Which statement is true about disulfiram and alcohol interactions?

• A. Any amount of alcohol can trigger a reaction; even very small amounts can cause a reaction
• B. Only large amounts trigger reaction
• C. No interaction with alcohol
• D. It enhances alcohol metabolism

Answer: (A)

Disulfiram creates an aversive reaction with alcohol by blocking aldehyde dehydrogenase, the enzyme that normally converts acetaldehyde into acetate. When any amount of ethanol is consumed, acetaldehyde can accumulate rapidly, producing the uncomfortable symptoms of the disulfiram-alcohol reaction. Because the enzyme is inhibited, even very small exposures to alcohol—such as from mouthwash, cough syrup, certain sauces, or vanilla extract—can trigger this reaction. The result is unpleasant effects like flushing, sweating, tachycardia, nausea, and vomiting, and occasionally more severe signs. So the statement that any amount of alcohol can trigger a reaction is true. This does not reflect enhanced metabolism; rather, it represents inhibited breakdown of acetaldehyde and a toxic buildup, and it isn’t limited to large amounts of alcohol.