Treating Alcohol Problems: Finding and Getting Help (2023)

When is the time for treatment?

Alcohol-related problems—those caused by drinking too much, too fast, or too often—are among the leading public health problems in the United States.

Many people struggle to control their drinking at some point in their lives. More than14 million adults 18 years and older have an alcohol use disorder (AUD),and 1 in 10 children live in a home with a parent who has a drinking problem.

Does the treatment work?

The good news is that no matter how serious the problem seems, most people with AUD can benefit from some type of treatment.

Research shows that about a third of people treated for alcohol problems no longer have symptoms after one year. Many others significantly reduce their alcohol intake and report fewer alcohol-related problems.

Signs of a drinking problem

Alcohol Use Disorder (AUD)it is a condition that doctors diagnose when drinking causes distress or harm to a patient. The condition can range from mild to severe and is diagnosed when a patient answers "yes" to two or more of the following questions.

In the past year have you:

• There were times when you ended up drinkingmore or moreWhat were you up to?

• I wanted more than oncereduce or stop drinking, or tried but failed?

• passed aa long timeTo drink? Or get sick or overcome the consequences?

• ExperienceDemand– a strong need or desire to drink?

• I found out I drink often, or get sick from drinkingintervened in the careof youheimoFamily? the causedWorkproblems? OSchoolProblems?

• I kept drinking even though I was the causeProblemwith hisFamilyoFriends?

• SurrenderopruningOneActivitiesWhat were important or interesting to you or what did you like to drink?

• More than once he was involved in situations during or after drinking thisincreases the risk of injury(for example, driving, swimming, operating machinery, walking in a dangerous area, or having unprotected sex)?

• You kept drinking even though you wanted todepressed or anxiousthe supplementother health problem? or after amemory failure?

• tivodrink much moreof what you ever didtake effectWant? Or she found herregular numberdrankmuch less effectas previously?

• He discovered that when the effects of alcohol wear off, onehad withdrawal symptomssuch as trouble sleeping, tremors, irritability, anxiety, depression, restlessness, nausea, or sweating? Or did you feel things that weren't there?

If you have any of these symptoms, your alcohol use may already be cause for concern. The more symptoms you have, the more urgent the need for change becomes. A doctor can perform a formal evaluation of your symptoms to determine if AUD is present. You can find an online assessment of your spending behavior atRethink Drinking.niaa.nih.gov.

treatment options

When asked how alcohol problems are treated, people often think of 12-step programs or 28-day inpatient rehab, but may have trouble finding other options. Thanks to significant advances in this field over the past 60 years, a variety of treatment methods are now available.

Ultimately, there is no one-size-fits-all solution, and what may work for one person may not work for another. Just understanding the different options can be an important first step.

types of treatment

behavioral treatments

Behavioral therapies aim to change drinking behavior through counselling. They are performed by health professionals and backed by studies that show they can be beneficial.

medicine

Currently, three drugs are approved in the United States to help people stop or reduce alcohol use and prevent relapse. They are prescribed by a GP or other healthcare professional and can be used alone or in combination with an appointment.

mutual support groups

Alcoholics Anonymous (AA) and other 12-step programs provide peer support for people who quit or reduce alcohol use. When combined with healthcare-directed treatment, support groups can provide a valuable additional layer of support.

Due to the anonymity of support groups, it is difficult for researchers to determine their success rates compared to those run by health professionals.

Start with a family doctor

For anyone considering treatment, speaking with a GP is an important first step; he or she can be a good source of treatment and medication recommendations. A GP can also:

• Evaluate a patient's drinking behavior

• Help create a treatment plan

• Assess overall health

• Evaluate if anti-alcohol medication is appropriate

People are advised to talk to their doctor about the best form of initial treatment.

Types of professionals involved in care

Treatments performed by health professionals

Professionally guided treatments include:

medicine

Some are surprised to learn that there are medications on the market approved to treat alcohol addiction. Newer types of these drugs work by balancing the changes in the brain caused by AUD.

All approved medications are non-addictive and can be used alone or in combination with other forms of treatment. Learn more about itapproved treatments.

behavioral treatments

Also known as alcohol counseling, behavioral treatments involve working with a doctor to identify and change behaviors that lead to binge drinking. Behavioral treatments share certain characteristics that may include:

• Develop the skills necessary to stop or reduce alcohol consumption.

• Help build a strong social support system

• Work to set achievable goals

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• Treat or avoid triggers that can cause a relapse

Types of behavioral treatments

• Cognitive Behavioral TherapyIt can be done individually with a therapist or in small groups. This form of therapy focuses on identifying the feelings and situations (called "cues") that lead to excessive drinking and managing stress that can lead to relapse. The aim is to change the thought processes that lead to alcohol abuse and to develop the necessary skills to deal with everyday situations that can trigger problems with alcohol use.

