Joshua Rivera

Naltrexone is an FDA-approved medication for alcohol use disorder that can reduce alcohol’s rewarding effects and help some people reduce heavy drinking or maintain recovery goals.

Acamprosate is an FDA-approved medication for alcohol use disorder that helps support continued abstinence after someone has stopped drinking.

Three FDA-approved medications are commonly used for alcohol use disorder: naltrexone, acamprosate, and disulfiram. They work differently and are selected based on the person’s goals, health, and treatment plan.

Wernicke encephalopathy is an acute neurologic emergency caused by severe thiamine deficiency. Heavy alcohol use raises risk by contributing to poor nutrition and impaired thiamine absorption and use.

Thiamine, or vitamin B1, is commonly given during alcohol withdrawal treatment because heavy alcohol use can cause thiamine deficiency and increase the risk of Wernicke encephalopathy.

Alcohol withdrawal kindling is the tendency for repeated withdrawal episodes to become progressively more severe, increasing concern for seizures and complicated withdrawal in people with multiple prior withdrawals.

Opioid tolerance means the body becomes less responsive to a given opioid dose over time. After treatment or abstinence, tolerance can fall, making a previously used dose dangerously strong and increasing overdose risk.

Extended-release injectable naltrexone is a monthly opioid-blocking medication approved for opioid use disorder after detoxification and for alcohol use disorder in appropriate patients.

Buprenorphine can be started during addiction treatment when a qualified clinician determines it is appropriate for opioid use disorder. The initiation strategy depends on recent opioid use, withdrawal, fentanyl exposure, and other clinical factors.

Someone may be able to continue buprenorphine or methadone during residential rehab when the medication remains clinically appropriate and the program can coordinate it safely. Medication should not be stopped automatically simply because residential treatment begins.