It is scary to drink while on medication for alcohol use disorder. But you can manage it. The next step depends on your medicine. It also depends on how much you had. The timing matters. Other drugs and symptoms play a part.
Call Poison Help for any other cases.If you have severe symptoms, call 911. Or go to the nearest emergency room now. Your prescriber or pharmacist is another person to ask. They will share advice that fits your specific situation. Do not stop or change your meds on your own.
We run a U.S. treatment directory. We do not act as a treatment provider. The info here is general, not medical advice. Read more about medications for alcohol use disorder. For a broader look at medication options for alcohol use disorder, see our guide to MAT for alcohol use disorder.
Relapse on Alcohol Medication: What to Do
It can be scary to drink when you take alcohol medication. If you have any danger signs below, call 911 or go to the nearest emergency room now; otherwise, contact a professional who knows your specific situation.
911
Call immediately for an emergency
988
Call or text for suicidal thoughts or a mental health crisis. For thoughts of suicide or self-harm, immediate danger, or an attempt in progress, call 911 or go to the nearest emergency room now.
- Get to a safe place. Do not drive. If possible, ask a sober friend or family member to stay nearby with you.
- Check for danger signs. Seizures, severe confusion, hallucinations, a high fever, or a racing heart during withdrawal can be signs of a serious emergency.[1] If you have any of these signs, or thoughts of suicide or self-harm, call 911 or go to the nearest emergency room now.
- Contact a professional. If you do not have any of those danger signs, call Poison Help at 1-800-222-1222, your prescriber, or a pharmacist for individualized advice.
- Follow professional guidance. Do not stop, skip, double, or change your medication based on a guess or general online rules. Only change your dose if a qualified professional tells you to.
It is normal to want to change your dose after drinking, but doing so without a doctor's advice can be risky. Tell your doctor what happened and how to move forward safely. You can find helpful tips on talking to your clinician to get ready for that talk.
When Does Drinking on Alcohol Medicine Need Urgent Help?
Call 911 or go to the nearest emergency room right away. Do not wait to see if things get worse.
Get emergency help now if you see:
- Seizures or convulsions
- Bad confusion or a hard time staying awake
- Hallucinations (hearing or seeing things that are not there)
- Fever that is high or a heart that beats fast and unevenly
- Signs of an overdose, like slow breathing or vomiting
- Thinking about suicide or hurting yourself
After heavy drinking stops, alcohol withdrawal can get serious.[1] You may need medical care.[1] Bad withdrawal can bring confusion, hallucinations, and seizures.[1] It can also cause fever or a fast heartbeat.[1]
If you think someone has an alcohol overdose, call 911 now.[2] Overdose signs include trouble waking up and slow breathing.[2] Vomiting and seizures are also warning signs.[2]
If someone is hard to wake up, they need help now. Not being able to breathe is an emergency. Collapsing or seizing means call 911. Do not sit and wait.
It is hard to say if signs come from alcohol or from the medication. Do not try to guess the cause at home. Read our guide on signs of severe withdrawal for more safety tips.
Call your doctor or pharmacist if you lack these danger signs. They can offer advice tailored to your specific situation. Prioritize alcohol-use-disorder medication safety by learning when to act fast.
How Your Specific Drug Affects Safety
It is hard to say if drinking is safe on alcohol medication. Risk levels shift with the drug you use. The FDA has cleared three drugs for alcohol use disorder: acamprosate, disulfiram, and naltrexone.[3] For a closer look at how naltrexone works for alcohol cravings, see our dedicated guide on that medication.
These drugs for alcohol use disorder work in distinct ways. Each one comes with its own safety rules.
| Medication | Role in Treatment | Safety Context After Drinking |
|---|---|---|
| Disulfiram | Helps stop drinking by causing bad reactions if alcohol is present. | A reaction may happen if you drink during treatment or for up to 14 days after stopping the medication.[4] Avoid alcohol during this entire period and check with your prescriber before drinking. |
| Naltrexone | Lowers cravings and the reward from alcohol. | Current opioid use or dependence can make naltrexone unsafe and may trigger withdrawal.[5] Ask your clinician about your specific opioid history. Read our guide on naltrexone safety considerations. |
| Acamprosate | Helps you stay sober by balancing brain chemicals. | It works with counseling and support to help you avoid drinking alcohol again.[6] Ask your provider for advice on managing any slips. |
Each drug has its own safety rules. Do not make guesses about safety. Call your prescriber or pharmacist for help with your prescription. If side effects appear, check managing medication side effects. Therapy and support groups can be used with these meds or alone.[3] Knowing which med you take is key to getting help after a slip.
