"Shots for alcohol abuse" is a search that usually refers to two distinct things: injectable naltrexone (brand name Vivitrol) and disulfiram implants. Both are real, evidence-backed medical treatments for alcohol use disorder that are significantly underutilised — partly because most people don't know they exist, and partly because the addiction treatment system in many countries defaults to 12-step programs rather than pharmaceutical approaches. Here's what they actually are.
Vivitrol (injectable naltrexone). Naltrexone is an opioid antagonist — it blocks the opioid receptors that mediate alcohol's rewarding and pleasurable effects. Oral naltrexone (a daily pill) has strong evidence for reducing alcohol consumption and craving, but adherence is the challenge: many people stop taking a daily pill during a period of ambivalence. Vivitrol is naltrexone delivered as a monthly intramuscular injection, providing sustained receptor blockade for 28–30 days without requiring daily decision-making. If you drink on Vivitrol, the expected reinforcement — the dopamine surge, the sense of reward — is significantly blunted. Over time, the drink stops paying off, and the craving cycle weakens.
The evidence for Vivitrol is strong. A large clinical trial (COMBINE study) showed naltrexone significantly reduced heavy drinking days and improved abstinence rates compared to placebo. The injectable form removes the adherence barrier that limits oral naltrexone's real-world effectiveness. It is approved by the FDA for alcohol use disorder and is available through addiction medicine physicians and psychiatrists.
Disulfiram (Antabuse) implants. Disulfiram is a medication that blocks aldehyde dehydrogenase — the enzyme that metabolises acetaldehyde (the toxic intermediate produced when alcohol is broken down). If you drink while disulfiram is active, acetaldehyde accumulates rapidly, producing flushing, nausea, vomiting, rapid heart rate, and severe discomfort. The effect is aversive conditioning: drinking becomes unpleasant enough to act as a deterrent. Oral disulfiram requires daily compliance; implants are placed subcutaneously (under the skin) and provide sustained disulfiram release over 6–12 months, removing the compliance variable entirely.
Disulfiram implants are more widely used in Europe than in the US and have a meaningful evidence base for sustained abstinence, particularly when combined with psychological support. They are not appropriate for people with certain cardiac conditions, liver disease, or who cannot commit to complete abstinence (drinking on disulfiram can produce severe, rarely fatal reactions). Careful medical assessment and ongoing monitoring are required.
Other injections in development. Researchers are investigating injectable forms of acamprosate, long-acting buprenorphine for co-occurring opioid/alcohol dependence, and novel compounds targeting the glutamate and endocannabinoid systems. The injectable delivery model is attractive precisely because it decouples sustained treatment from daily willpower — which is, for many people in early recovery, the highest-friction element of pharmacological support.
Who these treatments are for. Both Vivitrol and disulfiram implants are medical treatments appropriate for people with moderate to severe Alcohol Use Disorder who are motivated to reduce or stop drinking and for whom the structure of monthly or multi-month treatment is beneficial. They are prescribed by physicians, not available over the counter, and work best alongside behavioral support rather than as standalone treatments. If you're interested, the starting point is a conversation with a GP or addiction medicine specialist.