Acamprosate: Definition, Mechanism of Action, Uses, Dosage, Side Effects, Alternatives

Acamprosate helps individuals maintain abstinence from alcohol and drugs after completing detoxification. The U.S. Food and Drug Administration (FDA) approved Acamprosate in 2004 for the treatment of alcohol use disorder (AUD), and it is commonly prescribed to prevent relapse.

The mechanism of action for Acamprosate involves stabilizing brain chemistry by reducing excessive glutamate activity and enhancing the function of gamma-aminobutyric acid (GABA), a calming neurotransmitter. A study by Karl Mann, published in Alcoholism: Clinical and Experimental Research (2004), found that Acamprosate significantly reduced alcohol cravings and improved abstinence rates by 36 percent.

The approved uses of Acamprosate include maintaining sobriety in individuals with alcohol dependence and reducing the risk of relapse. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) states that Acamprosate is most effective when it is combined with behavioral therapy and ongoing abstinence from alcohol.

The standard dosage of Acamprosate is 666 milligrams, taken as two 333-milligram tablets three times daily. The FDA recommends reducing the dose to 333 milligrams three times daily for individuals with moderate kidney impairment. Acamprosate should not be used by individuals with severe kidney disease.

The side effects of Acamprosate are diarrhea, nausea, and insomnia. Severe side effects are rare but may include depression and allergic reactions. According to clinical trials reviewed by the FDA, patients—particularly those with a history of depression—should be monitored for changes in mood, as suicidal thoughts have been reported in a small percentage of users.

Alternatives to Acamprosate for the treatment of alcohol use disorder are Naltrexone and Disulfiram. Naltrexone works by blocking the rewarding effects of alcohol, while Disulfiram produces an unpleasant physical reaction when alcohol is consumed. According to data from the NIAAA, Naltrexone is prescribed to 35 percent of patients receiving medication-assisted treatment. In comparison, Disulfiram is used by 10 to 15 percent of individuals participating in supervised recovery programs.

What Is Acamprosate?

Acamprosate is an FDA-approved prescription medication used to support abstinence in individuals recovering from alcohol use disorder (AUD). Marketed under the brand name Campral, it was approved by the U.S. Food and Drug Administration (FDA) in 2004 for the maintenance of alcohol abstinence following detoxification. 

Acamprosate does not prevent withdrawal symptoms but helps reduce cravings and the likelihood of relapse. A study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that acamprosate increases abstinence rates by approximately 36% compared to placebo. 

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), over 14.1 million adults in the U.S. have AUD, yet less than 4% receive medication-assisted treatment. Despite acamprosate’s effectiveness, acamprosate is underutilized, with prescription rates significantly lower than naltrexone and disulfiram.

How Effective is Acamprosate in Treating Alcohol Addiction?

Acamprosate is moderately effective in treating alcohol addiction by increasing abstinence rates after detoxification. In a clinical study published in Alcoholism: Clinical and Experimental Research (2004), individuals who took Acamprosate experienced a 36% improvement in abstinence rates compared to those given a placebo. Its effectiveness is highest when combined with behavioral therapy and ongoing sobriety support for alcohol dependence.

How Does Acamprosate Help in Alcohol Addiction Recovery?

Acamprosate helps in alcohol addiction recovery by reducing cravings and restoring neurochemical balance in the brain. Chronic alcohol use disrupts neurotransmitter systems, particularly glutamate and gamma-aminobutyric acid (GABA), leading to excessive excitability and withdrawal-related distress. 

Acamprosate modulates glutamate activity and enhances GABA function, reducing hyperexcitability and stabilizing brain function during abstinence. According to a study by Karl Mann titled “The Efficacy of Acamprosate in the Maintenance of Abstinence in Alcohol-Dependent Individuals,” published in Alcoholism: Clinical and Experimental Research (2004), acamprosate increased continuous abstinence rates to 36.1% compared to 23.4% with placebo. 

Another meta-analysis by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that acamprosate significantly reduces the likelihood of relapse by 86% compared to untreated individuals. By reducing cravings, acamprosate supports long-term sobriety and increases treatment retention rates.

How Does Acamprosate Work?

Acamprosate works by regulating neurotransmitters in the central nervous system, specifically balancing glutamate and GABA activity. Chronic alcohol consumption disrupts this balance, causing excessive glutamate activity and reduced GABA function, which leads to withdrawal symptoms and heightened cravings. 

