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CME Early Recognition and Prevention of a Disulfiram-Ethanol Reaction Abstract. Disulfiram is an alcohol-aversive agent for pharmacological relapse prevention in alcohol dependency. When combined with alcohol, disulfiram induces a disulfiram-ethanol reaction (DER), causing mild to severe symptoms. While the anticipated adverse effects should support abstinence, failed abstinence can be potentially lethal. Since there is no specific antidote, early recognition and supportive treatment are vital. The aim of this article is to illustrate t