• motivational enhancement therapyit is carried out over a short period of time to build and strengthen motivation to change drinking behaviour. Therapy focuses on identifying the pros and cons of treatment, creating a plan to make changes in alcohol use, building confidence, and developing the skills necessary to follow the plan.

• Marriage and family counselingIt involves spouses and other family members in the treatment process and can play an important role in restoring and improving family relationships. Studies show that strong family support through family therapy increases the odds of staying abstinent (stopping drinking) compared to patients receiving individual counseling.

• short interventionsthese are short, time-limited individual or small group counseling sessions. The counselor provides information about the person's drinking behavior and potential risks. Once the client has received personalized feedback, the advisor will work with the client to set goals and provide ideas on how to help drive change.

Ultimately, the decision to treat may be more important than the approach used, as long as the approach avoids violent confrontation and includes empathy, motivational support, and a focus on changing drinking behavior.

What FDA-approved drugs are available?

Certain medications have been shown to be effective in helping people stop or reduce alcohol use and prevent relapse.

current medications

The US Food and Drug Administration (FDA) has approved three drugs to treat alcohol addiction, and others are being tested to see if they are effective.

• naltrexonit can help people reduce excessive alcohol consumption.

• acamprosatefacilitates abstinence maintenance.

• disulfiramIt blocks the breakdown (metabolism) of alcohol in the body and causes unpleasant symptoms such as nausea and reddening of the skin. These unpleasant effects can help some people avoid drinking while taking disulfiram.

It's important to remember that not everyone responds to medication, but for a subset of people, it can be an important tool in overcoming alcohol addiction.

Scientists are working to develop a broader range of pharmaceutical treatments that can be tailored to individual needs. As more drugs become available, people can try various drugs to see what works best for them.

"Isn't taking medication just trading one addiction for another?"

This is not an uncommon concern, but the short answer is no. All medications approved for the treatment of alcohol dependence are not addictive. These drugs are designed to help treat a chronic disease, just like someone might take drugs to control asthma or diabetes.

Looking ahead: the future of treatment

Progress continues to be made as researchers search for new and better treatments for alcohol-related problems. By studying the underlying causes of AUD in the brain and body, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) is working to identify important cellular or molecular structures, called "targets," that could lead to the development of new drugs. .

personalized medicine

Ideally, healthcare professionals would be able to determine which AUD treatment is most effective for the individual. The NIAAA and other organizations conduct research to identify genes and other factors that can predict how well someone will respond to a given treatment. These advances may optimize future treatment decisions.

Current NIAAA Research: Leads to Future Advances

Certain drugs that have already been approved for other uses have shown promise for treating alcohol dependence and alcohol-related problems:

• The anti-smoking drug varenicline (marketed under the name Chantix) reduced alcohol consumption and cravings for alcohol in people with AUD.

• Gabapentin, a drug used to treat pain and epilepsy, has been shown to increase withdrawal and reduce binge drinking. Those who took the drug also reported fewer alcohol cravings and improved mood and sleep.

• The antiepileptic drug topiramate has been shown to help people reduce drinking problems, especially in people with a certain genetic makeup that appears to be related to the effectiveness of treatment.

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Tips for choosing treatment

Alcohol treatment professionals will advise you on what to consider when choosing a treatment program.

In general, gather as much information about the program or provider as possible before deciding on treatment. If you know someone who knows the program firsthand, it might be helpful to ask them about their personal experience.

Here are some questions you can ask to make your choice easier:

• What type of treatment does the program or provider offer?
  It is important to assess whether the facility offers all currently available methods or relies on one approach. You may want to know if the program or provider offers medication and if mental health problems are treated along with addiction treatment.

• Is the treatment personalized?
  The individual coordination of the correct therapy is decisive for success. No single treatment will benefit everyone. It may also be helpful to determine if treatment will be adjusted to accommodate changing needs as they arise.

• What is expected of the patient?
  They want to understand what is required of you in order to decide which treatment is best suited to your needs.

• Is the success of the treatment measured?
  By evaluating if and how the program or provider measures success, you will be better able to compare your options.

• How does the program or provider handle a relapse?
  Relapses are common, and you want to know how they are managed. For more information on relapse, seeRelapse is part of the process..

When seeking professional help, it is important that you feel respected, understood, and that that person, group, or organization can help you. Keep in mind, however, that developing relationships with doctors, therapists, and other health professionals can take time.

More considerations

Treatment setting: hospitalized or outpatient?

In addition to choosing the type of treatment that is best for you, you must also decide whether treatment is inpatient (you would stay in an institution) or outpatient (you would stay at home during treatment). Inpatient facilities tend to be more intensive and expensive. Your doctor can help you weigh the pros and cons of each.

