Acamprosate (Campral) for Alcohol Use Disorder

What Is Acamprosate?

Acamprosate (brand name Campral) is an FDA-approved daily oral medication that helps people who have recently stopped drinking stay stopped. Unlike a medication that blunts cravings in the moment, acamprosate works quietly in the background to rebalance brain chemistry after alcohol cessation — making the weeks and months of early abstinence more manageable and more durable.

Acamprosate is one of two FDA-approved medications we prescribe for alcohol use disorder at Restoration Recovery. The other is Vivitrol (extended-release naltrexone). The two work through different mechanisms and fit different patients. Your provider will help you decide which is right for you — or whether a combination is appropriate.

Key point for anyone considering acamprosate: this medication is designed for patients who are already abstinent at the start of treatment. It supports the maintenance of abstinence; it does not help initiate it. If you are still actively drinking, the right conversation to start with is how to get through detox and early withdrawal safely — then acamprosate becomes an option for the weeks and months that follow.

How Acamprosate Works

When someone drinks heavily over a long period, the brain adapts. Chronic alcohol use dampens the glutamate system (the brain’s main excitatory signal) and amplifies the GABA system (the main calming signal). When drinking stops, that balance flips suddenly: glutamate activity surges and GABA activity drops, producing the restlessness, anxiety, disrupted sleep, and persistent cravings that characterize the first weeks and months of sobriety — often called post-acute withdrawal.

Acamprosate works by helping to normalize that glutamate/GABA balance. It doesn’t produce a drug effect, doesn’t block anything, and doesn’t interact with alcohol directly. It simply takes some of the chemical pressure off the brain while it heals. Patients often describe the difference as subtle but real: the constant, low-level pull to drink becomes quieter. Sleep improves. Anxiety eases. The day-to-day work of staying sober gets easier.

One meaningful pharmacologic advantage of acamprosate: the medication is not metabolized by the liver. It passes through the body essentially unchanged and is excreted by the kidneys. That makes it a particularly good fit for patients with significant liver disease, where other medications may be contraindicated or require extra caution.

Who Is a Candidate for Acamprosate?

Acamprosate may be appropriate for patients who meet one or more of the following:

• Already abstinent at the start of treatment. This is the most important clinical requirement. Acamprosate is a maintenance medication — it supports abstinence rather than inducing it.
• Diagnosed with moderate-to-severe alcohol use disorder and looking for medication support alongside counseling
• Prefer a daily oral medication over a monthly injection
• Have significant liver disease, which can make Vivitrol a less-than-ideal fit
• Have tried behavioral treatment alone and want additional pharmacologic support
• Want a non-addictive medication with no abuse potential or dependence risk

Acamprosate is not typically prescribed for patients who are still actively drinking. If you are still in the active-drinking phase, our team can help you think through what safe cessation looks like for your situation — we do not provide inpatient detox, but we can refer you appropriately, and acamprosate becomes an option once you’re through that stage.

How Treatment Works at Restoration Recovery

Starting acamprosate at Restoration Recovery follows our standard four-step first-visit flow, typically lasting 60 to 120 minutes:

1. Intake. You’ll complete paperwork and a clinical intake. For alcohol use disorder, this includes a DSM-5 assessment covering AUD criteria and severity, a review of your drinking history, current health status, and any relevant lab work. We’ll also check kidney function, since acamprosate is renally cleared and dose adjustments are required for reduced kidney function.
2. Counseling. You’ll meet with a counselor to discuss your drinking history, prior treatment, current abstinence status, and personal recovery goals.
3. Doctor evaluation. A medical provider reviews your intake and counselor notes, confirms abstinence at treatment initiation, explains how acamprosate fits your situation, and walks through what to expect during the first weeks on the medication.
4. Prescription. If acamprosate is clinically appropriate, you’ll leave the same day with a prescription. The standard dosage is two 333 mg tablets taken three times daily — morning, midday, and evening with meals. Your provider will discuss how to build the schedule into your daily routine.

