If drinking has become hard to control, medication can be one part of getting things back on track. Naltrexone and acamprosate are two options your doctor may discuss with you, based on your health and your goals.
Naltrexone and acamprosate are both used to help people reduce or stop drinking. Naltrexone works by blocking part of the brain's reward system, which can make alcohol feel less rewarding and lower the urge to drink. It comes as a tablet, usually taken once a day. Some people notice fewer cravings within the first few weeks, though everyone responds differently. Naltrexone is also used for opioid use disorder, so your doctor will ask about any opioid or pain medication use before prescribing it, since combining them can cause serious problems.
Acamprosate works differently. It helps steady brain chemistry that gets thrown off balance after long-term heavy drinking, which can ease some of the restlessness, anxiety, and sleep trouble that make staying sober harder. It's usually taken as tablets three times a day and is generally started once someone has already stopped drinking or is close to stopping. Acamprosate doesn't reduce cravings the way naltrexone does, so your doctor may recommend one, the other, or occasionally both, depending on your goals and health history.
Neither medication is a stand-alone cure, and no one can promise a specific result. They tend to work best as one part of a bigger plan that may include counselling, support groups, or check-ins with your family doctor. Your physician at the clinic will talk through the options with you, explain what each medication can and can't do, and help you decide what fits your situation and comfort level.
These medications can suit a wide range of people, from someone who wants to cut down on heavy drinking to someone who has already stopped and wants help staying that way. You don't need to have reached a crisis point to ask about medication, and you don't need to have tried and failed on your own first. Many people simply want an extra tool alongside their own efforts or other supports.
Naltrexone is not suitable for everyone. It shouldn't be used by people currently taking opioid pain medication or opioid agonist treatment, or by anyone who has used opioids recently, because it can trigger sudden, severe withdrawal. It also needs caution in people with certain liver conditions. Acamprosate is generally gentler on the liver but needs healthy kidney function, so your doctor will ask about kidney problems and may check this with a blood test before starting.
Being honest with your doctor about how much and how often you drink, any other medications or substances you use, and your overall health helps them choose the safer and more effective option for you. There's no need to feel judged or to downplay anything you share. The goal of the assessment is simply to understand your situation well enough to recommend the right medication, the right dose, and the right pace for you.
Treatment starts with booking an appointment. You can call 647-748-1337 between 9 a.m. and 5 p.m., seven days a week, to arrange a visit at the clinic, located at 55 Dundas St E in Toronto. Appointments are booked in advance rather than on a walk-in basis, so calling ahead gives you time to book a slot that works for your schedule.
At your first visit, the physician will review your health history, current medications, and your pattern of drinking, including how much, how often, and for how long. They may also ask about any past attempts to cut down, withdrawal symptoms you've had, and whether you use other substances. Depending on your history, they may order bloodwork to check your liver or kidney function before deciding which medication, if any, is right for you.
If naltrexone or acamprosate is a good fit, the doctor will explain the dose, how and when to take it, and what to expect in the first few weeks. Acamprosate can usually be started once you've stopped drinking or are very close to stopping. Naltrexone requires that you be free of opioids for a period beforehand, which your doctor will confirm with you so the medication is started safely.
Starting medication isn't a one-time event. Your doctor will book follow-up visits to check how you're doing, whether the medication is helping, and whether you're having any side effects. These visits are also a chance to adjust the dose if needed or to talk about anything that's come up, including cravings, mood, or life stresses that affect your drinking.
Because naltrexone is processed by the liver, your doctor may order periodic blood tests to check liver function, especially in the first few months. Acamprosate is cleared by the kidneys, so kidney function may be checked from time to time as well, particularly if you have other health conditions. These tests are a normal, low-effort part of monitoring and are done through routine bloodwork.
Common side effects can include nausea, headache, or stomach upset, and these often ease after the first week or two. Diarrhea is a known side effect of acamprosate for some people. If side effects are bothersome, don't stop the medication abruptly without checking in first — call the clinic so your doctor can advise you, adjust the dose, or suggest an alternative.
Physician visits at the clinic are covered by OHIP, so there's no charge to see the doctor if you have a valid Ontario health card. The medications themselves are filled at the pharmacy of your choice and may be covered in part or in full by a private drug plan, the Ontario Drug Benefit if you're eligible, or paid out of pocket, so it's worth checking your coverage before your visit.
For your appointment, bring your health card, a list of any medications, vitamins, or supplements you currently take, and a rough sense of your drinking pattern, such as how many drinks you have on a typical day or week. If you've had bloodwork done recently elsewhere, bringing those results can also help. It's fine to bring a written list of questions if that makes the conversation easier.
Once you and your doctor agree on a plan, you'll leave the visit with a clear next step, whether that's starting a medication, doing bloodwork first, or booking a follow-up appointment to reassess how things are going. You're also welcome to ask about other supports, such as counselling or community programs, if you'd like more than medication on its own.
If you're worried about your drinking, or worried about someone else's, reaching out is a reasonable first step, not a last resort. If you or someone else is in crisis, ConnexOntario is available anytime at 1-866-531-2600, and 911 is there for emergencies. For non-urgent questions or to book, call the clinic at 647-748-1337 or email info@addictionclinictoronto.ca.
Call 647-748-1337 (9 a.m.–5 p.m., seven days a week) or email info@addictionclinictoronto.ca to book a visit at 55 Dundas St E. Physician visits are covered by OHIP.