Comparison
Naltrexone vs Disulfiram (Antabuse)
By Naltrexone Reviews Editorial TeamUpdated 19 sourcesHow we check
On this page
Short answer
Naltrexone blocks part of the reward from drinking and causes no reaction if you drink. Disulfiram (Antabuse) makes you sick if you drink, so it helps only if taken, ideally with someone watching; it beat placebo in open-label trials but not blinded ones.1-4 Both US guidelines rate naltrexone higher for alcohol use disorder.5,6
Naltrexone
A daily pill, or a monthly shot
Disulfiram
Antabuse, a daily pill
Head to headBoth US guidelines rate naltrexone higher for alcohol use disorder.5,6
Key takeaways
- A disulfiram reaction can happen up to 14 days after the last tablet, and alcohol hidden in sauces, cough syrups and aftershave counts.3
- In head-to-head trials where patients knew which drug they had, disulfiram came out ahead on drinking outcomes. In one of them, craving was lower on naltrexone.4,7
- Disulfiram is meant for people aiming not to drink at all. The APA recommendation for naltrexone also covers cutting down.5,6
- Combining them added nothing in a 254-person VA trial, and the naltrexone label advises against pairing two drugs that can harm the liver unless the benefit outweighs the risk.2,8
Side by side
| Attribute | Naltrexone | Disulfiram |
|---|---|---|
| FDA-approved use | Alcohol dependence; also blocking the effects of opioids2 | An aid for people with chronic alcohol problems "who want to remain in a state of enforced sobriety"3 |
| How it works | Blocks opioid receptors involved in the reward from drinking1 | Stops the breakdown of alcohol, so acetaldehyde builds up after a drink3 |
| Forms and dose | One 50 mg tablet a day, or a 380 mg shot once a month (Vivitrol)2,9 | Tablets only: up to 500 mg a day for 1 to 2 weeks, then usually 250 mg (range 125 to 500 mg)3 |
| Before the first dose | No short-acting opioids for at least 7 to 10 days; tablets can be started while still drinking1,2 | At least 12 hours without alcohol3 |
| If you drink | No sickness reaction2 | Flushing, vomiting and a pounding heart; severe reactions can kill3 |
| Supervised doses | No supervision requirement in the label2 | Did best in trials where someone watched each dose4 |
| Liver | Warning for hepatitis; risk may be higher with single doses above 50 mg2 | Warning for hepatitis, including liver failure leading to transplant or death3 |
| Brand status | ReVia brand discontinued; generics marketed10 | Antabuse brand discontinued; generics marketed11 |
Side by side
FDA-approved use
How it works
Forms and dose
- Disulfiram
- Tablets only: up to 500 mg a day for 1 to 2 weeks, then usually 250 mg (range 125 to 500 mg)3
Before the first dose
If you drink
Supervised doses
Liver
Brand status
Which one suits your situation
The table draws on the labels, the American Psychiatric Association (APA), the VA/DoD guideline and NICE, England's guideline body. Take it to your prescriber.
| Your situation | Usually the better fit | What the sources say |
|---|---|---|
| You want to cut down, not stop | Naltrexone | The APA recommendation for naltrexone covers reducing drinking or stopping; its disulfiram suggestion is limited to people aiming for abstinence. The VA/DoD says disulfiram should be used only when abstinence is the goal.5,6 |
| You want to stop completely, and a partner, relative or clinic can watch you take each dose | Either; this is where disulfiram has its best results | In the 2014 meta-analysis, disulfiram's effect was large in open-label trials with supervised doses and not statistically significant without supervision.4 The VA/DoD calls it most appropriate for highly motivated people willing to have doses observed.6 |
| You are still drinking and can't go 12 hours without alcohol first | Naltrexone tablets | Disulfiram must not be started until 12 hours after the last drink; NICE says 24 hours. Naltrexone tablets can be started while someone is still drinking.1,3,12 |
| You take opioids, are on methadone or buprenorphine, or may need opioid pain medicine | Disulfiram | Naltrexone is ruled out in all of these.2,5 Opioids are not on disulfiram's list of contraindications.3 |
| Severe heart disease or a blocked coronary artery | Naltrexone | Disulfiram is contraindicated. A severe reaction can cause heart rhythm problems, a heart attack or heart failure.3 |
| A history of psychosis | Naltrexone | Disulfiram is contraindicated in psychoses.3 |
| Diabetes, epilepsy, an underactive thyroid or past brain damage | Naltrexone, as a rule | The disulfiram label calls for extreme caution in these conditions because an accidental reaction would be riskier.3 |
| Liver disease | Neither is simple; ask about acamprosate | Disulfiram needs extreme caution with cirrhosis or liver failure.3 Exposure to naltrexone is about 5 to 10 times higher in cirrhosis, and the APA recommends against naltrexone in acute hepatitis or liver failure.2,5 The VA/DoD says acamprosate may be preferable with liver disease.6 |