Acamprosate acts as a functional glutamate antagonist, reducing excitatory neurotransmission while enhancing GABA’s inhibitory effects. This stabilization helps prevent the hyperexcitability that contributes to relapse.

According to a study by Rainer Spanagel titled “Acamprosate Produces Its Anti-Relapse Effects Via Calcium,” published in Neuropsychopharmacology (2014), acamprosate prevents relapse by reducing excessive glutamate release in alcohol-dependent individuals. 

Acamprosate reduces alcohol withdrawal-related neurochemical imbalances and decreases excitatory signaling, leading to improved abstinence rates. By modulating neurotransmitters, acamprosate helps individuals recover from alcohol dependence with fewer withdrawal-related disturbances.

Why Does Acamprosate Require a Full Detox Before Starting Treatment?

Acamprosate requires a full detox before starting treatment because it is only effective in maintaining abstinence, not in managing withdrawal symptoms. Unlike benzodiazepines or other withdrawal medications, acamprosate does not alleviate acute alcohol withdrawal but works by stabilizing brain chemistry after the withdrawal phase is complete. 

If alcohol remains in the system, the drug cannot effectively regulate neurotransmitter activity, reducing its therapeutic benefit. According to a study by Karl Mann titled “The Efficacy of Acamprosate in the Maintenance of Abstinence in Alcohol-Dependent Individuals,” published in Alcoholism: Clinical and Experimental Research (2004), acamprosate showed a significant increase in abstinence rates only in patients who had already completed detoxification. 

Research from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) also confirms that acamprosate is ineffective in individuals still consuming alcohol, as it does not counteract withdrawal symptoms or prevent alcohol-related neurotoxicity. For optimal results, acamprosate is initiated once complete abstinence has been achieved.

Can Acamprosate Help Repair Cognitive Impairment Caused by Long-Term Alcohol Use?

Yes, acamprosate supports cognitive function recovery by promoting brain plasticity and reducing alcohol-induced neurotoxicity. Chronic alcohol use damages neurons, disrupts neurotransmitter balance, and impairs memory, decision-making, and executive function. 

Acamprosate aids in restoring neurochemical stability, which enhances brain plasticity and cognitive recovery in abstinent individuals. According to a study by Rainer Spanagel titled “Acamprosate Produces Its Anti-Relapse Effects Via Calcium,” published in Neuropsychopharmacology (2014), acamprosate reduces glutamate excitotoxicity, a major contributor to alcohol-related cognitive decline. 

Acamprosate also improves cognitive function by stabilizing glutamate and GABA levels, leading to enhanced learning and memory in recovering alcohol-dependent individuals. Research from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) indicates that acamprosate contributes to neural regeneration, particularly in the prefrontal cortex, where alcohol-related damage is most pronounced. 

While acamprosate does not reverse all cognitive deficits, it significantly aids in brain recovery during sustained abstinence.

How Long Does It Take for Acamprosate to Work?

It takes approximately 5 to 7 days for acamprosate to start working, with full effects developing over several weeks of continuous use. Unlike medications that provide immediate symptom relief, acamprosate gradually stabilizes neurotransmitter function, reducing alcohol cravings over time. 

Most patients experience a noticeable reduction in cravings after two to four weeks of consistent use, though individual responses vary. According to a study by Karl Mann titled “The Efficacy of Acamprosate in the Maintenance of Abstinence in Alcohol-Dependent Individuals,” published in Alcoholism: Clinical and Experimental Research (2004), acamprosate-treated patients showed improved abstinence rates within the first month, with maximum benefits observed after 90 days. 

For optimal results, acamprosate is added as part of a comprehensive recovery plan, including therapy and behavioral support. Research from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) emphasizes that acamprosate must be taken continuously, even if immediate effects are not noticeable, as stopping early reduces its efficacy in preventing relapse. 

What Are the Approved Uses of Acamprosate?

The approved uses of acamprosate are the maintenance of abstinence and relapse prevention in individuals recovering from alcohol use disorder (AUD). The FDA-approved indication for acamprosate is to support long-term sobriety in individuals who have already completed detoxification. 

