Alcoholism Treatment: Types, Programs and Issues
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Nearly a tenth of adults in America suffer from alcohol abuse or dependence. Adding to the sheer scale of the problem, alcohol abuse disorder (AUD) itself is a complex condition with many genetic, environmental, and social causes that make it difficult to overcome without professional help. That’s where alcohol treatment can make the difference.
Fortunately, in every community in America, help is available. For those who are serious about recovering from alcoholism and getting back to a more healthy and fulfilling lifestyle, many options are available to help them do so. All over the country, there are alcohol treatment centers and rehabilitation centers for alcoholics that are staffed by medical professionals who specialize in helping people overcome their problems with alcohol. These professionals guide people through every step of the recovery process – from detox to counseling, therapy and rehabilitation, and finally to a successful, alcohol-free life after rehab has been completed.
Table of Contents
Seeking Treatment for Alcoholism?
Although there is no “right” time to begin the treatment process, for alcohol abuse treatment to be successful, a person needs to 1) recognize their condition, and 2) have a sincere desire to stop drinking. Common signs that alcohol consumption has progressed beyond “social drinking” and has become a more serious problem include:
- Frequent episodes of drinking more – or longer – than intended.
- Radical mood swings, especially if they result in outbursts of anger or violence.
- Making excuses for poor performance at work or school.
- Denial of excessive alcohol use, even after it has caused trouble at work or home.
- Decreased interest in life, hobbies, and normal activities.
- Having to make excuses for neglecting important responsibilities.
- Experiencing cravings – a strong need or urge to drink.
- Having tried to cut down or stop drinking more than once, and failed.
- Continuing to drink even though it makes one more depressed or ill.
- Having memory losses or blackouts.
- Withdrawal symptoms on stopping drinking, such as insomnia, irritability, shakiness, anxiety, nausea, or excessive sweating.
The more of these symptoms a person experiences, the more urgent it is to seek help.
A good first step is to start with a family doctor or primary care physician. He or she can help to evaluate whether the drinking patterns are risky, estimate the overall state of health, assess whether medications are appropriate, and help to design a treatment plan. They can also provide referrals to local alcohol rehab facilities.
What Types of Professionally-Led Alcohol Addiction Treatment are There?
Alcoholism treatment programs vary, depending on many factors. They may be private or government-funded and may offer their services on an outpatient basis (for people who choose to live at home and continue working or studying during treatment) or on an inpatient basis (checking in to a residential treatment facility for a 30- to 90-day period).
Whatever their format, most alcoholism treatment programs start with a period of detox. For most people entering treatment, a week or more of medically-supervised detoxification is a necessary initial step. Detox is important because the body has built up a dependence on alcohol, and when a person quits drinking, it experiences uncomfortable symptoms of withdrawal. The withdrawal period may last for a week or more, so if necessary the treatment specialists will provide medications to ease pain and help keep the focus on getting better.
After detox, ongoing treatment may include counseling sessions and many forms of therapy. Some common types of therapy used as treatments for alcoholism include:
- Alcohol counseling. Individual sessions with a therapist may focus on ways to stop alcohol use and how to more effectively manage important aspects of life like work and family. Group counseling sessions at alcohol rehab centers can also be an effective form of treatment, because of reinforcement from peer discussion and support.
- Family counseling. Some treatment facilities encourage family counseling sessions because they provide a safe environment in which all parties can learn how to deal with the emotional pain and suffering that can result from alcohol abuse.
- Rehabilitation therapies. Alcohol rehab techniques help people control drinking urges and the things that trigger them. They can include cognitive behavioral therapy (CBT), which aims to prevent relapse by helping understand the factors that trigger alcohol abuse, and how to handle those triggers when they arise. Other forms of rehabilitative treatment include contingency management therapy (which encourages alcohol-free behavior by providing positive reinforcement in the form of rewards and privileges), and motivational enhancement therapy (which aims at increasing patients’ self-motivation for positive change and recovery).
- Medications to treat alcohol addiction. Medications can be used not only to control withdrawal symptoms during detox but also to help patients on an ongoing basis to manage the physical aspects of their addiction. Common drugs used during rehab include:
- Acamprosate, which reduces alcohol cravings and withdrawal symptoms,
- Naltrexone, to reduce alcohol cravings and its pleasurable effects, and
- Disulfiram, which causes severe negative effects when alcohol is consumed.
