Explaining anti-craving medicines after detox — CASC communication station

Open. Introduce role; acknowledge anxiety about craving and liver; involve partner with consent. [5]

Frame medicines. After detox, tablets or monthly injections can make relapse less likely by reducing the reward of drinking (naltrexone), supporting the brain’s balance in early sobriety (acamprosate), or causing a strong unpleasant reaction if alcohol is drunk (disulfiram). None is a forever cure; all work best with talking therapies and support.[1][2][4]

Opioid gate. Leftover oxycodone must be disposed/planned carefully; naltrexone must not start until opioids are fully stopped for a safe interval — otherwise severe withdrawal and pain medicines will not work as expected. Offer medical alert advice.[1]

Doses in plain language. Naltrexone often one 50 mg tablet daily (or monthly injection where available); acamprosate often 666 mg three times a day after kidney check; disulfiram often 200–250 mg daily only if she and a supervisor understand the alcohol reaction rules.[1][2][3]

Wedding / skip-dose myth. Skipping disulfiram to drink is unsafe and defeats the treatment contract; even small alcohol exposures can trigger reactions. If she is not ready for that commitment, choose another medicine.[3]

Liver. We check blood tests and avoid careless starts in severe liver failure; many people with milder enzyme changes still use medicines with monitoring — individualise.[1][5]

Close. Agree preferred option after opioid clearance; book early review; written information; partner supervision plan if disulfiram chosen; crisis contacts. Teach-back. [1][5]