Disulfiram

Under normal metabolism of alcohol ethanol is broken-down in the liver by the enzyme alcohol dehydrogenase and acetaldehyde dehydrogenase[?] to the harmless acetic acid. Disulfiram blocks this reaction at the intermediate stage where it is converted to acetaldehyde. After alcohol intake under the influence of disulfiram the concentration of acetaldehyde in the blood may be 5 to 10 times higher than that found during metabolism of the same amount of alcohol alone. As acetaldehyde is one of the major causes of the symptoms of a 'hangover' this produces immediate and severe negative reaction to alcohol intake. The patient may experience the effects of a severe hangover a period of 30 minutes up to several hours.

As disulfiram is absorbed slowly through the digestive tract and eliminated slowly by the body the effects may last for up to 2 weeks after the initial intake.

One weakness with Disulfiran and similar treatments is that if not taken under supervision an alcoholic will not stick to the treatment, since it is easier to give up the drug than alcohol. Even when strictly taken the negative effects will rarely break the drinking patterns of a chronic alcoholic. For these reasons disulfiram is not in itself a cure for alcoholism and is usually only indicated for select patients who wish to remain in an enforced state of sobriety during other forms of treatment, such as support groups and psychotherapy.