It does not treat withdrawal symptoms or reduce alcohol’s intoxicating effects, but it helps stabilize brain chemistry to lower the risk of relapse. According to a study by Katie Witkiewitz titled “Acamprosate for Treatment of Alcohol Dependence: Mechanisms, Efficacy, and Clinical Utility,” published in Therapeutics and Clinical Risk Management (2012), acamprosate significantly increases the duration of alcohol abstinence compared to placebo. 

Research from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) also found that acamprosate reduces the likelihood of returning to drinking by up to 36% when combined with behavioral therapy. 

While primarily used for AUD, ongoing studies are evaluating its potential for other neurochemical disorders, though these are not FDA-approved applications.

Who Can Benefit from Taking Acamprosate?

Individuals with severe alcohol use disorder (AUD), multiple relapses, and a strong commitment to abstinence can benefit from taking acamprosate. It is most effective for patients who have completed detox and need support in maintaining long-term sobriety. 

According to research by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), acamprosate is particularly beneficial for individuals with a history of prolonged alcohol dependence, as it reduces relapse risk by up to 36%. Patients with liver disease also benefit, as acamprosate is not metabolized by the liver, making it safer than other AUD medications.

Who Should Avoid Taking Acamprosate?

Individuals with severe kidney disease, pregnant women, and those still consuming alcohol should avoid taking acamprosate. Patients with severe kidney impairment should not use acamprosate because it is eliminated through the kidneys, and reduced kidney function increases the risk of drug accumulation and toxicity. 

According to a study by Teodoro Zornoza titled “Pharmacology of Acamprosate: An Overview,” published in CNS Drug Reviews (2006), acamprosate is contraindicated in patients with creatinine clearance below 30 mL/min due to poor renal elimination. 

Pregnant women should avoid acamprosate due to limited safety data and potential fetal risks, as studies on teratogenic effects remain inconclusive. People who are still drinking alcohol should not take acamprosate because it is only effective in maintaining abstinence, not in reducing withdrawal symptoms or counteracting alcohol’s effects.

What Is the Recommended Dosage of Acamprosate?

The standard recommended dose of Acamprosate is 666 mg (two 333 mg tablets) taken three times daily. This dosage is based on clinical trials demonstrating its effectiveness in maintaining abstinence in individuals recovering from alcohol use disorder (AUD). 

For patients with moderate kidney impairment (creatinine clearance between 30–50 mL/min), the dose is reduced to 333 mg three times daily. Acamprosate is not recommended for individuals with severe renal impairment (creatinine clearance below 30 mL/min) due to poor drug elimination.

According to FDA prescribing guidelines, acamprosate should be taken consistently, with or without food, to maintain stable blood levels. A study by Teodoro Zornoza titled “Pharmacology of Acamprosate: An Overview,” published in CNS Drug Reviews (2006), confirms that maintaining a steady dosage is crucial for preventing relapse, as missed doses reduce its efficacy. There are no dosage adjustments for elderly patients unless kidney function is impaired.

How Is Acamprosate Administered?

Acamprosate is administered through oral tablets, taken three times daily with or without food. According to FDA prescribing guidelines, consistent dosing is essential for maintaining therapeutic levels and preventing relapse in alcohol use disorder (AUD) patients.

Ways acamprosate is administered are as follows:

• Oral administration: Acamprosate is taken orally in the form of 333 mg enteric-coated tablets. It should be swallowed whole with water, not crushed or chewed, to ensure proper absorption. The recommended dose is 666 mg (two tablets) three times daily.
• With or without food: Acamprosate is taken with or without food, but taking it with meals may improve adherence by creating a routine. According to FDA guidelines, food does not significantly alter acamprosate’s absorption. However, consistency in dosing is more important than meal timing.
• Missed doses: Missed doses should not be doubled; instead, the patient should continue with the next scheduled dose. Acamprosate should be taken at evenly spaced intervals to maintain steady blood levels. It is only effective when taken consistently as part of a structured alcohol recovery plan.

What Should You Do If You Miss a Dose of Acamprosate?

You should take the missed dose of Acamprosate as soon as you remember, but skip it if your next scheduled dose is near to avoid an overdose risk if you miss a dose. Doubling doses leads to adverse effects without improving treatment outcomes. 

According to the U.S. Food and Drug Administration (FDA) prescribing guidelines, patients should follow a consistent dosing schedule and never take extra doses to make up for missed ones. Maintaining regular intake is crucial for sustaining its therapeutic effects in alcohol use disorder (AUD) treatment.

How Long Should You Take Acamprosate?

