Alcohol Use Disorder Treatment · Updated June 2026
Acamprosate (Campral) for Alcohol Use Disorder
FDA-approved daily oral medication that supports continuous abstinence from alcohol — prescribed at four outpatient clinics across Tennessee and Georgia. Requires that you be abstinent from alcohol at the start of treatment.
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At a glance
Who Acamprosate is best for
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Acamprosate is the daily oral medication for alcohol use disorder most appropriate for patients who are already abstinent at initiation and want to maintain that abstinence. Two 333 mg tablets taken three times daily reduce craving and the post-acute symptoms of alcohol withdrawal that drive relapse. Rösner 2010 Cochrane documented improved continuous-abstinence rates compared to placebo. Unlike Vivitrol, no injection visit is required.
Acamprosate is prescribed and managed through outpatient care at Restoration Recovery’s four CARF-accredited clinics across Tennessee and Georgia. Kidney function is checked before initiation (acamprosate is renally cleared). Same-day appointments available; TennCare, BlueCare, BCBS, UHC, and most commercial insurance accepted.
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 four FDA-approved medications we prescribe for alcohol use disorder at Restoration Recovery — alongside Vivitrol (extended-release naltrexone), oral naltrexone, and disulfiram. The four 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. For the full MAT picture across both opioid and alcohol use disorder, see our MAT Medications Compared tracker.
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.
Your options
Four FDA-Approved AUD Medications
Restoration Recovery prescribes all four FDA-approved medications for alcohol use disorder. They work through different mechanisms — some quiet cravings, one normalizes brain chemistry, one deters drinking outright — so your provider matches the medication to your situation at the first visit. Acamprosate is the daily oral option for patients who are already abstinent and want to maintain it.
This medication
Daily oral tablet
Acamprosate
Two 333 mg tablets, three times daily · taken with meals
For patients already abstinent who want to maintain it. A daily oral tablet that quiets the post-acute withdrawal symptoms driving relapse by normalizing glutamate/GABA balance. Renally cleared — often the preferred option for patients with liver disease. Not a controlled substance and no abuse potential.
Monthly injection
Vivitrol
Extended-release naltrexone · intramuscular injection once monthly
For reducing heavy drinking. A monthly injection that blocks the reward signaling alcohol activates, given in clinic. Works well for patients who are still drinking or in early cessation. Hepatically cleared, so liver health is a consideration. Administered at our Chattanooga, Cleveland, and Ringgold clinics.
Daily oral tablet
Naltrexone (oral)
Daily oral naltrexone · the same blockade as Vivitrol, taken by mouth
For craving reduction without an injection. The same opioid-receptor blockade as Vivitrol in a daily pill rather than a monthly shot. A fit for patients who want naltrexone’s mechanism but prefer oral dosing. Available at all four clinics.
Daily oral tablet
Disulfiram
Daily oral tablet (Antabuse) · an aversive deterrent
For highly motivated patients with stable support. Taken daily, it produces an unpleasant physical reaction if you drink — a deterrent rather than a craving modulator. Most effective for patients who want a built-in reason not to drink and have support at home. Available at all four clinics.
Some patients combine two — for example, acamprosate for ongoing maintenance and naltrexone for craving reduction. Vivitrol is an injection, so it is available at our Chattanooga, Cleveland, and Ringgold clinics; the three oral medications are offered at all four. For a side-by-side view of our five core MAT medications — Suboxone, Sublocade, Brixadi, Vivitrol, and acamprosate — see our MAT Medications Compared tracker.
The evidence
What the Research Shows on Acamprosate
Acamprosate has one of the largest evidence bases in alcohol-use-disorder care — pooled across 24 randomized trials and 6,915 patients. It is one of two AUD medications the American Psychiatric Association recommends at its highest evidence grade. The three findings below have been replicated across the literature.
23 → 36%6-month abstinence
36% of acamprosate patients stayed continuously abstinent at six months versus 23% on placebo — the European pivotal trials that formed the basis for the 2004 FDA approval. Witkiewitz K et al. Ther Clin Risk Manag. 2012;8:45–53.
NNT 9Return to drinking
A 14% relative reduction in returning to any drinking; for every nine patients treated, one additional patient avoids relapse who otherwise would have. Rösner S et al. Cochrane Database Syst Rev. 2010;(9):CD004332 — pooled across 24 trials, 6,915 patients.
Grade 1BAPA first-line
Co-first-line with naltrexone for moderate-to-severe AUD at the guideline’s highest recommendation category. Reus VI et al. APA Practice Guideline. Am J Psychiatry. 2018;175(1):86–90.
What these numbers actually mean
One of the largest evidence bases in AUD care
The Rösner 2010 Cochrane review pooled 24 randomized controlled trials across 6,915 patients and found a 14% relative reduction in the risk of returning to any drinking. The authors described the benefit as “moderate in magnitude ... valued against the background of the relapsing nature of alcoholism.” For every nine patients treated with acamprosate, one additional patient avoids returning to drinking who otherwise would have. The strongest single-trial evidence comes from the European pivotal studies behind acamprosate’s 2004 FDA approval: 36% of acamprosate patients maintained continuous abstinence at six months, compared to 23% on placebo.
