Anti-craving medication / pharmacotherapy

What is anti-craving medication?

Anti-craving medications are prescription medicines that can help people reduce cravings or stay off a substance, most commonly alcohol. They work in different ways: some reduce the urge to drink, some block the pleasant effects, and one causes an unpleasant reaction if you drink, to support a decision to stay abstinent.

The most important point is that these medicines are an adjunct, a helper, alongside psychological and social support. They are not a magic bullet and are not meant to be used on their own. UK guidance (NICE) recommends them in combination with talking therapy or structured support, and usually after a successful withdrawal (detox).

For alcohol, the main medicines are acamprosate and naltrexone (which reduce craving or block alcohol's effects), disulfiram (which causes an unpleasant reaction if you drink), and nalmefene (used to help cut down in some people). There are also medicines for opioid dependence, such as buprenorphine and methadone, and naltrexone after opioid detox. Which, if any, suits you depends on the substance, your goals and your health, and needs a proper medical assessment.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Common alcohol medicines at a glance

All of these work best alongside psychological and social support, not on their own. The right choice depends on your goals, your health and specialist advice.

Preparing for your treatment

• Have a full medical assessment, including blood tests for liver and kidney function, before starting (especially for acamprosate, naltrexone or disulfiram).
• Be honest about how much you drink or use and your goals (stopping completely or cutting down), as this guides the choice.
• Tell your clinician about all your medicines, including painkillers; naltrexone interacts with opioid medicines.
• Mention liver, kidney, heart or mental health problems and any pregnancy or breastfeeding.
• Understand that, for most, a detox usually comes first and that medication is part of a wider plan with support.
• Save crisis numbers in your phone: 999 for emergencies and Samaritans 116 123. For urgent but non-emergency advice, use NHS 111 in England, Scotland or Wales; in Northern Ireland, contact your GP out-of-hours service or your HSC Trust's Phone First service instead.

What happens

Starting anti-craving medication begins with a medical assessment. Your clinician checks how much you drink or use, your goals, your physical and mental health, and runs blood tests such as liver and kidney function. For alcohol, medication such as acamprosate or naltrexone is usually started after a successful detox.

You and your clinician choose a medicine that fits your goals and health. They explain how to take it, what to expect, and the cautions, for example that disulfiram causes a reaction with any alcohol (including hidden sources), or that naltrexone affects opioid painkillers.

The medicine is then prescribed alongside psychological support, not instead of it. You are reviewed regularly, often monthly at first, with repeat monitoring. If you keep drinking despite the medicine, or it does not suit you, the plan is reviewed and changed rather than simply continued.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

The main risks are medicine-specific and need respect. Disulfiram can cause a severe reaction with even small amounts of alcohol and rarely affects the liver, so it needs commitment and monitoring. Naltrexone interacts with opioid painkillers, so carry a warning card and tell any clinician treating you. None of these medicines works well without psychological and social support, so they should never be offered as a stand-alone fix. Ask your clinician what to monitor and when to seek urgent help.

Published figures to discuss

How much these medicines help, and the chance of side effects, varies with the person, the medicine, the dose and how consistently it is taken alongside support. Trials show benefits on average for medicines such as acamprosate and naltrexone, but they are modest and depend on combining medication with psychosocial support. Because individual results vary, we describe effects in general terms rather than quoting precise success percentages.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

This is about taking medication as part of recovery, so "recovery" here means how the medicine, alongside support, helps you stay on track over time. The effect builds gradually and works best when used with therapy or structured support.

• Mild side effects early on that often settle, such as stomach upset or tiredness
• Cravings easing gradually rather than disappearing overnight
• Needing regular appointments and blood tests while on treatment
• Ups and downs in mood and motivation, supported by therapy alongside
• A period of adjustment as the medicine becomes part of your routine

Aftercare

• Take the medicine exactly as prescribed and do not stop suddenly without advice.
• Keep psychological and social support going alongside the medicine.
• Attend monitoring appointments and blood tests as arranged.
• If on disulfiram, avoid all alcohol, including hidden sources in foods, medicines and products.
• If on naltrexone, carry the warning card and tell any clinician before opioid painkillers are used.
• Report side effects, and seek urgent help if you feel very unwell or become jaundiced on disulfiram.
• Use crisis numbers if your mood drops or you feel unsafe.