| You take metronidazole, or medicines that contain alcohol | Naltrexone | Disulfiram is contraindicated with metronidazole, paraldehyde and alcohol-containing products such as some cough syrups and tonics.3 |
| Allergy to thiurams, chemicals used in rubber and pesticides | Naltrexone | Disulfiram is contraindicated with this allergy, and people with a history of rubber contact dermatitis should be checked for it first.3 |
| You often skip pills | The monthly Vivitrol shot, or disulfiram handed to you by someone else | The VA/DoD says to consider the shot when sticking to medication is a significant concern.6 The disulfiram label says a patient who drinks with no reaction should be presumed not to be taking the tablets.3 |
| Pregnant or breastfeeding | Neither, as a rule | The APA recommends against medicines for alcohol use disorder in pregnancy or breastfeeding, except to treat withdrawal or a co-occurring condition.5 Disulfiram's label says not to give it while breastfeeding; naltrexone's advises caution. Both say safety in pregnancy is not established or not well studied.2,3 |
Which one suits your situation
Your situation: You want to cut down, not stop
- Usually the better fit
- Naltrexone
Your situation: You want to stop completely, and a partner, relative or clinic can watch you take each dose
- Usually the better fit
- Either; this is where disulfiram has its best results
Your situation: You are still drinking and can't go 12 hours without alcohol first
- Usually the better fit
- Naltrexone tablets
Your situation: You take opioids, are on methadone or buprenorphine, or may need opioid pain medicine
- Usually the better fit
- Disulfiram
Your situation: Severe heart disease or a blocked coronary artery
- Usually the better fit
- Naltrexone
- What the sources say
- Disulfiram is contraindicated. A severe reaction can cause heart rhythm problems, a heart attack or heart failure.3
Your situation: A history of psychosis
- Usually the better fit
- Naltrexone
- What the sources say
- Disulfiram is contraindicated in psychoses.3
Your situation: Diabetes, epilepsy, an underactive thyroid or past brain damage
- Usually the better fit
- Naltrexone, as a rule
- What the sources say
- The disulfiram label calls for extreme caution in these conditions because an accidental reaction would be riskier.3
Your situation: Liver disease
- Usually the better fit
- Neither is simple; ask about acamprosate
- What the sources say
- Disulfiram needs extreme caution with cirrhosis or liver failure.3 Exposure to naltrexone is about 5 to 10 times higher in cirrhosis, and the APA recommends against naltrexone in acute hepatitis or liver failure.2,5 The VA/DoD says acamprosate may be preferable with liver disease.6
Your situation: You take metronidazole, or medicines that contain alcohol
- Usually the better fit
- Naltrexone
- What the sources say
- Disulfiram is contraindicated with metronidazole, paraldehyde and alcohol-containing products such as some cough syrups and tonics.3
Your situation: Allergy to thiurams, chemicals used in rubber and pesticides
- Usually the better fit
- Naltrexone
- What the sources say
- Disulfiram is contraindicated with this allergy, and people with a history of rubber contact dermatitis should be checked for it first.3
Your situation: You often skip pills
- Usually the better fit
- The monthly Vivitrol shot, or disulfiram handed to you by someone else
Your situation: Pregnant or breastfeeding
- Usually the better fit
- Neither, as a rule
- What the sources say
- The APA recommends against medicines for alcohol use disorder in pregnancy or breastfeeding, except to treat withdrawal or a co-occurring condition.5 Disulfiram's label says not to give it while breastfeeding; naltrexone's advises caution. Both say safety in pregnancy is not established or not well studied.2,3
Naltrexone blocks reward; disulfiram works through the threat of a reaction
Naltrexone is a pure opioid antagonist with no opioid effects of its own.2 It blocks opioid receptors in the brain involved in the rewarding effects of alcohol.1 Exactly how that reduces drinking is not understood, and it is not an aversive drug: alcohol doesn't make you sick on it.2
Disulfiram stops the body's breakdown of alcohol at the acetaldehyde stage. After a drink, blood acetaldehyde can reach 5 to 10 times its usual level, and that causes the reaction. The longer someone takes it, the more sensitive to alcohol they become.3 According to the VA/DoD guideline, the drug works through the patient's expectation of that reaction, which tips the decision toward not drinking.6
Pooled trials favor disulfiram only when patients knew they were taking it
For disulfiram, the result depends on whether a trial was blinded, meaning no one knew who got the real drug. A 2014 meta-analysis pooled 22 randomized trials with 2,414 people, 89% of them men4:
- Open-label trials (patients knew they had disulfiram): disulfiram did better than the comparison group, an effect size of 0.70, which the authors call medium.