What to Prepare Before You Call
Getting the right advice is easier with clear facts. Write down these details before you dial. Pull from your pill bottle or a written list. Do not use memory.
The FDA uses set forms for its Medication Guides. These forms may not show every rule for a certain drug.[7] Check the label on your medicine for its exact details.
Before You Call
Your ticks are saved on this device only.
This list is for getting ready to call. It is not a medical check-up. Take your meds the way your doctor tells you to.
Relapse Does Not Undo Your Hard Work
Drinking again is not a moral failure. It does not mean you should quit treatment. Alcohol use disorder is a complex, multifaceted, but treatable medical condition.[8]
The ground you covered still holds value. Here are actions to take now:
- Call your prescriber or treatment team as soon as you can.
- Talk about what occurred and if your care plan needs a review.
- Ask for help with specific triggers or cravings.
- Talk to a peer support group or a recovery coach.
Support from peers that links people to ongoing help is tied to lower relapse and re-admission rates. It also boosts engagement and social support for change.[9]
Family and friends can support someone after an alcohol relapse by listening without judgment. Ask the person what type of help they want. You can offer to place the call or go to the next appointment with them. You only need to show up; you do not have to fix the problem.
See our guide on steps after a relapse for more details on moving forward.
Take a Safer Path Forward
Use this check to get ready for a talk with a pro. It is not a diagnosis. It cannot say if an interaction is safe.
Which Next Step Should I Take?
This self-check is for information only and isn't a diagnosis. It cannot determine whether an interaction is safe.
If you are unsure about alcohol-use-disorder medication safety after drinking, ask your care team for help.
Keep Reaching Out for Help
Reaching out for help after an alcohol relapse is vital for staying on course. You do not need to sort it all out on your own. If keeping sober is tough or you want help picking the right care, reaching out is a solid choice.
People with substance use disorders can get treatment info and referrals there.
If you are having emergency symptoms, call 911 or go to the nearest emergency room right away. Do not wait to search for a program. For everyone else, you can find treatment near you to see local options for alcohol use disorder care.
Frequently Asked Questions
What should I do if I drank while taking disulfiram?
Call Poison Help or your prescriber right away. Tell them how much you drank and when. Disulfiram-alcohol reactions can cause flushing, headache, nausea, vomiting, chest pain, weakness, blurred vision, mental confusion, sweating, choking, breathing difficulty, and anxiety.[4] If you have trouble breathing, chest pain, fainting, a seizure, or severe confusion, call 911 or go to the nearest emergency room now.
Should I stop or skip my next medication dose after drinking?
Do not stop, skip, double, or change your dose on your own. Ask your prescriber or pharmacist what to do next. Have your medication label and drinking details ready for that call.
What are the two commonly used medicines, and what is the “new drug” for alcoholism?
Two FDA-approved options for AUD are naltrexone and acamprosate; disulfiram is a third FDA-approved option.[3] The phrase “new drug” is ambiguous and does not identify a specific medicine. NIAAA lists these three medications as FDA-approved for AUD.[3] Ask for the exact product name and check its U.S. approval status. Do not rely on headlines or claims that a treatment is new. If a drug is used for an unapproved use, FDA has not determined that it is safe and effective for that use.[10]
Does returning to drinking mean treatment has failed?
What are common signs of an alcohol relapse?
No single observation proves that someone has returned to drinking. If you notice less contact, missed plans, or a change in their usual routine, ask how they are doing rather than assuming what it means. A return to drinking may mean treatment needs to resume or change; it does not mean treatment has failed.[11] If the person cannot be woken, is confused, vomiting, having seizures, or breathing slowly or irregularly, call 911 now; these can be signs of alcohol overdose.[2]
How many times can someone relapse, and how long does a relapse last?
Focus on what support the person needs now. A return to drinking may mean they need to resume or change treatment, or try another treatment.[11] Talk with their treatment team about next steps.
How can I support someone who has returned to drinking?
Listen without judgment. Ask what kind of help feels useful to them. Offer to make calls together with them. If there is immediate danger, call 911 or go to an emergency room.
Are medications for alcohol use disorder the same as medication for alcohol withdrawal?
No, they are different topics. Clinical guidance separates acute withdrawal care from ongoing AUD treatment.[12] Seizures, severe confusion, hallucinations, a high fever, or a racing heart during withdrawal require calling 911 or going to the nearest emergency room now.[1] For non-emergency questions, ask a clinician about withdrawal symptoms and discuss ongoing AUD treatment separately.
