Disulfiram (Efficacy)

Disulfiram is an aldehyde dehydrogenase inhibitor used in the treatment of chronic alcoholism. The presence of the polymorphism related to the "flush" reaction to alcohol of the ALDH2 gene makes this treatment ineffective for treating alcohol dependence.

Alcoholism and alcohol abuse are two different problems. Alcoholism is the term used when alcohol consumption causes serious problems in a person's life, but the person continues his/her drinking habit. Tolerance and physical dependency also coexist which means that to quit drinking abruptly can cause withdrawal symptoms at the same time as a progressively greater need to feel drunk.

The term "alcohol abuse" is used when drinking causes problems of diverse types and in different situations (work, home, personal relationships, etc.) but without the physical dependency of alcohol.

The causes of alcohol problems are not fully known but several factors come into play in the person genetically susceptible: the psychosocial environment, family background, impulsive personality or low self-esteem.

There is a greater risk to suffer alcoholism in the following cases:

  • Men who have more than 15 alcoholic beverages* a week
  • Women who have more than 12 alcoholic beverages a week
  • Drinking more than 5 alcoholic beverages in a row at least once a week

*An alcoholic beverage or standard unit of beverage is defined by the NIAAA as:

  • 12 ounces (355 milliliters) of regular beer (about 5 percent alcohol)
  • 8 to 9 ounces (237 to 266 milliliters) of malt liquor (about 7 percent alcohol)
  • 5 ounces (148 milliliters) of unfortified wine (about 12 percent alcohol)
  • 1.5 ounces (44 milliliters) of 80-proof hard liquor (about 40 percent alcohol)

A person is more predisposed to alcohol abuse or likely to become alcohol dependent if he/she:

  • is under social pressure to consume alcoholic beverages.
  • presents or has a background of depression, bipolar disorder, anxiety or schizophrenia disorders.
  • has easy access to alcoholic beverages.
  • has problems with interpersonal relationships.
  • has a stressful lifestyle.


When a person has problems with alcohol, the following problems or conduct can be detected:

  • Continued drinking even when one's health, work or family are affected
  • Drinking alone
  • Becoming violent, excited or tense when drinking
  • Being hostile when asked about alcohol consumption
  • Inventing excuses to drink
  • Missing work, school or not carrying out duties or activities  because of alcohol use
  • Not taking part in favorite activities because of alcohol use
  • Having to drink to get through the day
  • Neglecting to eat, to wash or to change clothes
  • Trying to hide one's alcohol consumption
  • Have tremors in the mornings or after long alcohol-free periods

The symptoms of alcohol dependence can also include:

  • Tolerance: the growing need for more and more alcohol to feel the same effects
  • Withdrawal symptoms when you haven't had a drink in a period of time
  • Alcohol-related illnesses such as alcoholic liver disease

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