Acamprosate for Addiction Treatment

Acamprosate for Alcohol Recovery

In 2019, the National Institute on Alcohol Abuse and Alcoholism reported that approximately 14.5 million adults have some type of alcohol use disorder. Adolescents are at risk for alcoholism as well. The reports show that an estimated 414,000 adolescents between 12 and 17 years old also struggle with alcohol use disorder.

Treatment numbers for those who live with alcoholism are significantly lower compared to the number of people who report signs of alcohol use disorder. In 2019, less than 8% of adults and adolescents received treatment in the past 12 months.

Treatment for Alcohol Use Disorder

Treatment for alcohol and drug use has evolved significantly in recent decades. As a result, the therapeutic approaches are proving much more successful. Most people who use alcohol on more than a social basis have underlying emotional issues that they mask with alcohol. This type of self-medication replaces the challenges of not having adequate coping skills for trauma, stress, and other challenging life experiences.

Counseling, clinical support, and medications provide those in recovery from alcohol use disorder with the comprehensive support they need to remain committed to a journey of sobriety. Unfortunately, alcohol withdrawal symptoms can be difficult enough to prevent a person from pursuing and completing treatment.

Alcohol Withdrawal

Alcohol withdrawal is a condition that emerges soon after a person stops consuming alcohol. When a person drinks heavily for several weeks, months, or years, the body becomes accustomed to the presence of alcohol. As a result, the physiological functions within the body adapt and change. Once the alcohol is removed from the system, the body has to readjust. This can cause a range of symptoms.

Symptoms of Alcohol Withdrawal

For a person with alcohol use disorder, symptoms of alcohol withdrawal can begin in as little as six hours after they have their last drink. The symptoms may last up to three days, or longer in some cases.

Initial Symptoms of Alcohol Withdrawal

Approximately six hours to 12 hours after consuming alcohol, a person with alcohol use disorder may experience:

• Nausea and vomiting
• Shaking and tremors
• Headaches
• Sweating
• Anxiety

Intermediate Symptoms of Alcohol Withdrawal

Twelve to 48 hours after consuming alcohol, a person with alcohol use disorder may experience:

• Hallucinations
• Seizures
• Hearing noises that don’t exist
• Difficulty sleeping

Advanced Symptoms of Alcohol Withdrawal

After two days without consuming alcohol, a person with alcohol use disorder may experience additional symptoms for another 24 hours or longer, such as:

• High blood pressure
• Racing heart
• Extreme sweating
• Fever
• Confusion

What Is Campral Used For?

Campral (acamprosate) is a medication that is used in conjunction with clinical support and counseling for those who are living with alcohol use disorder. It helps during detox by balancing the brain as alcohol is eliminated from the body. The medication will not help if you are still drinking, so it is most effective while you are going through detox and rehab.

Campral vs. Antabuse

Campral and Antabuse are two medications that are used to help people who are in treatment for alcohol use. The primary benefit of Campral is that it reduces your cravings for alcohol. However, it does not help to prevent symptoms of withdrawal. Antabuse may be the preferred medication for your treatment, but it does have some downsides to consider. Specifically, if you consume alcohol while using Antabuse, expect to have some severe reactions. Consumption includes taking any food products or medications that contain alcohol.

What Type of Drug Is Campral?

Campral is a prototypic neuromodulator that contains calcium acetylhomotaurinate, a synthetic substance that mimics natural amino acids in the body. After leaving the gastrointestinal tract, the medication reaches the brain where it helps to compensate for chemical imbalances caused by chronic alcohol use.

What Does Campral Do in the Body?

Cravings are linked to chemical imbalances in the brain that are caused by chronic alcohol and drug use. The active ingredients in Campral help to rebalance these chemical levels to reduce cravings. Although Campral does not prevent withdrawal symptoms, reducing cravings is an important part of the detox and effective treatment.

Side Effects of Campral

Some people who take Campral as part of a comprehensive therapeutic approach to alcohol use treatment do experience unwanted side effects, such as:

• Poor appetite
• GI problems (nausea, diarrhea, vomiting, flatulence, and constipation)
• Dizziness
• Feeling tired or exhausted
• Stomach aches and cramping
• Decreased libido
• Changes in weight
• Mood changes such as depression and suicidal thoughts
• Problems urinating or changes in urine color
• Disruptions with hearing and sight
• Rapid heartbeat
• Fainting
• Blood in stool or vomit

Managing Side Effects of Campral

Having side effects of Campral may disrupt your journey to sobriety, so you should discuss any new symptoms with your clinician or counselor. The dosing may need to be adjusted. Your clinician may also prescribe medications to counteract the side effects. It is best to discuss these concerns sooner rather than later.

