Which medication may be used to create an aversion to alcohol but will not decrease cravings?

Disulfiram, commonly known as Antabuse, is specifically designed to create an aversion to alcohol consumption. It works by inhibiting an enzyme, aldehyde dehydrogenase, that is involved in the metabolism of alcohol. When someone consumes alcohol while taking disulfiram, it leads to the accumulation of acetaldehyde, causing unpleasant reactions such as flushing, nausea, and palpitations. This negative reinforcement educates the individual to avoid alcohol.

However, disulfiram does not target the underlying cravings for alcohol; it does not have the pharmacological properties to reduce the desire to drink. Its primary function is to create a deterrent based on the adverse physical reactions to drinking while on the medication.

In contrast, naltrexone is an opioid receptor antagonist that helps to reduce cravings by blocking the pleasurable effects of alcohol. Acamprosate works to restore the balance of neurotransmitters in the brain and has been shown to reduce alcohol cravings as well. Topiramate, an anticonvulsant, has also demonstrated efficacy in decreasing alcohol cravings.

These differences highlight why disulfiram is the correct answer in the context of creating aversion without addressing cravings.