- Blinded trials: no difference (effect size 0.01).
- Open-label trials with supervised doses: 0.82, a large effect. Without supervision: 0.26, not statistically significant.
The authors' explanation is that in a blinded trial, everyone thinks they might be on disulfiram, so the fear of a reaction is spread across all groups. They also suggest that a partner or clinic watching the doses adds support, which may improve results by itself.4
The largest trial, a 1986 Veterans Administration (VA) study, was partly blinded. Its 605 men received counseling plus 250 mg of disulfiram, a 1 mg dose that carried the threat but not the drug effect, or no disulfiram, for a year. Total abstinence and time to first drink did not differ, even between 250 mg and no disulfiram, the comparison patients could see.4,13 Among men who drank and completed every assessment, those on 250 mg drank on fewer days: 49.0, against 75.4 on 1 mg and 86.5 on none.13
The 2023 review for the federal Agency for Healthcare Research and Quality (AHRQ) found no new disulfiram trials since its 2014 edition and concluded that limited evidence from well-controlled trials "does not adequately support the efficacy of disulfiram compared with placebo." The same review rated the evidence for 50 mg naltrexone tablets as moderate strength, with 11 people needing treatment for 1 to avoid a return to heavy drinking.14 A 2011 review of 11 trials with 1,527 patients found supervised disulfiram had some effect on short-term abstinence, and its long-term effect had not been evaluated.15 For naltrexone's own trial record, see does naltrexone work?
Head to head, disulfiram led in open-label trials
| Trial | Who, and for how long | Result |
|---|---|---|
| De Sousa, 2004 (open-label) | 100 men in an Indian city, each with a family member at follow-up visits; 1 year | Relapse came at 119 days on average with disulfiram vs 63 with naltrexone; 86% vs 44% stayed abstinent all year. Craving was lower on naltrexone.7 |
| Laaksonen, 2008 (open-label) | 243 outpatients, randomized to disulfiram, naltrexone or acamprosate; 12 weeks of supervised doses, then targeted use up to 52 weeks, unlike the daily dosing in both US labels2,3 | In the supervised phase, disulfiram did better on heavy drinking days, weekly intake, time to first drink and abstinent days. In the targeted phase, only abstinent days still favored it.16 |
| Petrakis, 2005 (disulfiram open-label, naltrexone blinded) | 254 patients at three VA clinics, each with a psychiatric disorder plus alcohol dependence; 12 weeks | People on either medicine had more consecutive weeks of abstinence and less craving than on placebo, with no other differences in drinking.8 |
| Pettinati, 2008 (double-blind) | 208 people dependent on both cocaine and alcohol; 11 weeks | No medicine beat placebo on the main outcomes. People taking disulfiram, alone or with naltrexone, were the most likely to stop both cocaine and alcohol.17 |
Head to head, disulfiram led in open-label trials
Trial: De Sousa, 2004 (open-label)
- Who, and for how long
- 100 men in an Indian city, each with a family member at follow-up visits; 1 year
- Result
- Relapse came at 119 days on average with disulfiram vs 63 with naltrexone; 86% vs 44% stayed abstinent all year. Craving was lower on naltrexone.7
Trial: Laaksonen, 2008 (open-label)
- Who, and for how long
- 243 outpatients, randomized to disulfiram, naltrexone or acamprosate; 12 weeks of supervised doses, then targeted use up to 52 weeks, unlike the daily dosing in both US labels2,3
- Result
- In the supervised phase, disulfiram did better on heavy drinking days, weekly intake, time to first drink and abstinent days. In the targeted phase, only abstinent days still favored it.16
Trial: Petrakis, 2005 (disulfiram open-label, naltrexone blinded)
- Who, and for how long
- 254 patients at three VA clinics, each with a psychiatric disorder plus alcohol dependence; 12 weeks
- Result
- People on either medicine had more consecutive weeks of abstinence and less craving than on placebo, with no other differences in drinking.8
Trial: Pettinati, 2008 (double-blind)
- Who, and for how long
- 208 people dependent on both cocaine and alcohol; 11 weeks
- Result
- No medicine beat placebo on the main outcomes. People taking disulfiram, alone or with naltrexone, were the most likely to stop both cocaine and alcohol.17
The 2014 meta-analysis pooled 9 open-label comparisons of disulfiram with naltrexone, including the first three trials above, and found disulfiram ahead (effect size 0.77).4 Three of the 9 were Indian trials in which family members supervised doses, and the authors note there was no way to verify that supervision.4