You should take acamprosate for at least six months to a year, with longer use recommended for those at high risk of relapse. According to a study by Karl Mann titled “The Efficacy of Acamprosate in the Maintenance of Abstinence in Alcohol-Dependent Individuals,” published in Alcoholism: Clinical and Experimental Research (2004), patients who took Acamprosate for 12 months had significantly higher abstinence rates than those who stopped earlier. 

Research from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) confirms that Acamprosate remains safe and effective for extended use beyond a year when needed. The duration of treatment depends on individual relapse risk, adherence to therapy, and ongoing recovery support.

What Are the Side Effects of Acamprosate?

The side effects of Acamprosate are diarrhea, nausea, and insomnia, with gastrointestinal issues being the most common. According to the U.S. Food and Drug Administration (FDA) prescribing guidelines, while most side effects are mild, some patients experience depression or suicidal thoughts, requiring close monitoring during treatment.

Mild Side Effects of acamprosate include:

• Diarrhea: It is the most common side effect, occurring in up to 17% of patients, according to a study by Karl Mann published in Alcoholism: Clinical and Experimental Research (2004). Diarrhea occurs because Acamprosate alters electrolyte balance in the intestines, leading to increased water secretion. Patients are advised to stay hydrated and consult a doctor if symptoms persist.
• Nausea: Nausea results from Acamprosate’s interaction with the gastrointestinal tract. It is usually mild and improves with continued use or by taking the medication with food. In most cases, dose adjustments are not required.
• Insomnia: Insomnia occurs due to Acamprosate’s effects on neurotransmitter balance. Alcohol-dependent individuals often have disrupted sleep patterns, which Acamprosate helps regulate over time. Sleep disturbances usually improve after a few weeks of continued treatment.

Severe Side Effects of acamprosate include:

• Depression and Suicidal Thoughts: While rare, some patients experience increased depression or suicidal ideation, particularly those with a history of mood disorders. According to the U.S. Food and Drug Administration (FDA), patients taking Acamprosate should be monitored for mood changes, especially in the first few months. Immediate medical attention is required if severe depressive symptoms arise.
• Allergic Reactions: Severe allergic reactions, including rash, itching, or swelling, are uncommon but require immediate discontinuation and medical evaluation. These occur due to hypersensitivity to Acamprosate’s active ingredients. According to FDA reports, severe reactions occur in less than 1% of patients.
• Kidney-Related Issues: Since Acamprosate is eliminated through the kidneys, patients with pre-existing kidney disease experience worsening renal function. Dose adjustments are necessary for those with moderate kidney impairment. The drug is not recommended for individuals with severe renal dysfunction (creatinine clearance <30 mL/min).

Does Acamprosate Cause Dependence?

No, Acamprosate does not cause dependence because it does not interact with dopamine or opioid receptors, making it a non-addictive medication. Unlike other substances used in alcohol recovery, Acamprosate works by regulating glutamate and GABA levels without producing euphoric effects or withdrawal symptoms.

According to the U.S. Food and Drug Administration (FDA), long-term studies confirm that Acamprosate does not lead to misuse, tolerance, or physical dependence.

How Does Acamprosate Affect Mood, Anxiety, or Sleep Patterns in Recovering Patients?

Acamprosate affects mood, anxiety, or sleep patterns in recovering patients by stabilizing neurochemical balance, reducing anxiety, and potentially causing sleep disturbances. By regulating glutamate and GABA activity, Acamprosate helps restore brain function disrupted by chronic alcohol use, leading to improved emotional stability. 

According to a study by Karl Mann titled “The Efficacy of Acamprosate in the Maintenance of Abstinence in Alcohol-Dependent Individuals,” published in Alcoholism: Clinical and Experimental Research (2004), patients on Acamprosate reported reduced anxiety symptoms compared to those on placebo. 

However, some individuals experience sleep disturbances, such as insomnia, which affects 5–8% of patients, as noted in FDA clinical trials. Over time, these effects tend to diminish as the brain adapts to a stabilized neurotransmitter environment.

Are There Long-Term Risks of Taking Acamprosate For Years?

No, there are no long-term risks of taking Acamprosate, but renal function must be monitored during extended use. Since Acamprosate is excreted unchanged through the kidneys, prolonged use requires periodic kidney function tests, especially in patients with pre-existing renal impairment. 

