Disulfiram was the first medication approved by the U.S. Food and Drug Administration (FDA) to treat chronic alcohol dependence. In its pure state, disulfiram is a white to off-white, odorless, almost tasteless powder, which is soluble in water and alcohol. Disulfiram, an alcohol-aversive or alcohol-sensitizing agent, causes an acutely toxic physical reaction when mixed with alcohol. Continuing research and clinical findings have clarified disulfiram's mode of action and established its safe and effective use in the treatment of alcohol use disorders (AUDs) in some patient groups.