One caveat: the largest U.S. trial — the 2006 COMBINE study — did not find a statistically significant benefit in its American sample, while European trials consistently did. The leading explanation is how patients were enrolled: European trials required full inpatient detox and abstinence at randomization, while COMBINE required only about four days of outpatient abstinence. This matches the FDA label: acamprosate supports maintenance of abstinence, not the initiation of it. That is why the first step in starting acamprosate at our clinic is confirming you’re abstinent, and building the rest of the plan from there.
The choice between acamprosate and naltrexone is a clinical one: acamprosate is renally cleared and often preferred for patients with significant liver disease; naltrexone is hepatically cleared and has slightly stronger evidence for reducing heavy drinking days. Both work. At Restoration Recovery, acamprosate is prescribed alongside counseling, peer support, and ongoing medical check-ins, which address the situations and habits that drive drinking.
Full citations in References: Rösner 2010 (Cochrane), Anton 2006 (JAMA, COMBINE), Witkiewitz 2012 (Ther Clin Risk Manag), Reus 2018 (Am J Psychiatry).
What to Expect at Your First Appointment
Your first visit typically lasts 2 to 3 hours and follows a four-step clinical flow. For alcohol use disorder, that includes a DSM-5 assessment and a check of kidney function — acamprosate is renally cleared, so dose adjustments are made for reduced kidney function. If acamprosate is clinically appropriate, you leave the same day with a prescription.
01
Intake
Paperwork and a clinical intake — a DSM-5 assessment covering AUD criteria and severity, a review of your drinking history, current health status, and relevant lab work, including a check of kidney function.
02
Counseling
You meet with a counselor to discuss your drinking history, any prior treatment, current abstinence status, and your personal recovery goals.
03
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 in the first weeks on the medication.
04
Prescription
If acamprosate is appropriate, you 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.
About 2–3 hours.If acamprosate is appropriate, you leave the same day with a prescription.Bring a photo ID, your insurance card, and a list of any medications.
What each step covers in detail+
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.
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.
Prescription. If acamprosate is clinically appropriate, you 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.
Bring a valid photo ID, your insurance card (if applicable), and a list of any medications you currently take. Records from previous treatment providers are helpful but not required. Anything you share during intake, counseling, or treatment is protected by HIPAA and 42 CFR Part 2 — the federal rule that specifically shields addiction-treatment records from disclosure without your written consent.
Ongoing Acamprosate Care
After your first visit, acamprosate is one component of a broader treatment plan. Early in treatment, follow-ups are more frequent — monthly or biweekly — to confirm the medication is tolerated and fitting your schedule; as you stabilize, visits shift to less frequent intervals. Medication alone is not a complete plan, so acamprosate is paired with individual counseling and peer support that address the behavioral, emotional, and situational drivers of alcohol use. Because acamprosate is a daily oral medication, many routine follow-ups can be done by telehealth once you’re stable — so staying on treatment doesn’t require disrupting work or family.
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: 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. Because acamprosate is renally cleared, your provider checks 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, and the monitoring is not burdensome.
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 will talk through what safe cessation looks like for your situation and the right timing to start — acamprosate becomes an option once you’re abstinent. For opioid use disorder we prescribe different medications — Suboxone, Sublocade, and Brixadi — and acamprosate is not used for opioid use disorder.
Why Patients Choose Restoration Recovery
Acamprosate works best when it is paired with counseling and steady follow-up. Here is what that looks like at Restoration Recovery:
Four physical clinics across Tennessee and Georgia. Chattanooga, Cleveland, Soddy-Daisy, and Ringgold. You are seeing a real provider in a real clinic — not filling prescriptions from an app with no follow-through.
The full AUD medication formulary under one roof. Acamprosate alongside Vivitrol, oral naltrexone, and disulfiram, so we can fit the medication to the patient rather than routing you elsewhere based on which drug you want to try. Some patients eventually switch or combine.
MAT-certified 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.
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 for established patients. Because acamprosate is a daily oral medication, many routine check-ins can happen from home once you’re stable — so staying on treatment doesn’t have to disrupt work or family.
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.
4.6 stars across 49 verified Google reviews. Real patients writing about real experiences. Read a few before you call.
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, which specifically shields addiction-treatment records from most forms of disclosure. What you share with us stays with us.
“I owe my entire recovery to this place. I had tried so many times in the past, but not until I found these guys did I succeed.”
CARF-accredited outpatient addiction care
TennCare, BlueCare, BCBS, UHC, Medicare & most commercial insurance accepted. We verify your benefits before your first visit — no surprises. Licensed in TN & GA · HIPAA · 42 CFR Part 2.
