Disulfiram, The Painful Cure For Alcoholism

“Drinking makes wise, but dry fasting makes glum.” —William R. Alger, “Wine Song of Kaitmas,” Poetry of the Orient

In A Nutshell

For over 50 years, doctors have been administering a drug called disulfiram to combat alcoholism. While it does nothing to eliminate the craving for strong drink, it makes the patient violently ill minutes after consuming even a small amount of alcohol. Symptoms include nausea, vomiting, and horrible throbbing headaches.

The Whole Bushel

Disulfiram is a drug discovered in the 1920s. It was originally used to treat parasitic infestations, but while in the testing phase at Medicinalco, a Danish drug company, it was discovered that the drug had a harsh reaction with alcohol. More specifically, it served to block the liver from breaking down acetaldehyde, the substance that makes hangovers so much fun. The drug is also being studied for use on those addicted to cocaine and opiates, as it makes it difficult for the body to break down dopamine, leading to uneasiness and anxiety.

Available in pill form under the trade name “Antabuse” or as a subdermal implant, the body cannot build up a tolerance to disulfiram. The longer it is taken, the more sensitive to alcohol a person becomes. While the drug does not do anything to curb the cravings for alcohol, if someone decides to “cheat” and sneak a drink, a few minutes later, they are subject to crippling pain. Symptoms of the disulfiram-ethanol reaction are wide ranging and agonizing, from headaches, weakness, vertigo, nausea, and vomiting, among others. The more alcohol that is consumed, the worse the effects, and at the severe end of the spectrum, it can cause unconsciousness and bring on respiratory failure, convulsions, or heart attacks.

Because of the horrible severity of the symptoms, alcoholics frequently stop taking their prescriptions. One must be in generally good health to take disulfiram, and side effects can be very ugly, not limited to hepatitis and psychotic breaks from reality.

Show Me The Proof

NPR: The killer cure for alcoholism in Russia
Disulfiram — Official FDA information

  • Exiled Phoenix

    Subdermal implants of this drug should be forced on anyone that commits a D.U.I or aggressive behavior due to alcohol.
    The choice for a future alcoholic beverage should not be theirs to make for a minimum of 3 years!

  • Passin’ Through

    If it does nothing for the underlying cause of drinking, the title should probably be

    Disulfiram, The Painful Deterrent to Alcoholism.

    Just a thought.

    • Tylor Skyy

      I absolutely agree

  • definitely not a cure. As AA will say, there is no cure. I am not a huge proponent of the 12 step philosophy but I believe this is something they have right. You don’t just stop having the predispositions which make you prone to addiction. Alcoholism is a handy name for a handful of psychological and genetic factors which will make it more likely that you enjoy indulging in mood altering substances. I know, I’m “an addict” “an alcoholic”. The “disease”, however, doesn’t just impact how you consume drugs and alcohol, it effects many areas of your life. You could call it the cliche “addictive personality”. The only way to avoid having these traits destroy in the form of addiction is to find healthier outlets. It’s not all bad, some addicts are the brightest, most creative, and compassionate people I know. The good comes with the bad. I took Antabuse and it’s not as terrible as advertised but it does depend on the individual biology, the dosage, and the amount of alcohol consumed. When I drank on it once it just made me red and I got a bit of a rash. Anyway, I take naltrexone now because it makes it to where drinking isn’t quite as rewarding and if you do slip up you don’t get sick or have those unpleasant side effects. I only drank on the naltrexone once and I can say that it essentially takes all the euphoric niceness away from the intoxication so as long as I take it I basically have no incentive to drink. You get all the negative crappy effects of drunkenness and hangover and really get no “wooo hooo this is awesome”! Someday I hope to not have to require a stop gap measure like naltrexone. Key to success for me is support, hobbies, education about mental illness and addiction, and fellow individuals who understand the struggle that I can talk to during the good and the bad times. A HUGE necessity is time, SOBER time. Relearning and adjusting to life with a clear mind and a healthy body and realizing what drinking had taken away from my life. It takes a good few months to a year to get the balance back and to recognize that many of the reasons that I drinking were being created by the negative effects of the drinking, a self perpetuating craptastic downward spiral.

    • Hadeskabir

      The AA is just a christian cult. The 7 steps program is ludicrous.

      • given that very little of my post is about AA, I find that interesting that you felt the need to point that out. Sure, there are very culty aspects to AA, but every chapter is different and there are all kinds of different approaches to 12 step philosophy. Culturally the movement has drifted away from blatant Christianity, there are even some 12 step atheist groups. It’s 12 steps by the way. I don’t go to AA, I don’t think it’s the best solution, research demonstrates that it’s no better than other methods, but it is a method and for some people it’s all they know and it’s free and easy to access. I don’t think they do harm, I just don’t think it’s the most psychologically healthy way to maintain sobriety, it is a way for some to maintain sobriety, however. If it keeps somebody sober that was otherwise destroying their lives, that should be considered helpful. I have very reasonable and rational friends who have found a way to make AA and the 12 steps useful for them, if you know how to take the good and leave the rest, I see no problem with that. Some people get way to into it though and take it all as scripture and are very dogmatic. Those people are the types that don’t find “emotional sobriety”. They may be sober, but they still need something to fill an existential void that replaces the drugs and alcohol. In this case it’s community, and it’s not always healthy. But again, it’s better than being a drunk in a ditch or destroying every relationship you have in your life through drug seeking behavior.

