
Opioid addiction and alcoholism are both serious conditions that can have devastating effects on individuals and their loved ones. Fortunately, there are treatment options available for those suffering from these disorders. The Food and Drug Administration (FDA) has approved several medications to treat opioid and alcohol use disorders, including buprenorphine, methadone, naltrexone, acamprosate, disulfiram, and naloxone. These medications work by relieving withdrawal symptoms, reducing cravings, and restoring normal body functions without causing euphoria or substituting one addiction for another. In addition to medication, therapy and counselling are also important components of treatment, and there are various helplines and support groups available for those seeking help.
| Characteristics | Values |
|---|---|
| Treatment for opioid addiction | Buprenorphine, methadone, and naltrexone |
| Treatment for alcoholism | Acamprosate, disulfiram, and naltrexone |
| Overdose prevention | Naloxone, nalmefene |
| Treatment referral | SAMHSA's National Helpline: 1-800-662-HELP (4357) |
| Treatment options | Outpatient counseling, inpatient rehabilitation, medication-assisted treatment (MAT) |
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What You'll Learn

FDA-approved medications for opioid and alcohol use disorders
Medications used to treat opioid and alcohol use disorders are approved by the Food and Drug Administration (FDA) and are clinically driven and tailored to meet each patient’s needs. These medications relieve withdrawal symptoms and psychological cravings that cause chemical imbalances in the body.
FDA-approved medications for opioid use disorder
Buprenorphine, methadone, and naltrexone are the most common medications approved by the FDA used to treat opioid use disorder (OUD). These medications help normalize brain chemistry by blocking the euphoric effects of opioids, relieving physiological cravings, and restoring normal body functions. They are effective in treating OUD related to short-acting opioids such as heroin, morphine, and codeine, as well well as semi-synthetic opioids like oxycodone and hydrocodone. They are safe for long-term use, ranging from months to a lifetime.
FDA-approved medications for alcohol use disorder
Acamprosate, disulfiram, and naltrexone are the most common medications used to treat alcohol use disorder (AUD). They do not provide a cure for the disorder but are most effective for people who participate in a treatment program. Unlike other medications approved to treat AUD, disulfiram does not directly affect receptors in the brain. Instead, it blocks enzymes in the body that break down alcohol.
FDA-approved medications for opioid overdose
Naloxone and nalmefene are both FDA-approved opioid overdose reversal medications (OORMs) that are used to prevent opioid overdose by reversing the toxic effects of the overdose. In March 2023, the FDA approved naloxone nasal spray as the first over-the-counter OORM, available in many pharmacies and local health departments, free of charge. Nalmefene is an OORM nasal spray that is available by prescription only and is intended for use in healthcare and community settings for individuals who are 12 years or older.
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Opioid overdose reversal medications
Opioid overdose is a life-threatening condition that requires immediate medical attention. Overdose reversal medications are safe and effective tools that can be administered to someone experiencing an opioid overdose. These medications can quickly restore normal breathing and reverse the toxic effects of the overdose, thereby saving lives.
Naloxone is a widely recognised and effective medication used to treat opioid overdose. It is available in various forms, including a 4mg intranasal spray and injection, an 8mg intranasal spray, and a 3mg intranasal spray approved in 2023. Naloxone is the only overdose reversal medication approved for individuals of all ages, including pregnant women. It is also available over the counter and can be administered by individuals with or without medical training.
Nalmefene is another opioid antagonist medication that has been recently approved. It is available as a long-acting intranasal spray and an auto-injector. While nalmefene has potentially longer-acting effects, current data indicates that it does not increase survival rates over naloxone 4mg, and it may lead to a more severe and protracted opioid withdrawal syndrome.
Both naloxone and nalmefene are approved to reverse overdoses caused by opioids like fentanyl. They are available as nasal sprays and can be carried and administered by anyone. These medications are critical harm reduction tools that play a vital role in preventing overdose deaths and providing individuals who use drugs with opportunities to access necessary services.
It is important to note that a delayed response of up to 5 minutes between administering an opioid antagonist medication and the resumption of normal breathing is expected. If normal breathing does not resume after 5 minutes, a second dose of the medication may be administered. Cardiorespiratory resuscitation (CPR) and activating emergency medical services are crucial life-saving measures that should accompany the administration of overdose reversal medications.
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Treatment referral services
The referral service connects individuals with local treatment facilities, support groups, and community-based organizations. It also provides information on various treatment options, including medication-assisted treatment and therapy. Medications such as buprenorphine, methadone, and naltrexone are commonly used to treat opioid use disorder, while acamprosate, disulfiram, and naltrexone are used for alcohol use disorder. These medications help normalise brain chemistry, relieve cravings, and restore normal body functions.
