Treatments and drugsBy Mayo Clinic staff
Many people with alcoholism hesitate to get treatment because they don't recognize they have a problem. An intervention from loved ones can help some people recognize and accept that they need professional help. If you're concerned about a friend or family member who drinks too much, talk to a professional for advice on how to approach that person.
Various treatments may help. Depending on the circumstances, treatment may involve a brief intervention, individual or group counseling, an outpatient program, or a residential inpatient stay.
The first step is to determine if you have a problem with alcohol. If you haven't lost control over your use of alcohol, treatment may involve reducing your drinking. If you have become addicted, simply cutting back is ineffective. Working to stop the use of alcohol to improve quality of life is the main treatment goal.
Treatment for alcoholism may include:
- Detoxification and withdrawal. Treatment for alcoholism may begin with a program of detoxification, which generally takes two to seven days. You may need to take sedating medications to prevent shaking, confusion or hallucinations (delirium tremens), or other withdrawal symptoms. Detoxification is usually done at an inpatient treatment center or a hospital.
- Learning skills and establishing a treatment plan. This usually involves alcohol treatment specialists. It may include goal setting, behavior change techniques, use of self-help manuals, counseling and follow-up care at a treatment center.
- Psychological counseling. Counseling and therapy for groups and individuals help you better understand your problem with alcohol and support recovery from the psychological aspects of alcoholism. You may benefit from couples or family therapy — family support can be an important part of the recovery process.
- Oral medications. A drug called disulfiram (Antabuse) may help to prevent you from drinking, although it won't cure alcoholism or remove the compulsion to drink. If you drink alcohol, the drug produces a physical reaction that may include flushing, nausea, vomiting and headaches. Naltrexone (Revia), a drug that blocks the good feelings alcohol causes, may prevent heavy drinking and reduce the urge to drink. Acamprosate (Campral) may help you combat alcohol cravings. Unlike disulfiram, naltrexone and acamprosate don't make you feel sick after taking a drink.
- Injected medication. Vivitrol, a version of the drug naltrexone, is injected once a month by a health care professional. Although similar medication can be taken in pill form, the injectable version of the drug may be easier for people recovering from alcohol dependence to use consistently.
- Continuing support. Aftercare programs and support groups help people recovering from problem drinking or alcoholism to stop drinking, manage relapses and cope with necessary lifestyle changes. This may include medical or psychological care or attending a support group such as Alcoholics Anonymous.
- Treatment for psychological problems. Alcoholism commonly occurs along with other mental health disorders. You may need talk therapy (psychotherapy or psychological counseling), medications, or other treatment for depression, anxiety or another mental health condition, if you have any of these conditions.
- Medical treatment for other conditions. Common medical problems related to alcoholism include high blood pressure, high blood sugar, liver disease and heart disease. Many alcohol-related health problems improve significantly once you stop drinking.
- Spiritual practice. People who are involved with some type of regular spiritual practice may find it easier to maintain recovery from alcoholism or other addictions. For many people, gaining greater insight into their spiritual side is a key element in recovery.
Residential treatment programs
For a serious alcohol problem, you may need a stay at a residential treatment facility. Many residential treatment programs include individual and group therapy, participation in alcoholism support groups such as Alcoholics Anonymous, educational lectures, family involvement, activity therapy, and working with counselors, professional staff and doctors experienced in treating alcoholism.
- Saitz R, et al. Screening for unhealthy use of alcohol and other drugs. http://www.uptodate.com/ index. Accessed June 2, 2012.
- Hoffman RS, et al. Management of moderate and severe alcohol withdrawal syndromes. http://www.uptodate.com/index. Accessed June 2, 2012.
- Alcohol and public health: Frequently asked questions. Centers for Disease Control and Prevention. http://www.cdc.gov/alcohol/faqs.htm. Accessed March 29, 2010.
- Gold MS, et al. Psychosocial treatment of alcohol abuse and dependence. http://www.uptodate.com/index. Accessed June 2, 2012.
- Esser MB, et al. Binge drinking intensity. American Journal of Preventive Medicine. 2012;42:625.
- Johnson BA, et al. Pharmacotherapy for alcohol abuse and dependence. http://www.uptodate.com/index. Accessed June 2, 20127.
- Substance-related disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed June 2, 2012.
- Harmful interactions: Mixing alcohol with medicines. National Institute on Alcohol Abuse and Alcoholism. http://www.niaaa.nih.gov/publications/brochures-and-fact-sheets. Accessed June 3, 2012.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. June 14, 2012.
- Overview of alcohol consumption. National Institute on Alcohol Abuse and Alcoholism. http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption. Accessed June 2, 2012.
- Underage drinking. National Institute on Alcohol Abuse and Alcoholism. http://www.niaaa.nih.gov/alcohol-health/special-populations-co-occurring-disorders/underage-drinking. Accessed June 2, 2012.
- Alcohol use disorders. National Institute on Alcohol Abuse and Alcoholism. http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders. Accessed June 2, 2012.
- Fetal alcohol exposure. National Institute on Alcohol Abuse and Alcoholism. http://www.niaaa.nih.gov/alcohol-health/fetal-alcohol-exposure. Accessed June 2, 2012.
- Beyond hangovers: Understanding alcohol's impact on your health. http://pubs.niaaa.nih.gov/publications/Hangovers/beyondHangovers.pdf. Accessed June 2, 2012.
- College drinking. National Institute on Alcohol Abuse and Alcoholism. Accessed http://www.niaaa.nih.gov/alcohol-health/special-populations-co-occurring-disorders/college-drinking. June 2, 2012.
- Breast cancer. American Cancer Society. http://www.cancer.org/Cancer/BreastCancer/DetailedGuide/breast-cancer-risk-factors. Accessed June 12, 2012.
- Public policy statement on the definition of alcoholism. American Society of Addiction Medicine. http://www.asam.org/advocacy/find-a-policy-statement/view-policy-statement/public-policy-statements/2011/12/15/the-definition-of-alcoholism-(ncadd-asam). Accessed June 25, 2012.
- Schneekloth TD (expert opinion). Mayo Clinic, Rochester, Minn. June 23, 2012.
- Thiamin. The Merck Manual for Health Care Professionals. http://www.merckmanuals.com/professional/nutritional_disorders/vitamin_deficiency_dependency_and_toxicity/thiamin.html. Accessed August 1, 2012.