Which drug creates unpleasant physical symptoms when taken with alcohol, helping to reinforce abstinence?

Disulfiram is a medication designed to support individuals in abstaining from alcohol by creating unpleasant physical symptoms when alcohol is consumed. This is accomplished through the inhibition of the enzyme aldehyde dehydrogenase, which leads to the accumulation of acetaldehyde when alcohol is ingested. The buildup of acetaldehyde causes a range of symptoms such as flushing, nausea, vomiting, palpitations, and hypotension. These adverse reactions serve as a strong deterrent against drinking alcohol, reinforcing the commitment to remain abstinent.

In contrast, naltrexone works by blocking opioid receptors to reduce the pleasurable effects of alcohol, making drinking less rewarding but not inducing physical reactions that deter consumption. Acamprosate helps stabilize the chemical balance in the brain disrupted by alcohol dependence but does not elicit immediate physical symptoms when alcohol is consumed. Bupropion, primarily used as an antidepressant and smoking cessation aid, does not have a direct role in treating alcohol dependence through aversive reactions. Thus, disulfiram is distinctive in its ability to promote abstinence through the potential for adverse effects when combined with alcohol.