Understanding Acamprosate as an MAT

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By: Renaissance Recovery

Medically Reviewed by: Diana Vo, LMFT

Last Updated: 7/1/2021

Acamprosate | Renaissance Recovery

Authored By: Joe Gilmore

Table of Contents

Acamprosate – sometimes referred to by its brand name Campral – is one of the three medications the Food and Drug Administration (FDA) approves for the treatment of alcohol use disorder. It is one of the most popular medications for treating ethanol alcohol abuse, in the United States and worldwide.

Most other treatments for alcohol dependence either create troublesome side effects if alcohol is consumed or they reduce the pleasurable effects of alcohol. Acamprosate, by contrast, reduces your brain’s dependence on alcohol.

Sustained alcohol abuse alters both the functioning and the chemistry of your brain. The longer this abuse continues, the more pronounced and severe these changes become.

If you stop drinking alcohol after a period of abuse, your brain will not function the way it used to. Resultantly, you can expect cravings when your body enters alcohol withdrawal. Withdrawal is not only uncomfortable and painful, but in some cases can even be fatal. That said, there are addiction treatment services, like those offered at Renaissance Recovery that can provide clients with evidence-based addiction treatment as well as sober living facilities to help them stay committed to their sobriety. But, before looking at that, let’s better understand this MAT.

What is Campral, then, and why is it used as part of medication-assisted treatment (MAT)?

What is Acamprosate?

Acamprosate serves to efficiently reduce the cravings you get for alcohol and it can also reduce your dependency on alcohol. This is achieved by the way the medication reacts with the neurotransmitters in your brain. 

You should only use acamprosate as prescribed, and it’s imperative that you first stop alcohol consumption and undergo the detoxification process and begin therapy processes from psychiatry experts.

Since acamprosate is a prescription medication, you should only use it under the close guidance of a medical professional and in coordination with various forms of addiction therapy. 

If you have kidney issues or you are pregnant or breastfeeding, you should avoid using acamprosate.

Assuming acamprosate makes the right fit, you’ll take the medication orally three times per day. You do not need to take the tablets with food, but incorporating them as part of breakfast, lunch, and dinner is one easy way of ensuring you don’t forget to take a dose. 

While acamprosate is typically prescribed for one year to alcohol-dependent patients, it may be used for longer or shorter periods. As with all aspects of treatment for alcohol use disorder, this should be personalized for best results. 

Crucially, acamprosate is not sufficient to treat alcohol use disorder in isolation. The medication should be combined with therapy and possibly other medications, too. Naltrexone and disulfiram are the other commonly prescribed and FDA-approved medications used to treat AUD. When used in combination with these medications, the effectiveness of acamprosate is increased.

The medication is especially effective because of the way it’s absorbed through your digestive tract instead of via your liver. This also reduces the chance of side effects in clients with liver damage sustained through alcohol abuse. 

There are no known adverse interactions with other substances or other medications and acamprosate. Overall, the side effects experienced are less prevalent and less severe than those triggered by other medications.

How Does Acamprosate Work?

Acamprosate reacts with the system of neurotransmitters in your brain. Researchers still do not fully understand this drug’s mechanism of action. It is known that the medication helps to calibrate and normalize brain function that’s been disrupted by the discontinued use of alcohol. Primarily, the medication impacts the GABA (gamma-aminobutyric acid) and glutamate systems.

 As well as minimizing the intensity of cravings for alcohol you’ll experience after withdrawal and detox, acamprosate can also reduce symptoms of anxiety, restlessness, and insomnia.

 For many people looking for help for treatment of alcohol dependence, acamprosate therapy starts in a residential rehab setting. They continue taking the medication after the treatment program is complete. The way the medication targets the reward system in your brain means you’ll no longer experience the high alcohol can produce. With no positive reinforcement, your cravings should start lessening, both in terms of frequency and severity.

 Abusing alcohol long-term or persistently binge drinking can change basic brain functioning. When you take acamprosate, the medication helps to stabilize the chemicals in your brain ravaged by excessive alcohol intake.

There are many variables that influence how long it will take for normal brain functioning to resume, primarily how much you were drinking and how often you were drinking. Underlying medical conditions will also play into this. You should continue taking this medication as prescribed, even if you don’t notice any immediate changes. It takes time for your brain to adjust after any period of substance abuse.

Your healthcare provider will consider several elements before suggesting that you discontinue use of acamprosate. These include:

  • How long you have been in recovery
  • Your goals for sobriety maintenance, short-term and long-term
  • The intensity and frequency of your cravings for alcohol
  • The effectiveness of your support system
  • Your participation in any aftercare programs
  • Whether you attend 12-step meetings

Acamprosate Side Effects

There are some common Campral side effects you should be aware of before taking this medication. These common side effects include:

  • Diarrhea
  • Gas
  • Dizziness
  • Upset stomach
  • Nausea
  • Vomiting
  • Dry mouth
  • Loss of appetite
  • Weakness
  • Itching
  • Anxiety
  • Problems falling asleep
  • Difficulties staying asleep
  • Sweating profusely
  • Vision problems
  • Irregular heartbeat
  • Fainting
  • Changes in hearing
  • Urinating not enough or not at all
  • Suicidal thoughts

You should speak with your healthcare provider if any of these symptoms persist. 

