Drugs for alcohol misuse – do they actually work?

Wouldn’t it be wonderful if there was a drug, a pill that would stop you wanting and drinking alcohol? As we all know, changing habitual behaviours is difficult for most of us, especially when it comes to a substance like alcohol. Even though humans have been drinking it for thousands of years, there is still much that we don’t know about how alcohol impacts us, both physically and mentally. Or about what is the best way of quitting or cutting down if your drinking has become a problem.

Please read the important note at the end of this article if you are in any way concerned about your health or your alcohol use!

Drugs for alcohol misuse

Depending on where you live in the world, doctors may prescribe you medicines to help you with your drinking. These vary because different countries have approved and recommend different drugs. There are advocates for all of them, and miraculous stories spread on the internet and in newspapers about how this or that pill is “the one”. From a scientific point of view all such stories may be interesting, but they are not proof that the drugs actually work – either for any one individual or for large numbers of people.

For that proof, doctors need to conduct rigorous studies, testing each drug one at a time, or against each other. And even when one study shows promising results, it is usually not conclusive. There are many reasons: it may only be based on a small number of people (this is often the case), or there may be other factors that have influenced the results. Only when several large, well-conducted studies show the same results, can we be more confident that something actually works as intended.

Sadly, newspaper articles are usually based on the results of single studies. And the more unexpected or unusual the results, the more newsworthy they are – but this also means that they are more likely to be unreliable. We have all read how coffee (or any other thing you can imagine) cures cancer one week, then the next week it will give you a heart attack, and so on. So any such headlines should be taken with considerable caution and skepticism.

Do the drugs work?

A new systematic review of five drugs has recently been in the news (here’s one example). In this review, academics have gathered together all the previous studies they could find, combined the results, and analysed the findings together. This is much more powerful than looking at individual studies on their own, and is considered the highest level of evidence for the efficiency of medicines. The review considered five drugs: Nalmefene, Naltrexone, Acamprosate, Baclofen and Topimarate, and combined the findings of 32 previous studies.

The main conclusion was that there is some limited evidence that some of the drugs may reduce alcohol use by small amounts. But none of them are the miracle drug that will make every user quit drinking. And they may have serious side effects which are still poorly understood. In all studies of this kind, many people disappear before the treatment ends – and obviously it is not known what happened to them: did they give up drinking and go away happy, did they carry on drinking and go away embarrassed, or something else? This factor alone could make the results meaningless.

There are also many other issues that make it difficult to draw firm conclusions from the review (such as different measures used to decide was “success” in reducing drinking meant in different studies). With all these caveats in mind, here’s what the findings were for each of the four drugs being studied:


Nalmefene seems to reduce alcohol use more than a placebo pill, but only by a small amount. But many people stopped the treatment and it is not known how their drinking changed, if at all.


Naltrexone doesn’t seem to lead to any significant reduction in alcohol use.


Naltrexone doesn’t seem to lead to any significant reduction in alcohol use.


Baclofen seems to reduce alcohol use more than a placebo pill, but only by a small amount. And there were only 4 small studies on Baclofen with only 106 patients altogether included in the review, so any conclusions have to be very preliminary.


Topimarate seems to reduce alcohol use more than a placebo pill. But here were only a few small studies on Topimarate included in the review, so the findings are not very reliable. And there are known to be serious side effects.


So what to make of all this? The review concludes that there is no “high-grade evidence” for any of the five drugs. Some of them may well be beneficial for some people in some circumstances, but it doesn’t seem that any of them is the “miracle cure” that they are sometimes described as.

Do talk to your doctor if you are concerned about your alcohol use and feel that you can’t cut down on your own. And if you have been prescribed one of these or any other drug by your doctor, and you have any concerns, please talk to your doctor (see link below to an article on this) – do not stop taking any medications on your own.

IMPORTANT: Club Soda always recommend that you discuss any concerns about your health with your doctor or another qualified medical professional; we are not qualified to give medical advice and nothing in this article should be taken as such either. You may find this article helpful if you are not confident about discussing your alcohol use with your doctor. Please also note that if you have been drinking alcohol every day for a long time, it may be dangerous to stop drinking on your own, as you may need medical care for any withdrawal symptoms.

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