Comprehensive Guide to Alcohol Addiction and Treatment

Treatment Approaches

There are several effective treatments for AUD, which can be selected based on the individual’s unique needs and preferences. For many, speaking to a primary care provider can be a helpful first step. They can offer referrals, evaluate the severity of AUD, and can even prescribe medications to assist in recovery.

There is no one-size-fits-all solution, and the path to recovery can involve trial and error. Persistence is key, and setbacks should be seen as a normal part of the process rather than as failures.

The following is an overview of the most common approaches.

Behavioral Treatments

Behavioral therapies focus on modifying drinking behaviors through developing new behaviors and strategies for change. These interventions are often delivered by trained professionals and can include:

Cognitive Behavioral Therapy (CBT)

This therapeutic approach is based on the idea that our thoughts, feelings, and actions are connected. It helps us identify negative thinking patterns that can lead to unhealthy behaviors. By challenging these thoughts and replacing them with positive ones, CBT effectively addresses the root causes of mental health issues and promotes better overall well-being.

Motivational Interviewing

This short-term approach fosters motivation for change by helping individuals explore their reasons for wanting to cut back or stop drinking. It emphasizes personal goals and reinforces positive behaviors.

Individual and Group Counseling

Counseling approaches focus on recognizing ways to change drinking behaviors through identifying triggers and high-risk situations, leveraging social supports, and supporting the development of healthy behaviors and routines.

Contingency Management

This method uses tangible rewards to reinforce positive behaviors, such as attending therapy sessions or achieving sobriety milestones.

Acceptance and Commitment Therapy (ACT)

This therapy encourages individuals to become aware of and accept their thoughts, feelings, and actions rather than fighting against them. By committing to honesty and taking actions based on your values, you can learn to accept yourself and find lasting peace.

Dialectical Behavior Therapy (DBT)

DBT combines acceptance and change, helping individuals manage emotions and develop healthier coping mechanisms. DBT provides patients with mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills.

Community Reinforcement and Family Training (CRAFT)

CRAFT helps family members guide loved ones with addiction toward treatment by rewarding positive behavior instead of confronting them. This supportive approach improves family dynamics and increases the chances of the person entering treatment

Medications for AUD

Medications can be prescribed to help reduce cravings or maintain abstinence from alcohol. These three FDA-approved medications are commonly used:

• Naltrexone: Available in pill or injection form, naltrexone reduces the pleasurable effects of alcohol, diminishing cravings.
• Acamprosate: Helping prevent those in recovery from drinking alcohol, acamprosate can reduce the negative symptoms associated with alcohol withdrawal, making it easier to stay sober.
• Disulfiram: Causing unpleasant effects when alcohol is consumed, disulfiram discourages individuals from drinking.

These medications are not addictive and are typically used in combination with behavioral therapy.

Mutual Support Groups

Programs like Alcoholics Anonymous (AA) and SMART Recovery offer peer support for individuals working to quit drinking. AA and other mutual support programs are widely available and can complement professional treatment by providing ongoing support in a group setting.

Treatment Setting

Along with selecting the most suitable type of treatment for yourself or a loved one, you’ll also need to choose the setting in which it will take place. There are different treatment setting options for AUD, including:

• Outpatient: This treatment involves regularly scheduled appointments without the need for an overnight stay. This may be done in intensive (e.g., multiple times per week) or less intensive (e.g., once per week) formats.
• Partial hospitalization: An intensive form of outpatient therapy, partial hospitalization refers to daily treatment sessions that last several hours and are designed for individuals who need more support than traditional outpatient care but do not require 24-hour supervision.
• Inpatient: For inpatient therapy, you reside at a hospital or treatment facility for several days or weeks, typically overnight.
• Residential: This treatment setting provides 24-hour care for individuals, typically lasting for at least several weeks, with varying levels of intensity tailored to their specific needs.

Why Alcohol Is Difficult To Quit

People often associate alcohol with positive feelings because it gives the brain a rush of dopamine, which makes us feel happy and rewarded. This feel-good connection makes people want to drink again. But over time, drinking becomes more of a habit than a choice, and it gets harder to stop. While alcohol might help numb bad feelings for a little while, it can actually make them worse in the long run, keeping the cycle of drinking going.

The risk of developing AUD is influenced by drinking patterns, including the amount, frequency, and speed of alcohol consumption. Misusing alcohol—such as through binge drinking or heavy use—raises the risk over time. Key risk factors include:

• Early drinking onset: Starting alcohol use before age 15 significantly raises the chance of developing AUD, especially in females. People who delay drinking until age 21 or later have a lower risk.
• Genetics and family history: Genetics account for up to 60% of AUD risk, with family environments and parental drinking habits also playing a role.
• Mental health issues and trauma: Conditions like depression, PTSD, and ADHD, as well as childhood trauma, increase susceptibility to AUD.