Either of the following serious side effects of acamprosate are uncommon, but potentially serious:

  • Burning or tingling in hands and feet or arms and legs
  • A rash developing

Seek immediate medical assistance if you experience these adverse effects from Campral medication.

Acamprosate can also cause other side effects. Liaise closely with your doctor while taking this medication and report any unusual problems you encounter.

Is Acamprosate the Same as Naltrexone?

These medications are not the same, although they both have FDA approval for the treatment of alcohol use disorder.

  • Campral: This medication, as outlined above, works by combating the way alcohol affects your brain chemistry. While the precise mechanism of action is not fully understood, we know that Campral stimulates your brain’s GABA receptors while subduing your brain’s NMDA receptors. The medication is not designed to address alcohol withdrawal symptoms or the symptoms of the early stages of detox
  • Naltrexone: This medication is used to help counter feelings of intoxication. Since drinking alcohol no longer results in any euphoric effects, even those struggling with severe alcohol use disorder usually feel disinclined to drink alcohol when taking naltrexone. The medication achieves this by blocking your brain’s opiate receptors. These receptors govern pleasurable feelings

Campral vs. Naltrexone

Let’s examine these two FDA-approved medications for treating AUD head-to-head.

Campral Benefits

Campral gained FDA approval in 2004 and has been widely prescribed for treating alcohol use disorder ever since. 

In the lead-up to FDA approval, several double-blind clinical studies were conducted involving patients who had already undergone detox. Those taking Campral had a higher chance of achieving long-term recovery than those given the placebo.

These studies showed that Acamprosate treatment is most effective when used to treat only alcohol use disorder. For anyone abusing multiple substances at the same time – this is known as polysubstance abuse – the medication is not as effective.

Campral Side Effects

Some people taking Campral experience a range of side effects. These tend to be fairly mild, and can include:

  • Digestive issues like constipation
  • Stomach discomfort
  • Gas
  • Body aches
  • Pruritus
  • Allergic reaction
  • Cottonmouth

Less than 1% of patients prescribed Campral experience more intense and severe side effects, including:

  • Hypertension
  • Cardiac arrhythmia
  • Tingling sensations in the extremities
  • Abnormally low blood pressure
  • Depression
  • Anxiety
  • Suicidal thoughts
  • Cognitive impairment
  • Problems breathing
  • Impaired kidney function
  • Sexual dysfunction in males

Naltrexone Benefits

Unlike Campral, naltrexone is highly effective for treating clients with multiple addictions. Of all instances of polysubstance abuse, naltrexone is primarily used for treating addictions to alcohol and opioids.

Various studies show that patients using naltrexone experience fewer cravings, reduced incidences of drinking, and relapse rates up to 50% better than those given the placebo. 

Naltrexone Side Effects

Naltrexone side effects include:

  • Nausea
  • Vomiting
  • Angst
  • Restlessness
  • Exhaustion
  • Headache

Campral or Naltrexone?

Both of these medications are viable if alcohol is the substance in question. For anyone abusing opioids, naltrexone likely makes the better choice.

Some people with certain medical conditions may find that neither medication is suitable.

You can get these medications from the following avenues:

  • By doctor’s prescription
  • At residential rehab
  • In an outpatient program through a pharmacy

Your doctor will not normally prescribe either of these medications unless you’ve already gone through a medical detox. Here, your health will be closely monitored for the duration of detox.

Following detox, the protocol for prescribing these medications will depend entirely upon your addiction and your overall health status.

If you feel Campral or naltrexone might benefit you in your treatment for alcohol use disorder, your best bet is to commit to an inpatient or outpatient treatment program. In either of these settings, you’ll receive robust support from a suite of professionals, and you’ll also benefit from the powerful peer support of others undergoing the precise same experience.

How Renaissance Recovery Can Help You

Here at The District Recovery Community, we have a variety of personalized treatment programs and work with Orange County rehabs to help you reclaim the life you lost to alcohol abuse.

We have a variety of outpatient treatment programs, including intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs). We can tailor the level of care you receive to the scope and severity of your addiction.

Effective treatment of alcoholism should include the use of FDA-approved medication-assisted treatment when appropriate. Campral (acamprosate) is one of the medications available to help with the maintenance of abstinence if cleared by a health professional. In combination with the proper dosing of acamprosate, you’ll also undergo psychotherapy such as CBT (cognitive behavioral therapy). This talk therapy helps, in conjunction with the drug interactions from MAT will you identify the triggers that cause you to abuse alcohol while fighting off the dangerous withdrawal symptoms that can occur. You’ll also learn how to cope without resorting to a chemical crutch.

Acamprosate works most effectively as one component of a comprehensive treatment plan, and that’s just the way it is used here at Renaissance. If you’re ready to put down the bottle and to reclaim the live you lost to alcohol, call the friendly team at 866.330.9449, we can help you find sober living homes, medication-assisted treatment, support groups, therapy with a trained health care professional, and more.

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Diana is an addiction expert and licensed marriage and family therapist who has been in the field of mental health for over 10 years.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country