The three FDA-approved options
Naltrexone
Reduces reward and craving
Blocks the opioid receptors alcohol acts on, so drinking becomes less rewarding. Works whether your goal is drinking less or stopping. Non-addictive, not a controlled substance. Taken as a daily pill. This is what we most commonly prescribe.
Acamprosate
Supports maintained abstinence
Thought to help stabilise brain chemistry after drinking stops. Generally used once someone has already stopped, rather than to reduce ongoing drinking. Taken three times daily, which some people find harder to sustain.
Disulfiram (Antabuse)
Deterrent
Causes an unpleasant physical reaction if you drink — flushing, nausea, a racing heart. It works by deterrence rather than by reducing craving, and it requires complete abstinence. Suited to a narrower group of people.
How the choice is actually made
The honest answer is that it depends less on which medication is "best" and more on what you want. If your goal is to cut down rather than quit entirely, disulfiram is a poor fit by design. If you have already stopped and want to stay stopped, acamprosate may make sense. If you are still drinking and want the pull to weaken, naltrexone is the most studied option for exactly that.
Your health history matters too — kidney function, liver function, and especially any opioid use, including prescription pain medication.
What it costs
Cash-pay — $149/month
- Initial 45–60 minute evaluation
- Naltrexone prescription, if appropriate for you
- Monthly follow-up visits
- Direct messaging with your provider
Medication is billed separately — generic naltrexone runs roughly $15–60/month at most pharmacies.
Insurance
- Aetna, BCBS, Cigna, UnitedHealthcare, Humana, Oscar, Ambetter, Medicare, Tricare, VA CCN, Carelon
- Typical copay $0–$40 per visit
Benefit verification is required before your first visit — we confirm your coverage at no charge.
Ready when you are.
A 45–60 minute video evaluation with a board-certified psychiatric provider. Same-week appointments are typical.