After your first visit, ongoing acamprosate care at Restoration Recovery includes:

• Monthly or biweekly follow-ups. Early in treatment, visits are more frequent to confirm the medication is being tolerated and is fitting your schedule. As you stabilize, visits can shift to less frequent intervals.
• Ongoing counseling. Medication alone is not a complete treatment plan. Acamprosate is paired with individual counseling and peer support to address the behavioral, emotional, and situational drivers of alcohol use.
• Telehealth follow-ups where appropriate. Because acamprosate is a daily oral medication, many routine follow-ups can be done via telehealth once you’re stable — which means staying on treatment doesn’t require disrupting work or family.

Benefits of Acamprosate for Alcohol Use Disorder

Patients who take acamprosate as prescribed often describe several practical advantages:

• Quieter cravings and more durable abstinence. The medication helps normalize the brain’s stress response to not-drinking. What was a constant pull becomes a softer signal.
• No abuse potential. Acamprosate is not a controlled substance and does not produce dependence. It can be stopped at any time without withdrawal.
• Safe in liver disease. Because it isn’t metabolized by the liver, acamprosate is often the preferred alcohol-use-disorder medication for patients with compromised liver function.
• Minimal drug interactions. The lack of hepatic metabolism also means acamprosate doesn’t compete with most other medications for liver enzymes — a meaningful benefit for patients on multiple medications.
• Daily pill, not an injection. Some patients prefer the flexibility of a medication they take at home, integrated into their daily routine.
• Pairs with counseling and peer support. Acamprosate works best as part of a comprehensive plan, and the surrounding care at Restoration Recovery is built around that.

What the Research Shows on Acamprosate

Acamprosate has one of the largest evidence bases in all of alcohol-use-disorder pharmacotherapy. Dozens of randomized trials. Thousands of patients. Decades of real-world use. The medication is also one of two alcohol-use-disorder medications recommended at the highest evidence grade by the American Psychiatric Association. What follows is the core data, with an honest note on how to read it.

What to Expect on Acamprosate

Acamprosate doesn’t produce a drug effect the way some medications do — you don’t feel a “dose” kick in. The benefits are subtler and accumulate over weeks. Patients commonly describe a softening of the constant background pressure to drink, improved sleep, and a reduction in the anxiety that dominates early sobriety.

Common side effects are mostly gastrointestinal: diarrhea is the most frequent (reported by about 16% of patients in trials versus 10% on placebo) and usually improves over the first several weeks. Some patients experience insomnia, anxiety, or mild nausea — often difficult to distinguish from post-acute withdrawal itself. Your provider will review the full profile during your evaluation and monitor for any concerns at each follow-up visit.

Because acamprosate is renally cleared, your provider will check your kidney function before starting and periodically during treatment. Patients with severely reduced kidney function (creatinine clearance 30 mL/min or less) should not take acamprosate; those with moderately reduced function may require a lower dose. These are routine labs; the monitoring is not burdensome.

It is important to understand that acamprosate is one component of a broader treatment approach. The medication is most effective when combined with regular counseling, peer support, and a commitment to recovery-oriented lifestyle changes. Your treatment team at Restoration Recovery will help you build a plan that addresses all of these elements together.

Why Patients Choose Restoration Recovery for Acamprosate

The research is clear that acamprosate works for the right patient — but the clinic you choose to receive it at shapes whether it actually sticks. Here is what patients find at Restoration Recovery:

• Four physical clinics across Tennessee and Georgia. Chattanooga, Cleveland, Soddy-Daisy, and Ringgold. You’re seeing a real provider in a real clinic — not filling prescriptions from an app with no follow-through.
• Licensed providers and a CARF-accredited program. CARF (Commission on Accreditation of Rehabilitation Facilities) is the gold standard in addiction-treatment accreditation — a level of clinical scrutiny most outpatient clinics do not pursue.
• Two FDA-approved AUD medications under one roof. Acamprosate alongside Vivitrol, so we can fit the medication to the patient rather than routing you to a different clinic based on which drug you want to try. Some patients benefit from either, and some eventually switch between them.
• Integrated counseling and behavioral health in-house. Acamprosate without counseling is only part of a treatment plan. We provide both under one roof.
• Telehealth follow-ups where appropriate. Because acamprosate is a daily oral medication, many routine check-ins can happen via telehealth once you’re stable — which means staying on treatment doesn’t have to disrupt work or family routines.
• One of Chattanooga’s longest-running outpatient clinics. Some of our patients have been with us for more than five years. Continuity matters in recovery.
• 4.5 stars across more than 40 verified Google reviews. Real patients, real experiences.
• Most major insurance plans accepted. TennCare, Medicaid, Medicare, and commercial carriers. For most patients, out-of-pocket cost is minimal to none.
• Confidential by federal law. Your treatment is protected under HIPAA and 42 CFR Part 2.

