Alcohol Medications: Questions to Ask Before Admission

Three medications are approved by the U.S. Food and Drug Administration to treat alcohol use disorder: naltrexone, acamprosate and disulfiram. That is the fact families most often miss when they start calling programs, and it changes what a useful admission call sounds like. Instead of asking only “do you take our insurance,” a person can ask which of the three medications the program’s prescriber would consider, who would assess it, and what has to happen before the first dose. The National Institute on Alcohol Abuse and Alcoholism describes these medications as one part of care that can be combined with counseling and other support.

Why medication questions belong in the admission call

Annandale Behavioral Health is a small, private six-bed residence in the Los Angeles and Pasadena area that treats substance use disorders, including when a mental health condition is present alongside them. In a residence that size, the person answering your questions is usually close to the clinical team, which makes the admission call a good moment to raise medication. Waiting until week two means the conversation happens when cravings, sleep problems and mood are already competing for attention.

Medication is not right for everyone, and it is never a substitute for a full assessment. It is a decision made by a licensed prescriber who knows the person’s medical history, current medications, liver and kidney function, and goals. What follows is educational: it helps you ask better questions, not choose a drug.

The three medications, in plain language

Naltrexone: works by blocking opioid receptors and is used to reduce heavy drinking and cravings, and a prescriber will want to know about any recent opioid use because the two do not mix safely.

Acamprosate: is used after drinking has stopped to support abstinence, and prescribers usually check kidney function first because the body clears it through the kidneys.

Disulfiram: causes an unpleasant physical reaction if alcohol is consumed, so it depends on the person being informed, willing and medically appropriate for it.

Each has different cautions, and the Substance Abuse and Mental Health Services Administration publishes general information on medications for substance use disorders. Our own page on medication-assisted treatment in Los Angeles explains how this fits into a residential plan in more detail.

What to do before any medication decision: detox comes first for many people

Heavy, regular drinking creates physical dependence, and stopping suddenly can cause withdrawal that includes seizures. Alcohol withdrawal can be dangerous, and it requires medical supervision. Benzodiazepine withdrawal carries the same seizure risk. Nobody should stop either on their own after a long period of heavy use, and that includes stopping “just for a few days” before an admission date.

This matters for medication timing. Acamprosate and disulfiram are generally started after withdrawal has been managed, not during it, and naltrexone timing depends on the person’s situation and the prescriber’s judgment. If detox is needed, ask the program to explain the order of events. Our page on alcohol detox in Los Angeles covers what supervised withdrawal looks like. The NIAAA also offers general guidance on alcohol withdrawal for the public.

An executable checklist: what to bring and ask today

You can do the following today, before any admission is confirmed. Write the answers down, because admission calls are stressful and details blur.

A medication list: write every prescription, over-the-counter product and supplement the person takes, with doses, and keep a copy to hand to the admitting team.

A drinking and drug history: note roughly how much, how often, when the last drink or dose was, and whether there have been past withdrawal symptoms or seizures.

Recent opioid use: say so plainly if it has happened, since it affects whether naltrexone is an option.

Recent lab work: if the person has had liver or kidney tests, bring the results, because prescribers use them.

Then ask these questions on the call: Who is the prescriber and when do they assess new residents? Which medications do you consider for alcohol, and for opioids? What is your process if detox is needed first? What happens to the medication plan when I leave the residence, and who prescribes it afterward? Ask for the answer to the last question in plain words, because continuity after discharge is where plans most often fall apart. Call 855-778-8668 to ask these directly, or use the same list with any program you are comparing.

Co-occurring conditions and medication

Many people who drink heavily also live with depression, anxiety, trauma-related symptoms or trouble sleeping. At Annandale, these are addressed as co-occurring with a substance use disorder, not as a separate reason for admission. Tell the team about them early. Some psychiatric medications interact with the drugs above, and a single prescriber who sees the whole picture is safer than several who do not. Our dual diagnosis treatment page describes this approach.

Insurance and cost questions to pair with the medical ones

Medication coverage and residential coverage are often handled by different parts of an insurer. Ask the program to verify benefits for both, and ask whether prior authorization might apply. Our PPO insurance page outlines how verification generally works. Coverage varies widely by plan, so no one can promise an outcome before the plan is checked.

Common questions families ask about medication

Choice and consent: the person in treatment decides with the prescriber whether to try a medication, and it is reasonable to say “not yet” or to ask for time to think it over.

Formulations: naltrexone is available as a daily tablet and as a monthly injection, so a person who worries about remembering pills can ask the prescriber whether the injection is an option for them.

Side effects: every one of these medications can cause side effects in some people, which is why a prescriber reviews history first and checks in afterward rather than prescribing once and stepping away.

Time on medication: how long someone stays on a medication is an individual clinical decision, so ask the prescriber what the plan is for reviewing it rather than assuming a fixed length.

How to compare programs fairly

When you call more than one program, ask each of them the same questions in the same order and keep the answers side by side. Differences in how clearly a program explains who prescribes, how detox is supervised and what happens at discharge are often more telling than any brochure. A program should be comfortable saying what it does not offer, and a straight answer of “we would refer that out” is a good sign, not a bad one. Because Annandale is a six-bed residence, it is also fair to ask how many clinicians are involved in each person’s plan and how often they meet with residents. Families sometimes find it helpful to add one final question about family involvement, such as whether relatives can join a call to understand the plan, and what the person in treatment must consent to before anyone else is told anything.

What medication cannot do

No medication cures alcohol use disorder. Research supports these medications as tools that can help some people reduce drinking or stay abstinent, and outcomes differ from person to person. They work best inside a broader plan that includes counseling, support and follow-up care. The SAMHSA treatment resources also help families understand the range of options.

If you need help right now

If someone is in immediate danger, call 911. If you or someone you love is thinking about suicide or in emotional crisis, call or text 988, the Suicide and Crisis Lifeline, at any hour. If someone has been drinking heavily and is shaking, confused, hallucinating or has had a seizure, treat it as a medical emergency. To talk through treatment options, you can reach our admissions team at 855-778-8668.

This article is for general education and is not medical advice. It does not diagnose any condition or replace an evaluation by a licensed clinician. Treatment decisions, including medication, should be made with a qualified prescriber who knows the individual’s history.