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What is Alcohol Addiction?
Alcohol use disorder (AUD) is the most common addiction in the US. More people suffer from alcohol abuse than any other substance.
In the U.S. in 2018, over 14 million adults and 400,000 youths (age 12 to 17) had AUD. However, only about 1 million of them received treatment.— 2018 National Survey of Drug Use and Health (NSDUH)
Luckily, there are thousands of treatment options available for people with alcohol use disorders (AUD). Effective alcohol addiction treatment guides an individual through the process of detoxification, helps them prepare for a sober life, and provides them with consistent aftercare.
Alcohol Abuse vs. Addiction
According to the 2018 NSDUH, the majority of Americans (86 percent of adults) have drunk alcohol in their life. Over one-quarter of the population said they engaged in binge drinking during the last month.
Because alcohol is so commonplace, it can be difficult to tell the difference between frequent enjoyment, alcohol abuse, and AUD. This confusion may be one of the reasons less than 8 percent of Americans suffering from alcohol addiction seek treatment.
Here is how the CDC defines drinking patterns and how to recognize patterns of alcohol abuse or addiction:
The definition of a standard drink is:
- .6 ounces or 14 grams of pure alcohol
- 12 ounces of beer (5 percent alcohol content)
- 8 ounces of malt liquor (7 percent alcohol content)
- 5 ounces of wine (12 percent alcohol content)
- 1.5 ounces of 80-proof liquor (40 percent alcohol content)
Moderate drinking is one drink for women or two drinks for men on any given day. It is not intended as an average over an extended length of time. Also known as “social drinking” or “responsible drinking.”
For men, heavy drinking is 15 or more drinks per week. Or eight drinks per week, for women.
Binge drinking is a pattern of alcohol consumption that raises the blood alcohol concentration (BAC) to .08 percent or more. This generally takes about five or more drinks for men and four or more drinks for women within 2 hours.
Excessive drinking includes heavy drinking, binge drinking, any alcohol use by people under the legal drinking age of 21, and any alcohol use by pregnant women.
Alcohol Use Disorder
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or DSM-5, is the primary authority for mental disorders. The previous edition, DSM-IV, separated alcohol misuse into two distinct disorders: alcohol abuse and alcohol dependence.
The DSM-5 has combined the two disorders into a single diagnosis called alcohol use disorder (AUD), with subclassifications of mild, moderate, and severe.
The DSM-5 defines an AUD as having at least two of the following symptoms in the last year:
- Drinking more, or longer, than you intended multiple times
- Wanting to cut down or stop drinking, but couldn’t
- Spending a lot of time drinking, being hungover, or getting sick from drinking
- Wanting to drink so badly, you couldn’t think of anything else.
- Drinking, or the effects of alcohol, has made it difficult to take care of your home, family, job, or school responsibilities
- Continuing to drink, even though it was causing problems with your family or friends
- Replacing activities that were important or interesting to you with drinking
- More than once, while or after drinking, getting into a situation that increased your chances of being hurt (such as driving, swimming, using machinery, walking in an unsafe area, or having unsafe sex)
- Continuing to drink after blacking out, feeling anxious or depressed, or when adding to another health problem
- Having to drink much more to feel the effect you once did or realizing the usual number of drinks had less of an impact than before
- Experiencing withdrawal when the effects of the alcohol wore off (such as trouble sleeping, trembling, restlessness, nausea, sweating, a racing heart, or a seizure)
Treatment for Alcohol Use Disorder
Overcoming AUD is a serious and challenging task. The best way to increase your chances of recovery is to seek treatment at a qualified treatment center that can help you identify underlying causes and treat co-occurring disorders, if necessary.
Alcohol Rehab Process
There are several treatment options for individuals suffering from AUD. However, there are five stages that patients enrolling in a comprehensive treatment program should expect:
During the first step of treatment, nurses, therapists, or a combination of the two will assess the severity of your alcohol use disorder. This may include questionnaires, interviews, and a medical examination if necessary.
During these assessments, they will check for co-occurring disorders and evaluate you for multiple addictions. The results of these assessments will provide the basis for the treatment plan that they, or your case manager, will coordinate.
2. Alcohol Detox
The next step in recovery is detoxification. Detoxing your body doesn’t cure you; it only prepares you for treatment. When alcohol leaves your body, you will experience withdrawal symptoms, typically six to 24 hours after your last drink.
Detoxification is often the most challenging part of alcohol rehab. Withdrawal symptoms range from mild to severe and include:
- Racing heart
- High blood pressure
- Hallucinations or delusions (delirium tremens)
The safest way to go through the detox process is under the supervision of a treatment center. Depending on the severity of the patient’s AUD, medical supervision and medication may be necessary. They can also provide nutritious food to avoid malnourishment during this difficult time.
