How effective are acamprosate and naltrexone for alcohol abuse? does the literature show one to better than another?

A bit more to it.: Generally chemicals are helpful on chemical issues. Addiction is a complex situation with quite a lot of social and psychological issues. Integrated approaches with group and family counseling (and often WITH medications including these but also often treatment of mood disorders) work most of the time while these drugs by themselves fail most of the time. http://summaries.cochrane.org/CD001867

About the same: Acamprosate and naltexone (as well as other drugs) are used to treat alcohol dependence in people who have quit drinking. However, drug therapy must be combined with counseling. These drugs reduce craving but a significant number of treated patients will still relapse. Some physicians have also combined both drugs and suggest a measurable benefit. You should speak with your therapist

Alcohol Abuse: Please check out article: “Naltrexone versus acamprosate: one year follow-up of alcohol dependence treatment” At end of 1 yr – 41% of people with naltrexone & 17% on acamprosate had not relapsed. REF: https://pubmed.ncbi.nlm.nih.gov/11524308/