• Your prescription and clear instructions on how to take it
• A note of which medicine you are on and its key cautions
• Naltrexone warning card, if relevant
• Dates of monitoring appointments and blood tests
• Details of your psychological or peer support alongside
• Crisis numbers saved: 999 and Samaritans 116 123, plus NHS 111 for urgent advice in England, Scotland or Wales (in Northern Ireland, your GP out-of-hours or Trust Phone First service)

⚠ Get urgent help if…

• Thoughts of suicide or of harming yourself — call 999 or the Samaritans free on 116 123 at any time
• Yellowing of the skin or eyes, severe tummy pain, dark urine or feeling very unwell (possible liver problem, especially on disulfiram) — seek urgent help
• A severe reaction after drinking on disulfiram (chest pain, severe breathlessness, collapse) — call 999
• Signs of opioid withdrawal or feeling very unwell after naltrexone if opioids were still in your system
• An allergic reaction (rash, swelling, difficulty breathing) — call 999
• A return to heavy drinking or drug use despite the medicine
• Severe low mood or feeling unable to cope

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your psychiatrist gives you.

Results & realistic expectations

A good result is fewer or weaker cravings and better odds of staying on track, as part of a wider plan that includes psychological and social support. The medicine is an aid, and how well it works varies from person to person.

These medicines cannot, on their own, cure addiction or guarantee you will not drink or use again. Used alongside support, they can make recovery more achievable for many people. If a medicine is not helping, that is useful information and the plan can be changed.

Anti-craving medicines are usually taken for around 6 months, and longer only if they are clearly helping, always alongside support. They do not provide lasting protection once stopped, so the wider work of relapse prevention and support remains important. Opioid substitution treatment may be continued for much longer, decided within specialist services.

Related tests, treatments or support

Anti-craving medication is designed to be combined with psychological therapy, relapse prevention and social support; it is not meant to be used alone. Where there is also a mental illness (dual diagnosis), that should be treated alongside, with care to avoid harmful medicine interactions.

Follow-up & long-term care

Follow-up usually means regular reviews, often monthly at first, with repeat blood tests and a check on how you are coping. If the medicine is not helping or causing problems, it is reviewed and changed. Ask your clinician how often you will be seen and when to seek urgent help.

• Take the medicine as prescribed and attend monitoring and blood tests
• Keep psychological and social support going alongside
• Carry a naltrexone warning card if relevant, and avoid hidden alcohol on disulfiram
• Review with your clinician at around 6 months whether to continue
• Keep relapse-prevention skills in place, especially when the medicine is stopped

Repeat, follow-on and what comes next

• If you keep drinking or using despite the medicine, the plan is reviewed and changed rather than simply continued.
• A different medicine may be tried if the first does not suit or help.
• Medication is usually reviewed at around 6 months and continued only if clearly helping.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Medication always combined with psychological and social support.
• Clear written instructions, including key cautions and warning cards where relevant.
• Regular review and blood-test monitoring while on treatment.
• A plan to change the medicine if it does not help or causes side effects.
• A clear route to urgent help for serious side effects or a crisis.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Whether the medicine is prescribed on the NHS or privately
• The specific medicine chosen and how long it is taken
• The cost of the medical assessment and blood tests
• How much monitoring and how many review appointments are needed
• Whether psychological support is provided alongside (and how it is funded)
• Whether specialist addiction service involvement is included

• The prescribing clinician's fee and their experience in addiction
• Which medicine is included and for how long
• Whether assessment, blood tests and monitoring are included
• Whether psychological support alongside the medicine is included or separate
• What happens, and what it costs, if the medicine needs changing or stopping
• The cancellation and missed-appointment policy

On the NHS? Anti-craving and relapse-prevention medicines are available on the NHS when clinically indicated, usually through GP or specialist addiction services and alongside support; private prescribing exists but still needs proper assessment and monitoring.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the psychiatrist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the psychiatrist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good psychiatrist will welcome every one of these.

• Which medicine suits my goals and health, and why?
• Do I need a detox before starting, and what support comes alongside the medicine?
• What side effects and interactions should I watch for, especially with my other medicines?
• How will I be monitored, including blood tests, and how often?
• What should I do, and when should I seek urgent help, if I feel unwell?
• How long will I take it, and what happens when I stop?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the psychiatrist who carries out my treatment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this treatment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified psychiatrist for anti-craving medication / pharmacotherapy

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NICE CG115 — Alcohol-use disorders (recommendations) NHS — Alcohol misuse: treatment NICE TA325 — Nalmefene for reducing alcohol consumption BNF — Naltrexone hydrochloride BNF — Disulfiram Royal College of Psychiatrists — mental health information nidirect — urgent and emergency care services nidirect — GP out-of-hours service

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.