According to a study by Teodoro Zornoza titled “Pharmacology of Acamprosate: An Overview,” published in CNS Drug Reviews (2006), long-term Acamprosate use remains safe, with no evidence of organ toxicity or increased health risks. 

The U.S. Food and Drug Administration (FDA) also confirms that Acamprosate does not lead to tolerance or dependence, making it suitable for extended use in alcohol relapse prevention. Patients should continue treatment as long as they benefit from it, under medical supervision.

What Are the Alternatives to Acamprosate for Alcohol Addiction Treatment?

The alternatives to Acamprosate for alcohol addiction treatment are Naltrexone, Disulfiram, and behavioral therapy. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), Naltrexone reduces cravings by blocking opioid receptors, Disulfiram discourages drinking by causing unpleasant reactions to alcohol, and therapy enhances long-term recovery by addressing behavioral triggers.

The alternatives to acamprosate for alcohol addiction treatment are explained below:

• Naltrexone: Naltrexone is an opioid receptor antagonist that reduces alcohol cravings by blocking the brain’s reward response to alcohol consumption. Unlike Acamprosate, Naltrexone helps control cravings even if alcohol is still in the system, making it suitable for individuals who struggle with cutting down before quitting entirely. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), Naltrexone is prescribed to approximately 35% of patients undergoing medication-assisted treatment for alcohol use disorder (AUD). It is not recommended for individuals with opioid dependence, as it triggers withdrawal symptoms in those actively using opioids.
• Disulfiram: Disulfiram works by blocking the enzyme aldehyde dehydrogenase, causing a toxic buildup of acetaldehyde when alcohol is consumed. This leads to severe nausea, flushing, and palpitations, acting as a deterrent to drinking. Unlike Acamprosate and Naltrexone, Disulfiram does not reduce cravings but discourages alcohol use through an immediate physical reaction. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), only 10–15% of AUD patients are prescribed Disulfiram due to its strict adherence requirements and the need for complete abstinence before use. Disulfiram requires strong commitment, as drinking even small amounts of alcohol causes dangerous reactions. It is most effective in highly motivated individuals or those under supervised treatment programs.

Can Acamprosate Be Used in Combination with Other Medications?

Yes, Acamprosate can be used in combination with other medications, but patients should consult a doctor to avoid potential interactions. It is commonly prescribed alongside Naltrexone or Disulfiram for a more comprehensive approach to alcohol addiction treatment, as these medications target different aspects of recovery. 

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), combining Acamprosate with Naltrexone has been shown to improve abstinence rates compared to using either medication alone. 

Acamprosate does not interact significantly with antidepressants, making it safe for individuals with co-occurring mood disorders. However, it should be used cautiously with medications that affect kidney function, as Acamprosate is excreted through the renal system.

Can Acamprosate and Naltrexone Be Taken Together?

Yes, Acamprosate and Naltrexone can be taken together to improve alcohol abstinence rates by targeting different mechanisms of addiction. Acamprosate regulates glutamate and GABA levels to reduce cravings, while Naltrexone blocks opioid receptors to decrease alcohol’s pleasurable effects. 

According to a study by Barbara Mason titled “A Double-Blind Study of Acamprosate and Naltrexone for Alcohol Dependence,” published in Neuropsychopharmacology (2006), patients who took both medications had higher abstinence rates (60%) compared to those on either drug alone (40–45%).

 The National Institute on Alcohol Abuse and Alcoholism (NIAAA) also supports this combination as safe and effective for long-term alcohol recovery when monitored by a healthcare provider.

Can Acamprosate and Disulfiram Be Used Together?

Yes, Acamprosate and Disulfiram can be used together to support alcohol abstinence by addressing different aspects of addiction. Disulfiram works by creating an aversion to alcohol through severe physical reactions when alcohol is consumed, while Acamprosate helps maintain abstinence by stabilizing neurotransmitter activity and reducing cravings. 

According to a study by Whitworth et al., published in The Lancet (1996), patients who took both Disulfiram and Acamprosate had a 50% higher long-term abstinence rate compared to those using either medication alone. 

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) confirms that combining these medications is beneficial for individuals with a history of frequent relapses, provided they are closely monitored for adherence and side effects. While both drugs support sobriety, they should always be taken under medical supervision to ensure safety and effectiveness.

Are There Any Dietary Restrictions While on Acamprosate?

