Three FDA-approved medications reduce cravings, block the rewarding effects of alcohol, and support recovery when combined with therapy. At iRely, MAT is individualized, physician-supervised, and integrated with the full clinical program.
Medication-Assisted Treatment for Alcohol Use Disorder
Call (818) 806-0933 · Available 24/7 · Confidential · No obligation
3FDA-approved medications for alcohol use disorder
50%+reduction in relapse rates when MAT is combined with therapy (NIAAA)
Physician-ledmedication evaluation and management at iRely
IntegratedMAT works alongside CBT, DBT, and all therapeutic modalities
Clinically reviewed by Vinsent Franke, MBA, AMFT, CADC-II, RALast updated June 2026Sources: NIAAA · FDA · SAMHSA · Anton et al. (2006)
What Is Medication-Assisted Treatment for Alcohol?
Medication-assisted treatment (MAT) for alcohol use disorder combines FDA-approved medications with counseling and behavioral therapies to treat AUD as the chronic medical condition it is. The medications used in MAT for alcohol work through different mechanisms: some reduce the rewarding effects of drinking, some reduce craving, and some create an aversive reaction to alcohol. None of them are a substitute for therapy. They work best as part of a comprehensive plan.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) estimates that fewer than 10% of people with AUD who could benefit from medication actually receive it. Stigma, provider unfamiliarity, and the myth that MAT is 'replacing one drug with another' are the main barriers. None of those barriers have a clinical basis.
At iRely, MAT decisions are made by a physician based on the individual’s medical history, withdrawal status, co-occurring conditions, and treatment goals. Not every client is a candidate for every medication, and the clinical team explains the options, evidence, and considerations in plain language before any prescription is written.
The Three FDA-Approved Medications for Alcohol Use Disorder
As of 2026, three medications are FDA-approved specifically for alcohol use disorder. Each works through a different mechanism and suits a different clinical profile.
Naltrexone (Vivitrol)
FDA-ApprovedNaltrexone blocks opioid receptors in the brain that mediate the rewarding and euphoric effects of alcohol. By reducing the pleasure response from drinking, it decreases both craving and the reinforcement that drives continued use. Vivitrol is the extended-release injectable form given once monthly, which removes the need for daily adherence.
Available as daily oral tablet or monthly injection · Requires opioid-free status · Most studied MAT medication for AUD · Evidence: Anton et al. COMBINE study, JAMA 2006
Acamprosate (Campral)
FDA-ApprovedAcamprosate reduces the neurological discomfort of early abstinence by modulating GABA and glutamate activity in the brain. It targets the restlessness, anxiety, and dysphoria that often drive relapse in the first weeks and months of sobriety. It does not affect the reward response the way naltrexone does and is often used when the primary driver of drinking is relief from withdrawal-related discomfort.
Oral tablet, taken three times daily · Most effective when started after detox · Well-tolerated in most clients · Evidence: Mason et al. (2006), multiple RCTs
Disulfiram (Antabuse)
FDA-ApprovedDisulfiram works through aversion: it inhibits the enzyme that breaks down acetaldehyde, a toxic byproduct of alcohol metabolism. Drinking while on disulfiram causes flushing, nausea, vomiting, and significant discomfort. The deterrent effect depends entirely on adherence, making it most useful for clients with high motivation and reliable supervision.
Daily oral tablet · Requires informed consent and medically supervised start · Not recommended for clients with certain cardiac or liver conditions · Best suited for highly motivated, supervised settings
Questions about medication options? Our physicians explain it in plain language.
MAT Works Best When Combined With Therapy
The research on MAT for alcohol use disorder consistently shows that medication combined with behavioral therapy produces better outcomes than either approach alone. This is why iRely never uses MAT in isolation. The medications address the neurobiological side of AUD; therapy addresses the cognitive, behavioral, and emotional drivers.
1
CBT + MAT
Cognitive behavioral therapy targets the thought patterns and triggers behind drinking. Combined with naltrexone or acamprosate, clients address both the behavioral and neurobiological dimensions of AUD.
2
DBT + MAT
For clients with significant emotional dysregulation, DBT skills training alongside MAT builds distress tolerance that reduces the urge to drink as a coping mechanism.
3
Group Therapy + MAT
Peer accountability and shared experience amplify the effects of MAT by adding social reinforcement and practical recovery support to the pharmacological foundation.
