Acamprosate (brand name Campral) is a medication approved for treating Alcohol Use Disorder (AUD). It is intended to help individuals who have achieved abstinence maintain it over time. This medication works best as part of a comprehensive recovery program that includes counseling and psychosocial support. Understanding its function is important for anyone utilizing it, especially regarding the implications of consuming alcohol while on treatment.
How Acamprosate Works to Support Abstinence
The primary goal of acamprosate is to reduce the psychological discomfort and craving that often lead to relapse in early recovery. Chronic, heavy alcohol consumption significantly alters the balance of neurotransmitter systems in the brain. Specifically, alcohol disrupts the relationship between the excitatory neurotransmitter, glutamate, and the inhibitory neurotransmitter, gamma-aminobutyric acid (GABA).
The brain adapts to prolonged alcohol use by increasing the activity of the glutamatergic system to counteract the depressant effects of the alcohol. When alcohol is suddenly removed, this heightened glutamatergic activity remains, creating a state of neuronal hyperexcitability. This state contributes to symptoms like anxiety, insomnia, and intense cravings, all of which increase the risk of returning to drinking.
Acamprosate works by modulating this activity, helping to stabilize the neurochemical environment and restore the natural balance between excitation and inhibition. It acts on the N-methyl-D-aspartate (NMDA) receptor, a subtype of the glutamate receptor, effectively dampening the excessive glutamatergic signaling. By normalizing these brain functions, the medication helps alleviate the underlying discomfort and reduces the urge to drink alcohol.
The Direct Effects of Combining Alcohol and Acamprosate
A person taking acamprosate who consumes alcohol will not experience an acute, immediate physical sickness. This is a crucial distinction, as acamprosate works differently than deterrent medications like disulfiram, which actively block the breakdown of alcohol and cause a severe, unpleasant physical reaction. Acamprosate does not affect how the body metabolizes alcohol, meaning it does not alter the blood alcohol level or prevent intoxication.
The effects of alcohol, such as impaired judgment, reduced coordination, and cognitive changes, will proceed exactly as they would without the medication. Acamprosate does not alter alcohol pharmacokinetics, the acute physiological effects, or most subjective alcohol effects. The medication will not serve as a safeguard against the behavioral risks or physical dangers associated with drinking, like operating a vehicle or making poor decisions.
The primary consequence of drinking while on acamprosate is that the alcohol counteracts the therapeutic mechanism of the drug. The medication is designed to normalize brain chemistry and reduce craving, and introducing alcohol directly disrupts this fragile balance. This action effectively renders the treatment ineffective, increasing the likelihood that the brief slip will escalate into a full, sustained return to heavy drinking.
While a severe physical reaction is not expected, consuming alcohol might exacerbate some of the common side effects associated with acamprosate. These side effects can include gastrointestinal issues like diarrhea, abdominal pain, or nausea. The combination of alcohol’s own irritating effects on the digestive system with the medication’s potential side effects could lead to heightened physical discomfort. The most significant risk remains the loss of the medication’s protective benefit against relapse.
Navigating Relapse and Maintaining Treatment Safety
If a person experiences a lapse and consumes alcohol while on acamprosate, the first step is to prioritize immediate safety and contact a healthcare provider. Unlike some other medications, there is typically no need to stop taking acamprosate after drinking, and patients are generally advised to continue their medication schedule. Stopping the medication unnecessarily could remove the protective factor it offers against future cravings.
A single instance of drinking is often viewed in recovery as a “slip” rather than a full “relapse,” and it provides an opportunity to reassess the treatment plan. It is important to communicate openly with the prescribing physician or treatment team about the lapse immediately. The provider can then evaluate the situation, ensure no underlying medical issues contributed to the slip, and determine if any adjustments to the medication dosage or the psychosocial support plan are necessary.
Continued communication helps the medical team monitor for any severe side effects or changes in mental health that might occur during this vulnerable time. Though rare, changes in mood or the emergence of suicidal thoughts are risks associated with Alcohol Use Disorder recovery and require immediate professional attention. The goal following a lapse is to maintain compliance with the treatment regimen and intensify psychosocial support to prevent the slip from progressing into sustained problematic alcohol use.