Acamprosate

Generic name: calcium acetylhomotaurinate

Use: Prevention of alcohol abuse.

Action, if known: Acamprosate is a calcium channel
blocker. It seems to stimulate inhibitory GABA receptors and to antagonize
excitatory amino acids, such as glutamate. This should prevent some of the
pleasurable, reinforcing effects of alcohol use.

Side effects: Diarrhea

Tips: Acamprosate is available in Australia and several
European countries, but is still in clinical trials in the US.

Antabuse

Generic name: disulfiram

Use: Prevention of alcohol abuse.

Action, if known: Antabuse works by inhibiting the enzyme
acetaldehyde dehydrogenase, which normally breaks down the toxic by-product
acetaldehyde that forms when the body metabolizes alcohol. If you drink
alcohol while taking Antabuse, acetaldehyde builds up immediately and you
will become violently ill.

Side effects: Drowsiness, mood swings, unusual sensations
in the hands or feet (tingling or pain). Antabuse can cause or exacerbate
heart or liver problems. Drinking large quantities of alcohol while taking
Antabuse can actually kill you.

Tips: Antabuse should be used only as part of a complete
recovery program, including counseling and peer support. People taking
Antabuse should be monitored for heart and liver problems. They must also
be careful to avoid healthcare and skin products that contain alcohol,
including many cough syrups. In addition, they should avoid contact with
the fumes of chemicals that may contain alcohol, acetaldehyde, paraldehyde,
or other related substances, including paint, paint thinner, varnish, and
shellac. Most doctors feel that Antabuse is of little or no help in
treating alcohol addiction–it is sometime used as a punitive,
court-ordered deterrence measure rather than a legitimate medical
treatment.

Calan

Generic name: verapamil

Also known as: Isoptin

Use: Angina, heart arrhythmia, high blood pressure,
prevention of alcohol abuse.

Action, if known: Calcium ion influx inhibitor.

Side effects: Dizziness, constipation, nausea. Lowers
blood pressure, can cause edema (water retention in the ankles and
legs).

Known interaction hazards: Do not use with beta blockers.
Calan may lower your lithium level. Potentiates digoxin. Be careful with
Calan if you use any other medication that affects blood pressure. May
counteract or interact negatively with verapamil, Quinidine, Disopyramide,
flecainide, neuromuscular blocking agents, carbamazepine, cyclosporine,
theophylline. Counteracted at least somewhat by rifampin, phenobarbital,
and Sulfinpyrazone. May interact with inhaled agents used in
anesthesia.

Tips: Blood pressure and liver function should be
monitored while taking this drug, especially in patients with known liver
damage. Take Calan with food.

Narcan

Generic name: naloxone hydrochloride

Use: Treatment of opiate and narcotic overdose or
addiction, reversal of the effects of anesthetics.

Action, if known: Opiate antagonist. Unlike ReVex and
ReVia, Narcan counteracts all of the effects of morphine.

Side effects: May raise blood pressure, may lower the
seizure threshold.

Known interaction hazards: Do not use with bisulfate or
alkaline solutions.

Tips: Naloxone has not been well-tested in treating
chemical dependency.

ReVex

Generic name: nalmefene hydrochloride

Use: Treatment of opiate and narcotic addiction or
overdose, reversal of the effects of anesthetics.

Action, if known: Opiate antagonist. Appears to activate
the hypothalamic-pituitary-adrenal (HPA) axis more strongly than
naloxone.

Side effects: Anxiety, nervousness, insomnia, abdominal
discomfort, nausea, headache, muscle or joint pain. May lower the seizure
threshold.

Known interaction hazards: Alcohol and all central nervous
system depressants, including anesthetics, narcotics, and sedatives. ReVia
may block the effects of these substances until they reach a critical, even
deadly, level.

Tips: Other than the difference already noted, ReVex is
essentially the same as ReVia–see the next entry.

ReVia

Generic name: naltrexone hydrochloride

Also known as: Trexan, NTX.

Use: Heroin/opiate and alcohol addiction withdrawal aid,
treatment of narcotic overdose, self-injurious behavior (SIB), reversal of
the effects of anesthetics.

Action, if known: Opiate antagonist–blocks opiate
chemicals.

Side effects: Anxiety, nervousness, insomnia, abdominal
discomfort, nausea, headache, muscle or joint pain. May lower the seizure
threshold.

Known interaction hazards: Alcohol and all central nervous
system depressants, including anesthetics, narcotics, and sedatives. ReVia
may block the effects of these substances until they reach a critical, even
deadly, level.

Tips: According to product literature, ReVia should not be
used by people who are currently addicted to drugs or alcohol–it is used
only after the detox process is over, to help the person stay sober.
However, a number of intensive detox centers do rely on ReVia, and it does
appear to help reduce cravings for drugs and alcohol. People with liver
problems must be closely monitored while taking ReVia. Recent studies
indicate that ReVia (and possibly other opiate blockers) can help stop the
cycle of self-injurious behavior.