The Medication Nobody’s Taking

Alcohol kills approximately 178,000 Americans per year — a figure that has risen nearly 30% since 2016. That toll rivals drug overdose deaths. Yet alcohol use disorder (AUD) remains dramatically undertreated: of the more than 29.5 million Americans who had AUD in 2022, fewer than 10% received any form of treatment, and fewer than 3% received medication.

This is not a story about drugs that don’t exist. It’s a story about drugs nobody told people about.

Three Medications. Almost Nobody Knows They Exist.

The FDA has approved three medications for AUD, each with a different mechanism and evidence base.

Naltrexone blocks opioid receptors that are activated when alcohol is consumed, reducing the reward response. Available as a daily oral pill or a monthly injection (Vivitrol). Reduces both the frequency of heavy drinking days and the likelihood of relapse.

Acamprosate restores balance in brain glutamate signaling — disrupted by chronic alcohol exposure — reducing the anxiety and discomfort of early sobriety. Most evidence supports its use for maintaining abstinence.

Disulfiram (Antabuse), the oldest option, causes an unpleasant physical reaction when alcohol is consumed, creating an aversive deterrent. Most effective with observed doses as part of treatment structure.

Why the Gap Persists

Dr. Joseph Schacht, a clinical psychologist at CU Anschutz, identifies the core problem: most people with AUD have never been told these medications exist. Primary care providers often don’t screen for AUD, don’t discuss pharmacotherapy, and may hold the same cultural assumptions as the broader public — that alcohol problems are willpower failures, not medical conditions with evidence-based treatments.

New Brain Research Reframes Recovery

Research published May 22, 2026 in Clinical Neurophysiology used EEG brain-wave analysis combined with machine-learning tensor decomposition in 20 people with alcohol dependence history and 26 healthy controls. Led by Dr. Mica Komarnyckyj at the University of Manchester, the study found that the brain’s error-signaling system — measured by feedback-related negativity — was reduced in people with alcohol dependence regardless of how long they had been abstinent. But a related signal, the feedback-P3, gradually normalized over years. The brain does recover — but on a longer, more complex timeline than the “90 days and you’re healed” framing suggests.

What’s Coming

GLP-1 receptor agonists are in trials for AUD with results expected within 1-2 years. Psilocybin combined with psychotherapy is showing early promise. These are additions to a toolkit that people with AUD overwhelmingly don’t know they have access to.

Why This Matters for People in Recovery

If you or someone you love is dealing with alcohol use disorder, asking your doctor specifically about naltrexone, acamprosate, or disulfiram is a reasonable starting point. Rize Recovery can also help you find treatment providers offering integrated medication and behavioral support for alcohol use disorder in Arizona. Start at rizerecovery.com/find-help.