Drinking on disulfiram can make you seriously ill
Even small amounts of alcohol on disulfiram cause flushing, a throbbing headache, nausea, heavy vomiting, sweating, chest pain, a racing heart, low blood pressure and fainting. Severe reactions can bring breathing problems, heart rhythm problems, a heart attack, heart failure, seizures and death. A reaction lasts from 30 to 60 minutes to several hours, or as long as alcohol stays in the blood.3
Hidden alcohol counts. Sauces, vinegars, cough mixtures, aftershave lotions and back rubs can contain enough to set off a reaction, which can occur up to 14 days after the last tablet.3 NICE adds perfume and aerosol sprays.12 The label suggests carrying a card that says you take disulfiram and whom to call in an emergency.3
Disulfiram must never be given to someone who is drunk or who doesn't know they are taking it. Its boxed warning tells physicians to make sure relatives understand this, and giving it without the patient's full knowledge can cause serious complications.3
Naltrexone's own rules for alcohol, including the limits for liver disease and opioids, are on drinking on naltrexone.
Both carry liver warnings; disulfiram adds heart and nerve risks
Disulfiram. It is ruled out with severe heart disease or a blocked coronary artery, because a severe reaction can cause a heart attack.3 Liver injury has been reported, including liver failure leading to transplant or death. Severe hepatitis can appear even after many months, in people with or without past liver problems. Liver tests are suggested before starting and again at 10 to 14 days, along with blood counts and blood chemistry. Report fatigue, weakness, loss of appetite, nausea, vomiting, yellow skin or eyes, or dark urine right away.3
Other warnings on the disulfiram label: inflammation of the optic and peripheral nerves; psychotic reactions, mostly with high doses, drug interactions or an underlying psychosis; and interactions with phenytoin, blood thinners taken by mouth and isoniazid. In the first 2 weeks, a few people get drowsiness, tiredness, headache, impotence, an acne-like rash or a metallic or garlic-like aftertaste, which usually fades.3 In the 2014 meta-analysis, adverse events were 40% more frequent on disulfiram than in control groups, with no difference in deaths or serious events needing hospital care.4
Naltrexone. Its label warns of hepatitis and liver dysfunction, with a possibly higher risk of liver injury from single doses above 50 mg. Anyone with opioids in their system can go into sudden withdrawal when they take it. After stopping, an opioid dose a person once tolerated can be fatal.2 See the opioid and overdose warnings, the full list of naltrexone side effects, and how often each drug turned up in a US liver-injury registry on naltrexone and your liver.
Taking both is not ordinarily recommended
The naltrexone label says the safety and efficacy of taking it with disulfiram are unknown, and that combining "two potentially hepatotoxic medications is not ordinarily recommended unless the probable benefits outweigh the known risks."2
In the 254-person VA trial, the combination did no better than either drug alone.8 In the cocaine-and-alcohol trial, the combination group was the most likely to reach 3 weeks in a row without cocaine or alcohol, but that was a secondary outcome, and no group beat placebo on the main ones.17 Whether to combine them is a decision for a prescriber.
The Antabuse brand is discontinued; generic disulfiram is sold
Antabuse was first approved in 1951. FDA's Drugs@FDA database now lists the brand as discontinued, with a Federal Register determination that it was not withdrawn for safety or effectiveness reasons. Generic disulfiram tablets from three makers are listed as marketed prescription drugs: Alvogen (250 mg), Chartwell and Sigmapharm (250 and 500 mg).11 The first naltrexone brand, ReVia, is also listed as discontinued, and generic naltrexone tablets are marketed.10
Guidelines put naltrexone first
The APA recommends naltrexone or acamprosate (grade 1B). It suggests disulfiram (grade 2C) for people aiming for abstinence who prefer it or haven't done well on those two, understand the risks of drinking on it, and have no contraindications.5 The VA/DoD rates naltrexone "Strong for" and disulfiram "Weak for."6 NICE says to consider disulfiram after withdrawal, together with psychological treatment, for people aiming for abstinence when acamprosate and naltrexone don't suit them, or who prefer disulfiram.12 The full comparison is in the guideline table on the AUD page. Acamprosate, off-label topiramate and gabapentin, and the other medicines for alcohol use disorder are compared on one page.