        • Hadeskabir

          It’s a cult. In the program you have to accept that there is a higher power and only then you can be cured! That’s so stupid. Last month a man went to court because he was caught driving drunk. The judge give him the option to go to the AA or going to jail. Of course the man chose the AA. When in the 12 program he said he didn’t accept that there was a higher power because he was an atheist. Because he didn’t go against his beliefs and go along with the program he was sent to jail. Do you think that’s right?

          • No but government mandated AA is obviously wrong. That wasn’t AA’s fault that was the government getting involved in the first place. He should have been sent to treatment, AA is not rehab or treatment. I’ve never been to an AA chapter that kicked anyone out for not believing in God or said that you couldn’t attend for that reason. Higher power is super vague and can easily just be associated with the power of the community and the collective to help derive purpose and lead someone to better themselves. Like i said, taking in the bad and leaving the good, it is possible to do that with AA. I have plenty of self aware friends that do that. I was open about my lack of belief in all AA meetings i ever attended and it was never a problem. The whole thing a long with the Big Book are most certainly modeled after christian concepts of sin, confession, belief, redemption, etc. Lots of things are cults, politics can be cultish. I didn’t say AA was a perfect silver bullet, but it works for a lot of people and plenty of people use it to just go let off some steam, it’s a free available community of people who understand what it’s like to have drugs and alcohol run their lives. There are better ways to get what is needed to overcome addiction but it’s not always easy to find. I don’t go, I have found the benefits elsewhere so I don’t have to accept the sillier and unfounded tenets of 12 step philosophy. Why didn’t your friend just BS his way through it so he didn’t have to go to jail? There comes a time for pragmatism when the government is screwing you over and threatening to put you in a cage. Anyhow, if it’s a cult it’s very benign, their are no blood oaths and, like anything else you can find the fanatics, but you can find people who don’t treat it so literally and make it work. I hope there are more options for people going forward, but for some it’s better than nothing, the alternatives are dire. It’s not the most psychologically healthy place but for some it’s a launching pad to reforming their lives. I can’t knock that. I can only say I hope they realize that it doesn’t require AA to stay sober and maintain meaning and purpose in life.

          • Hadeskabir

            ” Higher power is super vague and can easily just be associated with the power of the community “. It’s not vague in the 12 step program, It explicitly says God.

            These are 5 the clearly talk about god:

            3-Made a decision to turn our will and our lives over to the care of God as we understood Him.

            5-Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

            6-Were entirely ready to have God remove all these defects of character.

            7-Humbly asked Him to remove our shortcomings.

            11-Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that


            This is one of the 12 traditions of the AA:

            2-For our group purpose there is but one ultimate authority—a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not

            This is not a group where an atheist would be comfortable in, feel accepted in or thinking this will help him.
            Other than that I agree with everything you said.

          • there are atheist and agnostic 12 steps, it can be easily adapted. Taken literally, it is pretty bogus, sure.. I’m not really a defender, I’m just saying it’s better than nothing for some people and MOST AA groups I’ve ever been to have adopted the mentality of higher power being just about anything you want it to be. Having known the hell that often is problematic drinking and substance abuse, if it works for somebody, it’s a good start. The problem I do see with AA is its general acceptance in American culture as the only system that works. While that’s starting to change, it’s still the dominant “solution” people turn to for alcoholism and the reality is it won’t work for everyone, in fact, it won’t work for MANY people. We need to be honest now that there are better and more solutions. The psychological and medical community have taken way to recommending AA almost across the board and that’s a problem

          • Hadeskabir

            They like to sent people to the AA because it’s cheaper than sending them to rehab and treatment.
            The most important thing is that people must be psychologically strong to get rid of their addiction. But that’s a problem, because most people who are addicts are weak in mind. That’s one of the reasons they became addicts.

          • It’s more than cheap it’s free, weak in the mind as in mentally ill? There are plenty of reason addicts become addicts, some of it isn’t entirely in their control as its been seen that it can run in families. That can be due to both genetic and environmental factors. But, just like depression isn’t merely an issue of weak will to overcome, nor is addiction that simple. Most addicts in my experience are also dealing with co-occurring mental health diagnosis as well (ADHD, Bipolar, Depression) etc. It’s a soup of stuff that can make it happen and make it very hard to really find the solutions. And once you are in full blown addict mode, withdrawal symptoms are so hellish that it can fuel the continued use as strongly as just about anything. Nobody wants to go to the hospital to have to admit they need to get off drugs but that’s usually the only safe option if you are abusing heavily. If it was as easy as “buck up and get over it” we wouldn’t have an addiction epidemic in this country.

          • seb

            Send me a link to view anything that supports that claim and i will personally act on it. I dont believe that is true. I’m not interested in hearing more of your opinion so please dont bore me as i wont be reading anything thats not a link.