For more on the therapeutic side of iRely’s program, see CBT for Alcohol Addiction, DBT for Alcohol, and the alcohol rehab program overview.
Who Is a Candidate for MAT for Alcohol Use Disorder?
MAT is appropriate for a wide range of people with AUD, but not every medication is right for every person. A physician evaluation at iRely considers medical history, co-occurring conditions, prior treatment, and individual goals.
✓
People who have attempted abstinence and relapsed despite motivation and effort.
✓
Clients with strong cravings as the primary driver of drinking.
✓
Those who want to reduce the reinforcing effects of alcohol while in early recovery.
✓
Clients whose drinking is heavily driven by the relief of withdrawal discomfort.
✓
People with a history of severe AUD or multiple prior treatment episodes.
✓
Individuals who prefer the structure of a daily or monthly medication as part of recovery.
✓
Those without contraindications (prior opioid use for naltrexone; liver disease for acamprosate).
✓
Clients motivated to engage with therapy alongside medication.
Contraindications exist for each medication. Naltrexone requires a period of opioid abstinence. Disulfiram is not suitable for clients who cannot commit to supervised adherence. Acamprosate requires monitoring for kidney function. The iRely medical team explains all relevant considerations before any medication is started.
Frequently Asked Questions
Is MAT for alcohol the same as MAT for opioids?
No. The medications used in alcohol MAT (naltrexone, acamprosate, disulfiram) are different from those used in opioid use disorder (buprenorphine, methadone). There is overlap in the case of naltrexone, which is FDA-approved for both conditions and can be useful when AUD and opioid use disorder co-occur. But the medications, mechanisms, dosing protocols, and clinical considerations differ significantly between the two populations.
Is Vivitrol (naltrexone injection) better than the oral form?
For many clients, yes. The monthly Vivitrol injection eliminates daily adherence decisions, which removes a significant vulnerability point. If a client stops taking a daily naltrexone tablet, the medication effect is lost within days. With Vivitrol, the monthly injection provides continuous coverage. The trade-off is cost and the need to be opioid-free for at least 7-10 days before the first injection. iRely physicians discuss both options with each client.
Does MAT mean I will be on medication permanently?
Not necessarily. The duration of MAT for alcohol use disorder is individualized. Some clients use medication for 3-6 months during the highest-risk period of early recovery. Others benefit from longer-term maintenance. The research does not support a universal duration, and the decision is made collaboratively based on clinical response, recovery stability, and client preference.
Can I take these medications if I have liver disease?
Some MAT medications require consideration in the context of liver disease. Naltrexone carries a black box warning for liver toxicity at high doses, though at standard therapeutic doses the risk is low and the benefit often outweighs it. Acamprosate is processed through the kidneys, not the liver, making it a preferred option for clients with significant liver disease. Disulfiram can be hepatotoxic and is generally avoided in clients with active liver disease. The iRely physician evaluates each case individually.
Does insurance cover medication-assisted treatment for alcohol?
Most major insurance plans cover FDA-approved MAT medications for alcohol use disorder under the Mental Health Parity and Addiction Equity Act (MHPAEA). Vivitrol coverage varies by plan. iRely’s insurance verification team can confirm coverage specifics before admission.
Medication Can Change the Biology. Therapy Changes the Rest.
If you have tried to stop drinking and cravings have pulled you back, that is not a willpower problem. It is a neuroscience problem, and there are FDA-approved treatments designed specifically for it. A confidential call with iRely is where to start.
Available 24/7 · Private and confidential · Los Angeles, CA
Sources & References
Anton, R.F., et al. (2006). Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study. JAMA, 295(17), 2003-2017.
Mason, B.J., et al. (2006). A double-blind, placebo-controlled study of oral nalmefene for alcohol dependence. Archives of General Psychiatry.
National Institute on Alcohol Abuse and Alcoholism (NIAAA). Helping Patients Who Drink Too Much: A Clinician's Guide.
Substance Abuse and Mental Health Services Administration (SAMHSA). Medication for the Treatment of Alcohol Use Disorder: A Brief Guide.
U.S. Food and Drug Administration (FDA). FDA-Approved Medications for the Treatment of Opiate Dependence and Alcohol Use Disorder.