- Education. Although the cornerstone of most treatment for alcohol abuse is psychotherapy and counseling, another important part of recovery is understanding the mechanics of alcoholism and how excessive drinking affects the brain. So there may be educational sessions about the disease of alcoholism and how to overcome it.
- Aftercare. One of the most important aspects of alcoholic treatment is training in how to manage the transition back into daily life. This type of treatment focuses on putting a support structure into place, which might include introductions to peer support groups such as 12 Step groups or SMART programs, or the creation of personalized plans to prevent relapse.
Issues that May Appear During Treatment for Alcohol Abuse
It is reassuring to know that modern alcoholic rehab treatments DO work. Millions have benefited from these programs, and because of advances in medicine, psychology, and the types of treatments available, success rates for recovery are higher than ever.
However, freedom from alcohol does not happen overnight. It takes a long time to develop an alcohol addiction, and it can take just as long to overcome one. Yes, there are medications that can help to reduce the craving for alcohol, but there is no “magic pill” that makes it go away entirely. The path to recovery is not necessarily going to be a straight or easy one:
- Treatment programs are demanding. Both inpatient and outpatient treatment are challenging. Success rates at a residential rehabilitation center for alcoholics are the highest, but to take advantage of them people have to leave their home and work for the duration of the treatment and live in a controlled environment. And even with outpatient alcoholic treatment, all scheduled sessions must be attended and all facility rules followed.
- Physical and mental distress during recovery. Yes, medications can help, but experiencing insomnia and other physical discomforts is common during the early stages of recovery. Also, because an important part of the rehab process is facing hard truths about addiction, many people have to deal with feelings of guilt and shame about past behavior. This is part of the process, because overcoming these feelings requires total honesty, and learning to forgive oneself.
- Anger, sadness, depression, and irritability. All of these feelings are common during recovery. To be honest, they have been there all along, but have been dulled by alcohol use. But during the recovery process, one has to find some peace with them and rediscover a more balanced approach to life.
- Boredom and loneliness. Recovery from alcoholism is about restructuring life, not just quitting alcohol. It takes some time to learn how to replace one’s previous “drinking time” and “drinking friends” with healthier alternatives. And speaking of “drinking friends”…
- Learning how to handle being around those who still drink. This is a BIG issue for almost everyone in recovery from alcohol addiction because many of their friends, family, and co-workers still drink. Patients have to deal with “trigger situations” like having to attend business meetings at what used to be their favorite bar. This can be a particular problem on holidays and special occasions because friends and family are going to expect to “celebrate” in ways that patients no longer can.
- Financial problems. People emerging from a period of inpatient rehab for alcoholics, or even periods of outpatient care that weren’t completely covered by their health insurance can often find themselves worrying about money. Naturally, these worries, or having to return to a high-stress job that contributed to addiction in the first place, can be challenging and a potential trigger for relapse.
- Marriage, dating, and overcoming codependency. One of the most difficult obstacles that people in recovery from alcohol addiction report is learning how to deal with romantic partners who still drink. Relationships are one of the major causes of relapse.
- Making mistakes, and relapsing. Both are probably going to happen, so it’s best to prepare for them now. Recovery from alcoholism is a lifelong project, so remember that the only thing we can do after falling is pick ourselves up and try again.
Setbacks and relapses are a natural part of recovery from alcoholism, so most alcohol abuse programs spend a lot of time with patients to prepare them for such issues before they arise. So remember that all of these issues, challenges, and obstacles can be overcome with a strong recovery plan and help from professionals.
- Robert B. Huebner, Lori Wolfgang Kantor. Advances in Alcoholism Treatment. Alcohol Res Health. 2011; 33(4): 295–299. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860532/
- Anton RF, O’Malley SS, Ciraulo DA, et al. Effect of combined pharmacotherapies and behavioral interventions for alcohol dependence: The COMBINE study: A randomized controlled trial. JAMA: Journal of the American Medical Association. 2006;295(17):2003–2017. https://www.ncbi.nlm.nih.gov/pubmed/16670409
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