Alcohol Abuse Treatment Overview

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Your success in treatment for alcohol abuse and dependence is strongly linked to admitting that you have a problem and your desire to stop drinking. Supportive treatments, such as counseling, won't be successful if you continue to drink.

Treatment also depends on whether you are physically dependent on alcohol. Most people with alcohol problems need to completely stop drinking. Treatment first focuses on relieving symptoms of withdrawal, and then the focus shifts to staying sober.

You might need medicines that help reduce withdrawal symptoms during the process of detoxification.

Counseling, support groups, education, and sometimes medicines can help you stay sober during recovery. It can be very discouraging to start drinking again (relapse). Although you might feel guilty about relapsing—and you should do everything you can to avoid it—a relapse is no reason to quit treatment. Staying sober is a lifelong process.

The family members of someone who has an alcohol problem are affected too. They can benefit from education, family therapy, and participation in Al-Anon or other self-help support groups. Sometimes family members with good intentions will enable you to continue drinking by making excuses for your drinking or covering up problems that your alcohol use is causing. Counseling can help them recognize destructive, enabling behaviors and might help strengthen relationships.

Initial treatment

Initial treatment for alcohol abuse and dependence includes:

• Screening with a test such as the Alcohol Use Disorders Identification Test (AUDIT).
• Assessing your life and the impact alcohol has had on it.
• Stopping drinking.
• Treating withdrawal symptoms if you are alcohol-dependent. This is best done under medical supervision.
• Staying sober throughout your recovery.

How to stop drinking alcohol

Although some people can stop drinking on their own, others need medical help to manage the physical process of withdrawal. If you think you have an addiction to alcohol, talk to your doctor about whether you need to withdraw from alcohol under medical supervision.

Your doctor might be able to give you medicine that will help you safely withdraw from alcohol. Other medicines might be prescribed later to help you stay sober. Withdrawal from alcohol is safer, less painful, and quicker when you get a doctor's help.

If you have severe withdrawal symptoms (such as uncontrolled shaking, seizures, or hallucinations), you might be admitted to a treatment center or hospital for detoxification.

Medicines to reduce withdrawal symptoms include:

• Antianxiety medicines (such as diazepam), which treat withdrawal symptoms such as delirium tremens (DTs).
• Seizure medicines, which are used to reduce or stop severe withdrawal symptoms during detoxification.

Medicines to help you stay sober during recovery include:7

• Disulfiram (Antabuse), which slows the pleasurable effects that alcohol produces and makes you nauseated when you drink.
• Naltrexone (ReVia), which interferes with the pleasure you get from drinking.
• Acamprosate (Campral), which can reduce your craving for alcohol. This medicine was recently approved to treat alcohol abuse and dependence.
• Topiramate (Topamax), which is a medicine used to treat seizures. One recent study shows that it might also help treat alcohol problems.8 Experts are still studying how this medicine, and medicines like it, might help with recovery from alcohol abuse and addiction.

Alcohol abuse can cause your body to become low in certain vitamins and minerals, especially thiamine (vitamin B1). You might need to take thiamine supplements to improve your nutrition during recovery. You also might need supplements to help replace fluids and electrolytes.

If you are considering a treatment program, prepare some questions to ask about the treatment program before you go to visit.

Ongoing treatment

After you go through detoxification for alcohol dependence and you recover from withdrawal symptoms, you and your doctor can discuss how to help you remain sober. Possible treatment plans include:

• Education about alcohol and other substance abuse and the effects on your life and the lives of your family members.
• Counseling, both in individual and group settings. Types of counseling used to provide support to help you stay sober during recovery include:
  • Cognitive-behavioral therapy, which helps you change thinking and behavior patterns.
  • Motivational enhancement, which helps you create a plan and set your own goals.
  • 12-step recovery program, with a private counselor who provides education and support.
• Support group attendance, such as Alcoholics Anonymous (AA). Your family members might also want to attend a support group such as Al-Anon or Alateen.
• Medicines that might help you stay sober include:
  • Disulfiram (Antabuse), which slows the pleasurable effects of alcohol and makes you nauseated when you drink.
  • Naltrexone (ReVia), which interferes with the pleasure you get from drinking.
  • Acamprosate (Campral), which can reduce your craving for alcohol. This medicine was recently approved to treat alcohol abuse and dependence.
  • Topiramate (Topamax), which is a medicine used to treat seizures. One recent study shows that it might also help treat alcohol problems. Experts are still studying how this medicine, and medicines like it, might help with recovery from alcohol abuse and addiction.

Many people start drinking again (relapse) when they are recovering from alcohol problems. Even though you might feel discouraged about it, having a relapse is no reason to give up on treatment. You might have to take a few steps back, but you can successfully continue with your recovery.

If you are considering a treatment program, prepare some questions to ask about the treatment program before you go to visit.

How to stop drinking alcohol

Treatment if your condition gets worse Managing alcohol problems is a lifelong process. Many people have one or more relapses during recovery from alcohol abuse and dependence. If you experience repeated relapses or severe withdrawal symptoms, you can get help from your doctor. If you have withdrawal symptoms, you might need treatment at a hospital or treatment facility.

If you can't stop drinking alcohol on your own, a treatment facility can help you stay on course and get through the initial cravings for alcohol and help you learn how to stay sober.

Continued alcohol abuse and dependence can lead to other dangerous complications such as cirrhosis and bleeding peptic ulcers. If you have any other health conditions related to alcohol use, they will need appropriate treatment.

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Reviewed: 11/2005