How to Use Campral

Most people do not need Campral for the rest of their lives. When combined with effective counseling and clinical support for alcohol use disorder, Campral is typically only needed for about 12 months. Dosing is based on several factors, but most people take the medication three times a day. If you drink alcohol while taking Campral, continue taking the medication as prescribed. Your doctor will work with you to determine when you no longer need the medication as well as the best way to stop using it.

What to Expect From Campral

When it comes to Campral as part of a comprehensive rehab treatment plan, it is more about what you don’t experience during recovery. As with any type of craving, your brain eventually adapts to the presence of alcohol as part of your normal functioning.

Science of Cravings

When you transitioned from being someone who occasionally enjoyed an alcoholic beverage to someone who uses alcohol as a coping mechanism, your brain started to learn a new association. Perhaps you went through a difficult time in life that brought about grief, depression, fear, or anxiety. You may have had a traumatic experience. As you use alcohol to avoid these difficult emotions, new neuropathways form in your brain. Each time you feel those same emotions, your brain triggers you to drink. This is the science behind cravings.

Campral Rewires the Brain

People who use Campral during recovery find that they no longer experience those negative emotions. The additional support of a clinician and counselor teaches your brain a different way to respond to those emotions. This is why it is recommended that you take Campral for at least 12 months. It takes time for your brain to rewire and build neuropathways that lead to healthier choices. Working with your clinician to manage any side effects is important because you want the experience of recovery to be positive.

Is Campral Alone Enough to Recover from Alcoholism?

Although Campral is an effective medication that helps reduce cravings, it’s important to remember that you started abusing alcohol for a reason. It may have been an unconscious choice, but something triggered you to drink more than occasionally. Campral is intended to be another tool available to you that supports the process of addressing those underlying factors so you can learn new coping skills.

Limitations of Campral for Alcohol Use Disorder

The National Library of Medicine published a study that compared the three primary medications for alcohol use disorder: Campral, Antabuse (disulfiram), and Vivitrol/Revia (naltrexone). Each of these medications is approved by the FDA, but each works in a different way to help people recovering from alcoholism. Campral rebalances chemicals in the brain to reduce cravings. Antabuse works on an aversion basis by producing unpleasant physical reactions when a person consumes alcohol while taking the medication. Naltrexone blocks certain receptors in the brain to reduce any learned association with the consumption of alcohol.

One limitation of Campral is that it may not be as effective for people with alcohol use disorder who engage in heavy drinking. According to the study, naltrexone may be a better medication. The results show that naltrexone reduced heavy drinking in 83% of participants, and there was a 4% decrease in the number of days that the participants consumed alcohol. In general, heavy drinking for men is defined as having at least 15 alcoholic beverages per week. For women, heavy drinking is defined as having eight or more alcoholic beverages per week.

Using Campral in Conjunction With Other Medications

Some research for alcohol use disorder has been conducted to study the effects of using Campral in conjunction with other medications for alcohol use disorder. Although limited, the results of the study reveal that using Campral and naltrexone may be a viable and effective option for some people in alcohol recovery. Adverse reactions were rare, but you should discuss the potential with your clinician. The most common unwanted side effects were nausea and diarrhea.

Researchers believe that it is the dual approach of these medications that contributes to positive results for those going through treatment. Both medications help the brain rewire as part of the recovery process. Campral helps to reduce cravings, and naltrexone helps to change the association with alcohol consumption. The two-pronged approach to medication support during recovery may enhance outcomes and help a person stay committed to the journey of recovery from an alcohol use disorder.

Another study was conducted to determine if combining Campral and Antabuse produced better outcomes for people in recovery. After one year, 73% of the participants who were given Antabuse and Campral did not consume alcohol. Only 43% of participants who used Antabuse alone reported no alcohol consumption. This study demonstrates that the combination of reducing cravings and increasing aversion to alcohol may produce higher benefits than using one medication alone.

Is Campral Right for You?

If you are considering rehab for alcoholism or Campral to reduce your cravings, discuss the option with your recovery team. Your clinician may require a thorough physical exam, blood tests, and a review of your medical history. Also, be prepared to discuss any other medications that you are taking. The information provides your doctor with insights that are used to determine if Campral is right for you.

Should Everyone Use Campral for Alcohol Rehab?

The benefits of Campral are still being studied, and little research has been conducted into the usefulness of the medication for adolescents, older patients, and women who are pregnant. If Campral is not the best option for your recovery, your clinician may recommend other medications to support your path to sobriety.

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Reviewed By:

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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