Cost can be a factor when choosing a treatment approach.Evaluate your health insurance coverage to determine how much your insurance will cover and how much you will have to pay. Ask different programs if they offer different rates; some programs may offer lower rates or payment plans for those without health insurance.

a continuous process

Overcoming an alcohol use disorder is an ongoing process that can involve setbacks.

The importance of persistence

Because AUD can be a chronic, relapsing disease, persistence is key. It is rare that someone goes to treatment once and never drinks again. Most of the time, people have to repeatedly try to stop or slow down, experience the repetition, learn from it, and keep trying. For many, ongoing follow-up with a treatment provider is critical to overcoming alcohol problems.

Relapse is part of the process.

Relapses are common in people who overcome problems with alcohol. People with alcohol problems are more likely to relapse during times of stress or when exposed to people or places associated with previous alcohol use.

Just as some people with diabetes or asthma may have flare-ups of their disease, a relapse into alcohol use may be seen as a temporary setback to full recovery rather than total failure. Seeking professional help can prevent a relapse: Behavioral therapies can help people develop skills to avoid and overcome triggers, such as stress, that can lead to alcohol use. Most people benefit from regular checkups with a treating provider. Medications can also discourage alcohol use at times when there is an increased risk of relapse (eg, divorce, death of a family member).

Mental health problems and alcohol use disorder

Depression and anxiety are often associated with excessive alcohol consumption. Studies show that people addicted to alcohol are two to three times more likely to experience depression or anxiety at some point in their lives. When treating problems with alcohol, it is important to also seek treatment for any associated medical and psychological problems.

Tips for friends and family.

Caring for someone with a drinking problem can be very stressful. It is important that while you are trying to help your loved one, you also find a way to take care of yourself. It may be helpful to seek support from others, including friends, family, the community, and support groups. If you develop your own symptoms of depression or anxiety, consider seeking professional help for yourself. Remember that your loved one is ultimately responsible for managing their illness.

However, your participation can make a big difference.Based on clinical experience, many health professionals believe that the support of friends and family is important in overcoming alcohol-related problems. However, friends and family may not be sure how best to provide the support they need. The family and friend groups listed below may be a good place to start.

Remember that changing deep habits is difficult, takes time, and requires repeated effort.We usually experience mistakes along the way, learn from them, and then move on. AUD is no different. Try to be patient with your loved one. Overcoming this disorder is not easy or fast.

Pay attention to your loved one when they are feeling better or just exerting themselves.We are often so angry or discouraged that we take for granted when things are going better. A word of appreciation or recognition of a success can go a long way.

Professional Help

you doctorPrimary care physicians and psychiatrists can provide effective treatment for AUD by combining new medications with brief counseling sessions. To help clinicians, the NIAAA has developed a guide for younger patients,Alcohol Screening and Brief Intervention for Adolescents: A Guide for Professionals. This guide and other resources are available athttps://www.niaaa.nih.gov/health-professionals-communities.

AUD specialists.Contact your doctor, health insurance company, local health department, or employee assistance program for specific addiction treatment options. Other features are:

Specialists in medical and non-medical addictions

American Academy of Addiction Psychiatry
www.aaap.org
401–524–3076

American Psychological Association
www.apa.org
1-800-964-2000 (ask for your state referral number to locate addiction psychologists)

American Society of Addiction Medicine
www.asam.org
301-656-3920 (ask for state chapter phone number)

NAADAC, Association of Addiction Specialists
www.naadac.org
1–800–548–0497

Federation of Social Workers
www.helpstartshere.org(Search for social workers specializing in addictions)

Treatment plants

Research site for substance use treatment facilities
www.findtratamiento.samhsa.gov
1-800-662-HELP

Support groups

Alcoholics Anonymous (AA)
www.aa.org
212–870–3400

moderation management
www.moderation.org
212–871–0974

Säkulare AA
www.aasecular.org
323–693–1633

SMART recovery
www.smartrecovery.org
440–951–5357

women for sobriety
www.mujeresporsobriedade.org
215–536–8026

Groups for family and friends.

Al-Anon Family Group
www.al-anon.alateen.org
1-888-425-2666 for meetings

adult children of alcoholics
www.niñosadultos.org
310–534–1815

information resources

National Institute on Alcohol Abuse and Alcoholism
www.niaaa.nih.gov
301–443–3860

National Institute on Substance Abuse
www.nida.nih.gov
301–443–1124

National Institute of Mental Health
www.nimh.nih.gov
1–866–615–6464

Research shows that most people with alcohol problems can cut down or stop drinking completely.

There are many ways to improve. The important thing is that you find yours.

Understanding the treatment options available, from behavioral therapies and medications to support groups, is the first step. The most important thing is that you are committed to the method you choose.

Ultimately, treatment can improve your chances of success.