Disulfiram is the first drug that was approved for alcohol use disorder by the FDA in 1948 .

Disulfiram is a white odorless and tasteless powder and is soluble in water and alcohol. This is the reason many times surreptitiously family members give it but usually end up causing more harm than good.

Mechanism of action of disulfiram-It irreversibly inhibits acetaldehyde dehydrogenase enzyme which is required for conversion of acetaldehyde to the acetate.

Acetaldehyde get accumulated into the body and is responsible for an unpleasant reaction and this is called as the disulfiram ethanol reaction (DER)

Re-establishment for the enzyme needs a time of two weeks and hence DER may occur even in the initial days of stopping disulfiram.

Disulfiram is actually an aversive agent and not an anti-craving agent per se.

Fear of DER is responsible for extinguishing the unwanted behavior - that is the alcohol consumption and not the pharmacological action per se.