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This Month’s Topic: By the time we get them in RSAT, our inmates committed for DWI have been detoxed many times, been in repeated counseling programs, participated in AA, sometimes for months, been monitored with SCRAM, rewarded and sanctioned by the DWI court, all to no avail. Any suggestions when their sentences run out and they graduate RSAT?

As Einstein supposedly said, doing the same thing over and over again and expecting different results is the definition of insanity. Maybe it is time to encourage these chronic alcohol abusers to add medication assisted treatment to their relapse prevention counseling and programming once released to the community.

Although most people associated medication assisted treatment with opioid treatment, the FDA has approved several medications for alcohol use disorder treatment.  They are Acamprosate (Campral), Disulfiram (Antabuse) and Naltrexone (Pills-Depade, ReVia; Injectable- Vivitrol). While Disulfiram has been around since 1951, the others are newer.  Acamprosate is a pill that has to be taken three times a day.  It decreases craving, relieving symptoms of protracted alcohol withdrawal or post-acute withdrawal.  Naltrexone blocks cue triggers and craving and decreases the euphoric effects of both alcohol and opioids. It is a pill that has to be taken daily.   Injectable Naltrexone, Vivitrol, lasts 30 days so only have to be administered monthly.  Disulfiram causes severe physical discomfort if alcohol is consumed and is administered in pill form.

Like all medications, these medications pose risks to some persons under some circumstances. None of the above medications is controlled substances unlike some of the medications for opioid treatment, like methadone and buprenorphine (suboxone).

See the RSAT TTA Manual on MAT on this website and take the eLearning Course on MAT to learn more about MAT for alcohol.  Also if you check out prior RSAT webinars under Archives a RSAT program in Barnstable, Massachusetts described their MAT program that used Vivitrol for opioid and alcohol use disordered inmates.  Inmates receive their first injection three days before release to make sure they don't revert quickly to old habits immediately upon release.  The RSAT MAT manual contains a copy of the PowerPoint the Barnstable RSAT program developed to educate inmates on how MAT might help them upon release to stay sober.

A report I have contained the following quotes from repeat drunk drivers under supervision of a DWI Court that provides access to Vivitrol  for repeat drunk drivers.  They described what they said Vivitrol did for them: “Brains settled down”, “ less craving”, “became better person”, “calmer mind/better concentration”, and “ amazed it worked.”