Who Answers?



Antabuse (disulfiram) is a medication used in the treatment of chronic alcoholism. The drug works by inhibiting a key enzyme involved in the metabolism of alcohol, and results in a rapid build-up of acetaldehyde, a major cause of hangovers. Naturally, drinking on Antabuse is highly unpleasant.


One controversy surrounding Antabuse is that the drug does not directly address the mental obsession associated with alcoholism. My counter-argument is that with continued abstinence, the alcoholic can be introduced to recovery and potentially experience the gradual lift of that obsession. Many alcoholics never reach physical sobriety, and Antabuse essentially forces open that door. Whether the alcoholic takes the 12 steps through it is his or her own decision, but at least the alcoholic is given that choice.

Another controversy is over the severity of the physical reaction when alcohol is combined with Antabuse. My response is that taking the Antabuse is my decision; my psychiatrist warned me of the consequences of drinking on the medication. And personally, I’d prefer a terrible short-term hangover to long-term legal repercussions following a violent blackout; and I’d definitely choose that hangover over the permanence of a fatal overdose.

Now, to make things really personal… I was recently prescribed Antabuse to combat my impulsivity in regards to that first drink. A month prior, I had relapsed during a vacation with family. I was two weeks out of rehab and had no intention of drinking. When I entered my hotel room, I saw wine bottles and snatched them almost instanteously. I took one swig and there was no turning back. Over the next couple days, I stole and abused about a dozen of my Grandma’s Ativan as well as half of her 50-pill Vicodin presciption. After the pills and alcohol wore off, I was appalled with myself, but frankly not all that surprised.

I am naturally impulsive, but on Antabuse, I know I’ll become violently ill if I drink at all, let alone the way I typically drink. I am learning to pause; that would have never happened if I were still in active addiction. I don’t plan to stay on Antabuse for life, but it’s done it’s job thus far. I’m becoming grounded in AA and feel further from the bottle than ever. Even if I had an impulsive episode and decided to discontinue the Antabuse abruptly, I know that the drug would remain in my system for up two weeks, giving me ample time to return to my senses. To the critical sober purists who can abstain “all by themselves,” I’ll say this: Good for you, but it’s not really a competition. I’m trying to live, and with this disease, I need all the help I can get.


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