Insurance and Access
Restoration Recovery accepts most major insurance plans for acamprosate treatment, including TennCare, Medicaid, Medicare, and a wide range of commercial insurance providers. Acamprosate is typically classified under the pharmacy benefit, and generic acamprosate is widely available. 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 do not have insurance or are unsure about your coverage, contact us anyway. Self-pay for care at the clinic is a flat $250 per month. The prescription itself is filled and paid for at your pharmacy, separate from the clinic — and generic acamprosate is inexpensive even without insurance, often $30 to $80 a month. To check your specific plan before you book, use our 2-minute insurance verification or visit our insurance page.
Ready to start acamprosate?
Same-day appointments at all four clinics. Call and our team will verify your insurance and get you scheduled, in person or by telehealth follow-up after your first visit.
We operate four outpatient clinics across Tennessee and North Georgia. Acamprosate is an oral medication prescribed at all four, with same-day appointment availability.
All locations are designed for a comfortable, confidential outpatient experience. Telehealth follow-up visits are also available for established patients who have completed their initial in-person evaluation. Phones are answered Monday through Friday, 9am to 4:30pm Eastern. After hours? The 988 Suicide & Crisis Lifeline and the free, confidential SAMHSA National Helpline (1-800-662-4357) are available 24/7.
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.
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. [PubMed]
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. [PubMed]
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. [PubMed]
Witkiewitz K, Saville K, Hamreus K. Acamprosate for treatment of alcohol dependence: mechanisms, efficacy, and clinical utility. Ther Clin Risk Manag. 2012;8:45–53. [PubMed]
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.
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. [VA/DoD]
American Association for the Study of Liver Diseases (AASLD). How Do I Manage Alcohol Use Disorder in Hepatology Clinic? Liver Fellow Network clinical pearls.
CAMPRAL (acamprosate calcium) delayed-release tablet. Prescribing Information. Accessed via DailyMed, U.S. National Library of Medicine. [DailyMed]
Questions
Frequently Asked Questions
How does Acamprosate work?+
Acamprosate (brand name Campral) is thought to restore the balance between glutamate (excitatory) and GABA (inhibitory) neurotransmitters that becomes dysregulated during chronic alcohol use. This imbalance drives many post-acute withdrawal symptoms — persistent anxiety, restlessness, insomnia, mood variability — that can extend for weeks or months after stopping drinking. By partially normalizing these neurotransmitter systems, Acamprosate reduces the intensity and duration of those symptoms, making abstinence easier to maintain. The Rösner 2010 Cochrane review (24 RCTs, 6,915 patients) found a number-needed-to-treat of 9 for continuous abstinence.
Do I need to stop drinking before starting Acamprosate?+
Yes. Acamprosate is indicated for maintenance of abstinence in patients who have already stopped drinking. FDA labeling requires initiation after abstinence is achieved, and the evidence base supports this — the European pivotal trials required full detox before starting, while the US COMBINE trial (2006) started patients 4 days abstinent and saw less benefit. If you’re actively drinking, talk to your provider about timing — Vivitrol (naltrexone) may be a better fit for your current state, or a brief period of supervised abstinence may precede Acamprosate.
How is Acamprosate different from Vivitrol?+
Different mechanisms and administration. Acamprosate is a daily oral tablet (two 333 mg tablets, three times daily) that supports long-term abstinence by normalizing neurotransmitter balance. Vivitrol is a monthly intramuscular injection that blocks the reward pathway alcohol activates, reducing craving. Acamprosate is best for patients already abstinent who want to maintain it; Vivitrol works well for patients who are still drinking or in early cessation. Many patients use both together — Acamprosate for ongoing maintenance and Vivitrol for craving reduction. Your provider will help you choose or combine.
Is Acamprosate safe for patients with liver disease?+
Yes, and it’s often preferred over naltrexone in that context. Acamprosate is renally cleared (processed by the kidneys), not hepatically metabolized — meaning it doesn’t add stress to a liver that may already be stressed from years of alcohol use. Naltrexone, by contrast, is processed by the liver and can require dose adjustment or alternative choice in advanced hepatic disease. For patients with cirrhosis, elevated liver enzymes, or other liver conditions, Acamprosate is typically the first-line medication option for alcohol use disorder.
What are the side effects of Acamprosate?+
The most common side effect is diarrhea, which tends to improve over the first few weeks. Other possible side effects include headache, nausea, and fatigue. Compared to other alcohol-use-disorder medications, Acamprosate has a generally mild side-effect profile. Serious side effects are uncommon. The medication is not metabolized by the liver, so liver enzyme monitoring is not required the way it might be with naltrexone-based medications. Dose adjustment is needed for patients with moderate-to-severe kidney impairment, and it’s contraindicated in severe renal impairment.
Does my insurance cover Acamprosate, and how much is it?+
Most insurance plans cover Acamprosate, including TennCare (BlueCare, Wellpoint, UHC Community Plan), traditional Medicare Part D, Medicare Advantage, and most commercial plans. Acamprosate is typically classified under the pharmacy benefit (not medical benefit, since it’s a patient-administered tablet). Generic Acamprosate is available and inexpensive even without insurance — typical cash price is around $30–80/month depending on the pharmacy. Prior authorization is occasionally required. Our intake team can help verify your specific coverage during your first visit.
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