Coverage favors naltrexone
Medicaid coverage favors naltrexone: in 2023, 49 of 53 fee-for-service programs covered the tablets and 35 covered disulfiram.18 What the online programs charge is on the naltrexone cost page.
Share your experience
Have you taken disulfiram, naltrexone or both? Tell us what happened, or read other people's naltrexone reviews.
Frequently asked questions
Which works better, naltrexone or Antabuse?
In open-label trials, where patients knew their drug, disulfiram did better than naltrexone. In blinded trials, disulfiram did no better than placebo. See the evidence.4
Is Antabuse still available?
The Antabuse brand is listed as discontinued, but generic disulfiram tablets are still marketed in the US.11
How long after stopping disulfiram can I drink?
The label warns that a reaction can occur up to 14 days after the last dose. Ask your prescriber before drinking.3
Which is better for cravings?
In one open-label trial, craving was lower on naltrexone, even though more people stayed abstinent on disulfiram.7
Can you drink on naltrexone?
It causes no sickness reaction with alcohol, unlike disulfiram. See drinking on naltrexone.2
How we checked
- Sources include the current DailyMed labels for disulfiram, naltrexone tablets and Vivitrol, Drugs@FDA records, the 2014 disulfiram meta-analysis (full text), a 2011 review, trial abstracts, the 2023 AHRQ review, and the APA, VA/DoD and NICE guidelines.2-6,9,11,12,14,15
- The head-to-head table counts 4 trials; 3 also sit in the meta-analysis and are not counted twice.
- Each figure was checked against the saved files on October 17, 2026.
Programs that prescribe naltrexone
To compare online programs that prescribe naltrexone for alcohol, with posted prices, see where to get naltrexone online.
Related guides
References
19 sources, numbered in the order they are first cited (AMA style). Each is labelled by type so you can weigh it; commercial and media sources are never the only support for a clinical claim.
- 1.Recommend evidence-based treatment: know the options. In: Core Resource on Alcohol. National Institute on Alcohol Abuse and Alcoholism. Revised May 8, 2025. Accessed October 17, 2026. https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/recommend-evidence-based-treatment-know-optionsGovernment source
- 2.Naltrexone hydrochloride tablets USP, 50 mg. Prescribing information. SpecGx LLC; revised May 2026. DailyMed SPL version 15. Accessed October 17, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=06ff2d5a-e62b-4fa4-bbdb-01938535bc65FDA drug label
- 3.Disulfiram tablets USP, 250 mg. Prescribing information. Alvogen, Inc.; revised December 2025. DailyMed SPL version 16. Accessed October 17, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b90f8ff4-4fb3-46ab-8149-cb55f24a4044FDA drug label
- 4.Skinner MD, Lahmek P, Pham H, Aubin HJ. Disulfiram efficacy in the treatment of alcohol dependence: a meta-analysis. PLoS One. 2014;9(2):e87366. doi:10.1371/journal.pone.0087366Systematic review / meta-analysis · Our summary of this study
- 5.American Psychiatric Association. Guideline statement summary. In: The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder. American Psychiatric Association Publishing; 2018. Accessed October 17, 2026. doi:10.1176/appi.books.9781615371969Clinical guideline
- 6.US Department of Veterans Affairs; US Department of Defense. VA/DoD Clinical Practice Guideline for the Management of Substance Use Disorders. Version 5.0. 2021. Accessed October 17, 2026. https://www.healthquality.va.gov/HEALTHQUALITY/guidelines/MH/sud/VA-DoD-SUD-CPG_Final_for-508_v3.pdfClinical guideline
- 7.De Sousa A, De Sousa A. A one-year pragmatic trial of naltrexone vs disulfiram in the treatment of alcohol dependence. Alcohol Alcohol. 2004;39(6):528-531. doi:10.1093/alcalc/agh104Randomized controlled trial · Our summary of this study
- 8.Petrakis IL, Poling J, Levinson C, et al; VA New England VISN I MIRECC Study Group. Naltrexone and disulfiram in patients with alcohol dependence and comorbid psychiatric disorders. Biol Psychiatry. 2005;57(10):1128-1137. doi:10.1016/j.biopsych.2005.02.016Randomized controlled trial · Our summary of this study