Once the patient has undergone detox, they will begin a variety of treatment practices. These include, but are not limited to:
- Individual behavioral therapy
- Group counseling
- Educational programs
- Skills training
- Holistic treatments (including yoga, mindfulness, animal therapy, art therapy, and more
- Medications (if necessary)
Each patient will receive personalized care based on the severity of their AUD, their mental and physical health, and a variety of other factors that the medical professionals treating them will analyze. This stage may take weeks or months, depending on the rate of recovery.
Once a patient has learned the proper skills, gained the necessary education, and built a solid support system, the next step is for them to take these new behaviors and begin applying them in real-world scenarios.
Support groups and 12-step programs such as Alcoholics Anonymous, SMART Recovery, and other outside resources may be utilized to provide patients with a safe place to practice their new skills and prepare to live a healthy and sober life.
Aftercare is a crucial part of recovery. Just because an individual has completed an alcohol rehab program, doesn’t mean they are cured. The world is filled with triggers and opportunities for relapse.
Peer counseling and support groups are often a part of aftercare treatment. This part of the recovery process may last for years or even a lifetime.
Treatment Options for Alcohol Abuse & Addiction
- Inpatient Programs — Inpatient treatment is the option for alcohol addiction treatment. These intensive programs are usually 30, 60, or 90 days but can be longer in certain cases. Throughout the duration of your stay at an inpatient rehab facility, you will live on site is a safe, substance-free environment. You will go through medically supervised detoxification first, then behavioral therapy and other services will be added to your regimen. Most programs will will help you set up an aftercare program upon completion.
- Partial Hospitalization Programs (PHPs) — Partial hospitalization programs (also called intensive outpatient programs, or IOPs) are comparable to inpatient programs, but you return home after each session. Some PHPs provide food and transportation, but this varies by program. Their services may include detoxification, medical services, behavioral therapy, support groups, and other holistic or custom treatments. PHPs accept new patients, along with patients who have completed an inpatient treatment program and still require intensive care.
- Outpatient Programs — Outpatient programs are less intensive and offer a more flexible treatment schedule. They are best for people who have responsibilities at work, home, or school and are highly motivated to achieve sobriety. Outpatient treatment programs customize your treatment sessions around your personal schedule. Outpatient programs can help new patients achieve success, and may also be a part of aftercare program once a patient completes an inpatient or PHP.
- Medication-Assisted Therapy (MAT) — Certain patients with Alcohol Use Disorder will qualify for medication-assisted therapy. Medications can help you detoxify, reduce cravings, and normalize bodily functions. Disulfiram (Antabuse), acamprosate (Campral), and naltrexone (Revia and Vivitrol) are the most common medications used to treat Alcohol Use Disorder. MAT is most effective when combined with other treatment therapies.
- Support Groups — Support groups are peer-led groups that help people stay sober. They can be a first step in overcoming alcoholism or a component of an aftercare plan. Many of them follow the 12-step approach, however there are secular options that don't follow the 12-step approach as well.
Alcohol Rehab Timeline
When considering a timeline for recovery from AUD, the most important thing to remember is that everyone’s rehabilitation and recovery process will be unique. Therefore, everyone’s timeline will be different.
Most treatment programs happen in 30, 60, or 90-day increments. However they can be lengthened or (rarely) shortened based on the individual’s progress through the recovery process.
It’s important to keep in mind that treatment programs do not provide a cure. Many people consider recovery to be a life-long process and attend peer counseling groups or other aftercare programs for the rest of their lives.
Medications Used to Treat AUD
Doctors prescribe medications to treat AUD in a small percent of (usually severe) cases. Many people with AUD may already be prescribed medications, suffering from a co-occurring disorder, or have an additional addiction. Therefore, it is crucial to exercise extreme caution when taking medications for alcohol addiction.
Currently, there are three medications that the FDA has approved to treat alcohol addiction:
- Disulfiram — causes unpleasant reactions such as nausea or headache when mixed with alcohol
- Naltrexone — prevents pleasurable effects and reduces cravings for alcohol
- Acamprosate — curbs cravings for alcohol
These medications must be a part of a larger treatment program that includes behavioral therapy or other AUD treatment services.
In addition, doctors may prescribe other medications to help manage withdrawal symptoms, such as Topamax or Valium to help manage withdrawal symptoms. These are not meant to help treat alcoholism, only to provide relief during detoxification.
If you or a loved one is suffering from alcohol abuse or dependency, contact a medical professional today to review your treatment options.