SAMHSA's referral service also takes into account the financial situation of the individual seeking treatment. If an individual has no insurance or is underinsured, they will be referred to their state office, which can provide information on state-funded treatment programs. The service can also refer individuals to facilities that offer sliding fee scales or accept Medicare or Medicaid. Additionally, individuals with health insurance are encouraged to contact their insurer to learn about participating healthcare providers and facilities.
The referral process is designed to be confidential and respectful of privacy. While trained information specialists provide guidance and support, they do not ask for any personal information. They may, however, request geographic information, such as a zip code, to accurately identify local resources and connect individuals with the appropriate state services and local assistance. This includes connecting individuals with other community-based organisations and support groups, such as Alateen, that can provide additional support during the treatment and recovery process.
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Family therapy
In family therapy, sessions may be devoted to discussing each person's feelings and concerns, or they may involve education on effective communication and improved listening to reduce misunderstandings. Therapists may use different types of family therapy, including behavioural couples therapy (BCT), which promotes and rewards abstinence through a daily "Recovery Contract". Solution-focused brief therapy is another approach that helps families dealing with co-occurring disorders. This therapy focuses on finding solutions for specific problems rather than pinpointing the reasons for family dysfunction.
Community reinforcement and family training (CRAFT) is a structured approach that teaches families positive reinforcement strategies to encourage their loved one to change their substance use behaviours. Multisystemic therapy (MST) is a model used for adolescents with SUDs, violent behaviours, and/or criminal records. MST utilizes goal-oriented techniques and family-strengthening strategies to encourage positive change. Multi-dimensional family therapy (MDFT) is a treatment approach suitable for diverse populations, including adolescents with severe SUDs and their families. MDFT is designed to improve the adolescent's and family's well-being.
Research has found that network therapy is associated with decreased substance use over time. This approach can be combined with behavioural therapy and naltrexone, a medication used to treat both opioid and alcohol use disorders. Family therapy can also be integrated with community reinforcement approaches, such as Social Behaviour and Network Therapy.
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Buprenorphine, methadone, and naltrexone
Buprenorphine
Buprenorphine is a medication used to treat opioid use disorder (OUD). It suppresses and reduces cravings for opioids and prevents withdrawal symptoms without causing the intense "high" associated with opioid drugs. Buprenorphine is less addictive than other opioids and can be prescribed by many doctors, nurse practitioners, and physician assistants, making it more accessible. It can also be administered in emergency departments to ease cravings and withdrawal after an overdose, motivating individuals to seek long-term treatment.
Methadone
Methadone is an opioid medication that has been used for decades to treat opioid use disorder. It reduces opioid cravings and withdrawal symptoms and blunts or blocks the effects of opioids. Methadone can also help manage pain for individuals with acute or chronic pain conditions. However, it can produce dependence, and individuals should consult their doctors before discontinuing its use.
Naltrexone
Naltrexone is a medication approved for the treatment of both opioid use disorder (OUD) and alcohol use disorder (AUD). It works by blocking opioid receptors, preventing the euphoric and sedative effects of opioids, and reducing cravings. Naltrexone is also effective in treating OUD related to short-acting opioids like heroin and morphine, as well as semi-synthetic opioids. It is safe for long-term use and does not cause the intense pleasurable effects of opioids.
These medications (Buprenorphine, Methadone, and Naltrexone) are safe and effective treatments for opioid use disorder, and they can be used in combination with therapy to support recovery and reduce the risk of contracting diseases like HIV or hepatitis C.
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Frequently asked questions
The Food and Drug Administration (FDA) has approved several medications to treat opioid and alcohol use disorders. These include:
- Buprenorphine
- Methadone
- Naltrexone
- Acamprosate
- Disulfiram
- Lofexidine
You can call SAMHSA's National Helpline at 1-800-662-HELP (4357) or TTY: 1-800-487-4889. This helpline provides referrals to local treatment facilities, support groups, and community-based organizations. Alternatively, you can text your zip code to 435748 (HELP4U) to find help near you.
These medications work by relieving withdrawal symptoms and psychological cravings that cause chemical imbalances in the body. They normalize brain chemistry by blocking the euphoric effects of opioids and alcohol, ultimately restoring normal body functions.







































