis, call or text 988 to reach the Suicide and Crisis Lifeline.