Insurance and Payment

Restoration Recovery accepts most major insurance plans for acamprosate treatment, including TennCare, Medicaid, Medicare, and a wide range of commercial insurance plans. Our patient services team can verify your coverage before your first visit and explain any out-of-pocket costs so there are no surprises. If you have questions about insurance or payment options, visit our insurance page or call us directly. Acamprosate is available as a generic, which in most cases keeps the monthly prescription cost low even without insurance.

Four Convenient Locations

Acamprosate is prescribed at all four of our outpatient clinic locations:

• Chattanooga, Tennessee
• Cleveland, Tennessee
• Soddy-Daisy, Tennessee
• Ringgold, Georgia

Each location is staffed by licensed providers experienced in alcohol use disorder treatment and medication-assisted care. Same-week appointments are frequently available.

Acamprosate vs. Vivitrol

Acamprosate is one of two FDA-approved medications we prescribe for alcohol use disorder at Restoration Recovery. The other is Vivitrol (extended-release naltrexone). Both are recommended at the highest evidence grade by the American Psychiatric Association. The right choice depends on your situation:

• Acamprosate (Campral) — daily oral tablet (two 333 mg tablets, three times daily). Supports continuous abstinence by normalizing brain chemistry after alcohol cessation. Renally cleared, which makes it safer in liver disease. Requires patient to already be abstinent at the start of treatment. Strongest evidence base for maintenance of abstinence.
• Vivitrol (extended-release naltrexone) — monthly intramuscular injection. Blocks the reward signaling associated with drinking, reducing heavy drinking days. Hepatically cleared, so liver health is a consideration. Strongest evidence for reducing heavy drinking.

For opioid use disorder, we prescribe different medications — Suboxone (buprenorphine/naloxone), Sublocade, and Brixadi — all designed for that condition. Acamprosate is not used for opioid use disorder.

If you or someone you care about is struggling with alcohol use disorder, we encourage you to reach out. Recovery is possible, and the right combination of medical support and clinical care can make a meaningful difference. Contact Restoration Recovery today to schedule an evaluation or to learn more about how acamprosate can support your path to sobriety.

For a full list of conditions we treat and treatment approaches we offer, visit our services page.

References

The statistics and clinical findings on this page come from peer-reviewed medical research and authoritative public-health sources. Patients, family members, and providers are welcome to verify any claim against the original source.

1. Rösner S, Hackl-Herrwerth A, Leucht S, Lehert P, Vecchi S, Soyka M. Acamprosate for alcohol dependence. Cochrane Database of Systematic Reviews. 2010;(9):CD004332. doi:10.1002/14651858.CD004332.pub2.
2. Anton RF, O’Malley SS, Ciraulo DA, et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA. 2006;295(17):2003–2017.
3. Reus VI, Fochtmann LJ, Bukstein O, et al. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder. Am J Psychiatry. 2018;175(1):86–90.
4. Witkiewitz K, Saville K, Hamreus K. Safety and efficacy of acamprosate in the treatment of alcohol dependence. Substance Abuse. 2010;2010(2):117–124.
5. Fairbanks J, Umbreit A, Kolla BP, et al. Alcohol Use Disorder: Pharmacologic Treatment Options. Am Fam Physician. 2020;102(7). American Academy of Family Physicians.
6. American Society of Addiction Medicine (ASAM) and U.S. Department of Veterans Affairs / Department of Defense (VA/DoD). Clinical Practice Guidelines for Substance Use Disorders.
7. American Association for the Study of Liver Diseases (AASLD). How Do I Manage Alcohol Use Disorder in Hepatology Clinic? Liver Fellow Network clinical pearls.
8. CAMPRAL (acamprosate calcium) delayed-release tablet. Prescribing Information. Accessed via DailyMed, U.S. National Library of Medicine.