FDA-Approved Drugs for Alcohol Addiction Remain Underutilized

Medications like naltrexone, acamprosate, and disulfiram can help reduce drinking, but are rarely prescribed.

Published on Feb. 24, 2026

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Despite the existence of three FDA-approved medications to treat alcohol use disorder (AUD) - naltrexone, acamprosate, and disulfiram - these drugs are broadly unknown to patients and widely underprescribed by doctors. Just 2% of Americans with an alcohol disorder diagnosis receive approved medications for treatment, compared to 85% of people diagnosed with diabetes receiving approved treatments. Experts say the challenge is to treat addiction the same way other chronic conditions are treated, with a combination of medications and behavioral therapies.

Why it matters

Alcohol use disorder affects millions of Americans and takes thousands of lives each year. The approved medications for AUD can help reduce heavy drinking and cravings, as well as promote abstinence, yet they remain underutilized due to stigma, lack of patient and provider awareness, and the historical siloing of addiction treatment outside of mainstream healthcare.

The details

The three FDA-approved medications for AUD work in different ways - naltrexone blocks the pleasurable effects of alcohol, acamprosate helps restore brain balance, and disulfiram makes people sick if they drink. Research shows these medications can be effective for some patients, with relatively few side effects. However, they are rarely prescribed, often due to doctors' lack of training in addiction medicine and societal biases that view alcoholism as a moral failing rather than a chronic condition.

  • The FDA recently formally recognized a reduction in drinking as a valid endpoint in alcohol-related clinical trials, a 'paradigm shift' that may lead to more drugs to help curb drinking and more doctors aware of the health benefits of cutting back.

The players

Dr. Lorenzo Leggio

A senior investigator at the National Institute on Alcohol Abuse and Alcoholism.

Katie Witkiewitz

A psychologist at the University of New Mexico who specializes in substance use disorders.

Sarah Wakeman

The senior medical director for substance use disorder at Mass General Brigham in Boston.

Dr. Caleb Alexander

A practicing internist and drug safety expert at the Johns Hopkins Bloomberg School of Public Health.

Keith Humphreys

A professor of psychiatry at Stanford University who specializes in addiction and a former senior policy advisor in the Obama administration.

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What they’re saying

“The challenge here is to really treat addiction the same way we treat diabetes, hypertension, cancer, Parkinson's, depression, and the list goes on and on.”

— Dr. Lorenzo Leggio, Senior Investigator, National Institute on Alcohol Abuse and Alcoholism

“I really view medications as being tremendously helpful in turning the volume down on craving, on withdrawal symptoms, on some of the other reasons that people struggle.”

— Katie Witkiewitz, Psychologist, University of New Mexico

“There's lots of benefits and very few drawbacks. These medications are incredibly safe, and you need very little, if any, lab monitoring.”

— Sarah Wakeman, Senior Medical Director for Substance Use Disorder, Mass General Brigham

“If doctors don't want to prescribe it and patients have never heard of it, then a company is not going to develop the next drug for drinking because they're like, 'It's a waste of money.'”

— Keith Humphreys, Professor of Psychiatry, Stanford University

“There's this idea that medications are a crutch or making it an easy way out.”

— Sarah Wakeman, Senior Medical Director for Substance Use Disorder, Mass General Brigham

What’s next

Researchers are studying whether GLP-1 drugs like semaglutide and tirzepatide might help reduce alcohol consumption, which could help accelerate a shift in how we think about medication to curb drinking.

The takeaway

The real test is whether we finally treat alcohol addiction like a disease rather than a character flaw, by making approved medications more widely known and prescribed, and integrating addiction treatment into mainstream healthcare like other chronic conditions.