No, there are no specific dietary restrictions while taking Acamprosate, as food does not significantly impact its absorption or effectiveness. Unlike some medications for alcohol use disorder, Acamprosate does not interact with common foods or beverages, making it easy to incorporate into daily routines. 

However, maintaining a balanced diet supports overall recovery by improving brain function and reducing alcohol cravings. According to the U.S. Food and Drug Administration (FDA), Acamprosate is taken consistently, with or without food, to ensure stable blood levels.

Dietary guidelines while taking acamprosate include:

• Consistency in Meals: Taking Acamprosate with meals helps establish a routine and improve adherence.
• Hydration: Drinking enough water is important, especially for patients experiencing diarrhea as a side effect.
• Nutrient-Rich Foods: A diet rich in lean protein, whole grains, and vegetables supports brain recovery and reduces relapse risk.
• Avoid Alcohol-Containing Foods: Certain sauces, extracts, and fermented foods contain small amounts of alcohol, which could trigger cravings.
• Monitor Caffeine Intake: While not a direct interaction, high caffeine consumption worsens anxiety or sleep disturbances, which are already common in alcohol recovery.

What Happens if You Drink Alcohol While Taking Acamprosate?

Low effectiveness, increases in relapse risk, and neurochemical balance disruption happen if you drink alcohol while taking Acamprosate. Unlike Disulfiram, Acamprosate does not cause an immediate physical reaction to alcohol, but it loses its ability to support abstinence if alcohol is reintroduced. 

According to a study by Mason et al., published in Neuropsychopharmacology (2006), patients who drank while on Acamprosate had relapse rates 45% higher than those who remained abstinent. Acamprosate works best when taken as part of a structured recovery plan that includes complete sobriety and behavioral therapy.

What Is the Success Rate of Acamprosate in Preventing Alcohol Relapse?

The success rate of Acamprosate in preventing alcohol relapse is approximately 36–50%, with higher abstinence rates when combined with therapy. According to a study by Karl Mann, published in Alcoholism: Clinical and Experimental Research (2004), Acamprosate increased continuous abstinence rates to 36.1% compared to 23.4% with placebo. 

Another meta-analysis by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that patients taking Acamprosate had a 50% greater chance of maintaining sobriety over a year compared to those not using medication. 

These findings confirm that Acamprosate is most effective when used as part of a comprehensive treatment plan, including counseling and behavioral support.

Why Is Acamprosate Often Underprescribed Compared to Other Alcohol Treatment Medications?

Acamprosate is often underprescribed compared to other alcohol treatment medications due to a lack of awareness, physician preferences, and prescription barriers. Many healthcare providers are more familiar with Naltrexone, which is preferred because it is started while a patient is still drinking, unlike Acamprosate, which requires full abstinence. 

According to a report by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), only 10–15% of eligible patients receive medication-assisted treatment (MAT) for alcohol use disorder (AUD), with Naltrexone being the most prescribed, followed by Disulfiram and then Acamprosate. 

Another study by Mark Willenbring, published in the Journal of the American Medical Association (JAMA) (2010), found that only 9% of patients with AUD were ever prescribed Acamprosate, despite its proven efficacy in maintaining abstinence. 

Prescription barriers include insurance coverage issues, lack of training among physicians on AUD treatment, and the misconception that behavioral therapy alone is sufficient for recovery. Expanding awareness and integrating Acamprosate into primary care settings improve treatment rates for alcohol dependence.

Is Acamprosate Covered by Insurance in the U.S.?

Yes, Acamprosate is covered by Medicare, Medicaid, and most private insurance plans, but copayments and coverage restrictions apply. According to the Centers for Medicare & Medicaid Services (CMS), Acamprosate is included in most state Medicaid formularies, though prior authorization is required. 

Private insurance plans cover Acamprosate under prescription drug benefits, but out-of-pocket costs vary depending on deductibles and copays. Patients should check their specific plan details to determine coverage and any potential cost-sharing requirements.

Can You Buy Acamprosate Over the Counter?

No, Acamprosate is a prescription medication and is not available over the counter. It requires a doctor’s prescription because its use must be monitored for effectiveness, adherence, and potential side effects. 

According to the U.S. Food and Drug Administration (FDA), Acamprosate is regulated to ensure proper medical supervision in alcohol use disorder (AUD) treatment. Patients seeking Acamprosate must consult a healthcare provider to determine if it is appropriate for their recovery plan.