- 9.Vivitrol (naltrexone for extended-release injectable suspension). Prescribing information. Alkermes, Inc.; revised May 2026. DailyMed SPL version 39. Accessed October 17, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=cd11c435-b0f0-4bb9-ae78-60f101f3703fFDA drug label
- 10.Drugs@FDA application records for naltrexone products (including NDA 018932, NDA 021897 and ANDA 213195). openFDA. US Food and Drug Administration. Accessed October 17, 2026. https://api.fda.gov/drug/drugsfda.json?search=products.active_ingredients.name:"NALTREXONE"&limit=100Government source
- 11.Drugs@FDA application records for disulfiram products (including NDA 007883, ANDA 091563, ANDA 091619 and ANDA 091681). openFDA. US Food and Drug Administration. Accessed October 17, 2026. https://api.fda.gov/drug/drugsfda.json?search=products.active_ingredients.name:%22DISULFIRAM%22&limit=100Government source
- 12.National Institute for Health and Care Excellence. Alcohol-Use Disorders: Diagnosis, Assessment and Management of Harmful Drinking (High-Risk Drinking) and Alcohol Dependence. Clinical guideline CG115. Published February 23, 2011. Updated October 21, 2014. Accessed October 17, 2026. https://www.nice.org.uk/guidance/cg115/chapter/RecommendationsClinical guideline
- 13.Fuller RK, Branchey L, Brightwell DR, et al. Disulfiram treatment of alcoholism: a Veterans Administration cooperative study. JAMA. 1986;256(11):1449-1455. doi:10.1001/jama.1986.03380110055026Randomized controlled trial · Our summary of this study
- 14.McPheeters M, O'Connor EA, Riley S, et al. Pharmacotherapy for Adults With Alcohol Use Disorder in Outpatient Settings: Systematic Review. Executive summary. Comparative Effectiveness Review No. 262. AHRQ Publication No. 23(24)-EHC011. Agency for Healthcare Research and Quality; November 2023. Accessed October 17, 2026. doi:10.23970/AHRQEPCCER262Systematic review / meta-analysis · Our summary of this study
- 15.Jørgensen CH, Pedersen B, Tønnesen H. The efficacy of disulfiram for the treatment of alcohol use disorder. Alcohol Clin Exp Res. 2011;35(10):1749-1758. doi:10.1111/j.1530-0277.2011.01523.xSystematic review / meta-analysis · Our summary of this study
- 16.Laaksonen E, Koski-Jännes A, Salaspuro M, Ahtinen H, Alho H. A randomized, multicentre, open-label, comparative trial of disulfiram, naltrexone and acamprosate in the treatment of alcohol dependence. Alcohol Alcohol. 2008;43(1):53-61. doi:10.1093/alcalc/agm136Randomized controlled trial · Our summary of this study
- 17.Pettinati HM, Kampman KM, Lynch KG, et al. A double blind, placebo-controlled trial that combines disulfiram and naltrexone for treating co-occurring cocaine and alcohol dependence. Addict Behav. 2008;33(5):651-667. doi:10.1016/j.addbeh.2007.11.011Randomized controlled trial · Our summary of this study
- 18.Substance Abuse and Mental Health Services Administration. Medicaid Coverage of Medications to Reverse Opioid Overdose and Treat Alcohol and Opioid Use Disorders. HHS Publication No. PEP22-06-01-009. SAMHSA; 2024. Accessed October 17, 2026. https://www.govinfo.gov/content/pkg/GOVPUB-HE20_400-PURL-gpo222769/pdf/GOVPUB-HE20_400-PURL-gpo222769.pdfGovernment source · Coverage data are from 2023.
- 19.SAMHSA's National Helpline. Substance Abuse and Mental Health Services Administration. Updated June 9, 2023. Accessed October 17, 2026. https://www.samhsa.gov/find-help/helplines/national-helplineGovernment source
Medical disclaimer
This page is for general information only and is not medical advice. It does not replace advice from your own clinician or pharmacist. Don't start, stop or change a medicine without talking to your prescriber. If you drink heavily every day, stopping suddenly can be dangerous; get medical advice first. If you use opioids, starting naltrexone in either form can cause sudden, severe withdrawal. For free, confidential treatment referrals 24 hours a day, call SAMHSA's National Helpline at 1-800-662-4357.19
Full medical disclaimer.