HAMS: Harm Reduction for Alcohol

What Is Antabuse?

Antabuse is the drug which makes you sick when you drink alcohol. Antabuse works by blocking the metabolism of acetaldehyde. Acetaldehyde is a poisonous byproduct of alcohol metabolism which is normally eliminated from the body almost as quickly as it is produced. Antabuse blocks the action of the enzyme which breaks down acetaldehyde and allows it to build up in the body.

If a person drinks alcohol after taking Antabuse it causes flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, copious vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, marked uneasiness, weakness, vertigo, blurred vision, and confusion. In severe reactions, there may be respiratory depression, cardiovascular collapse, arrhythmias, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death. The intensity of the reaction may vary with each individual but is generally proportional to the amount of disulfiram and alcohol ingested. In the sensitive individual, mild reactions may occur when the blood alcohol concentration is increased to as little as 5 to 10 mg/100 mL. At a concentration of 50 mg/100 mL symptoms are usually fully developed, and when the concentration reaches 125 to 150 mg/100 mL unconsciousness may occur.

The generic name for Antabuse is disulfiram. Because medication compliance is extremely low, Antabuse has not generally been found more effective than a placebo in treating drinking problems. However, there is some evidence that antabuse is useful for individuals who are highly motivated to abstain. Antabuse has also proven effective when used with a community reinforcement approach, for example when the antabuse is administered by a spouse.

Some people have used antabuse to help them practice harm reduction. In this case the individual takes antabuse while they are choosing to maintain an abstinence period. When the individual chooses to have a drinking day the individual discontinues the antabuse and allows about four days for the antabuse to clear the system. The individual has their drinking day and then returns to antabuse and abstinence.

CAUTION: Antabuse should not be taken by people with liver damage or heart disease. Antabuse can cause liver damage or failure even in healthy individuals. Antabuse can react with many medications other than alcohol. People who are allergic to antabuse should not take antabuse. For full FDA cautions on the use of antabuse please visit this page:

Please also visit our web pages:
Medications for Abstinence or Moderate Drinking
The Efficacy of Antabuse, Campral, and Naltrexone in Treating Alcohol Use Disorders


Garbutt JC (2009). The state of pharmacotherapy for the treatment of alcohol dependence. Journal of Substance Abuse Treatment. Jan;36(1):S15-23.
PubMed Abstract: http://www.ncbi.nlm.nih.gov/pubmed/19062347

O'Brien, CP., McKay, J (2002). Pharmacological treatments for substance use disorders. In Nathan, PE., Gorman, JM. (Eds.) A guide to treatments that work (2nd ed.). (pp. 125-156). New York, NY, US: Oxford University Press.

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