How Are Problems With Alcohol Treated?
By Peg Rosen
Experts don’t use the terms “alcoholic” or “alcoholism” anymore. Those outdated words made the condition all about the person, rather than the medical condition they were experiencing. It also made it seem like people either had a severe problem with alcohol or they were just fine with drinking, and there was nothing in between.
The reality is that people can have different levels of difficulty with alcohol use, your relationship to alcohol can be problematic without being as severe as what you see in the movies, and there are different approaches to treatment you can consider.
Experts now use “alcohol use disorder” (AUD) to describe when people have difficulty controlling their drinking.
AUD is a brain disease that often runs in families. It needs treatment just like diabetes and other chronic illnesses.
Like many illnesses, there is no cookie-cutter treatment that works best for everyone. When you are ready to discuss your goals with drinking, your counselor, therapist, or physician will help you create an individualized plan.
Choosing Alcohol Treatment
It’s possible to choose a treatment on your own or with help from your parents, caregivers, or other loved ones.
Most people, however, do better with at least some guidance from a medical provider, such as a pediatrician, a campus doctor, or an addiction physician. They’ll do a physical exam and make a recommendation based on multiple other things, including:
- How much you are drinking.
- If you have tried and been unable to quit.
- If you are having symptoms of withdrawal.
- Whether you have or are showing signs of other health problems, such as anxiety and depression, or have additional mental health conditions.
- What’s available where you live.
- What you or your parents or caregivers can afford.
Treatment Options for Problem Drinking
Treating AUD doesn’t have to be an all-or-nothing thing. If you aren’t ready to quit drinking, there are treatments and programs that can help you cut back and stay safe.
Whatever the goal, people often rely on a combination of treatments and make changes to their care plan over time.
Below are the basic options.
Licensed addiction therapists generally treat AUD with cognitive behavioral therapy (CBT). Offered one on one and in small groups, CBT helps you explore how your thoughts and emotions are connected to your drinking and other behaviors. CBT is often used along with motivational enhancement therapy (MET). This type of talk therapy helps you get past feelings of ambivalence about your substance use and make positive changes in your life. Psychology Today has an online directory of addiction therapists.
Peer-Led Support Groups
“Peer-led” means group members help each other overcome their addiction issues and stay sober. Alcoholics Anonymous is the best-known of these groups. Its free meetings happen both virtually and in person. AA also has groups specifically for young adults, women, people of color, and the LGBTQ community. There are some misconceptions that you have to be religious or spiritual to join AA, but that’s not really the case. Leaning on a “higher power” during recovery may have originally referred to God or the like, but many groups now just encourage members to lean on other forces, like their community or nature.
Another great option is SMART Recovery. “SMART” stands for Self-Management and Recovery Training. It focuses on helping you learn how to notice and manage triggers and urges to drink. It helps you understand the relationship between your thoughts, feelings, and behaviors around drinking, and encourages you to notice if there are certain thoughts, feelings, or behaviors that make it more or less likely you’ll drink.
If you aren’t ready to quit alcohol entirely, Moderation Management is a group that can help you reduce how much you drink and the negative impact drinking has on your life.
There are medications to treat AUD. Some work by making you very sick if you drink while on the drug, while others decrease your cravings to drink. These meds are usually used along with other treatments to help with recovery and prevent you from relapsing. An addiction physician, psychiatrist, or a primary-care provider can write the prescription.
Detox and Withdrawal-Management Care
If you drink heavily for a long time, your brain gets used to it. When you go without alcohol—even for just a handful of hours—your nervous system can have trouble adjusting. This is called alcohol withdrawal. Depending on how heavily you drink, the symptoms can be mild or life-threatening. If you are showing withdrawal symptoms, your doctor may recommend medically supervised detoxification before any other treatment.
Detox manages your withdrawal symptoms while you clear drugs and alcohol from your system. If you have mild to moderate withdrawal symptoms, you may be able to go through detox as an outpatient. You’ll need to live at home or another place where someone can watch over you.
You’ve probably heard about 28-day (more or less) programs, which help with detox if you need it. They also provide a structured recovery environment with on-site counseling and support that readies you to re-enter your life and stay sober. Some people may need an even longer inpatient program if their AUD is severe. Inpatient treatment can be expensive, but most insurance companies are required to cover the cost. If you don’t have health insurance, some facilities offer free or low-cost care or charge on a sliding scale. Every state also has funding to help people without insurance pay for treatment.
Partial Hospitalization and IntensiveOutpatient Programs
A partial hospitalization program (PHP) or an intensive outpatient program (IOP) are other options for getting treatment for AUD. A PHP is comparable to a residential recovery program, but, unlike traditional rehab programs, in a PHP program you don’t live onsite at the facility during your treatment. You have the ability to choose your own housing accommodations and come in for daily programming—usually five days a week for at least 20 hours total. An IOP has less time commitment than a PHP, allowing you to get back into your daily routine, including going to school, work, or other commitments. Generally IOP is up to three times a week for about nine hours.
If you’re concerned that you have signs of an alcohol problem, talk to your parent or caregiver. If that isn’t an option, seek out another trusted adult who can help you find the help you need. Once you get that help, you will have the support you need to free yourself from alcohol’s control over your life.