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Treatments and drugs
By Mayo Clinic staffMany people with alcoholism enter treatment reluctantly because they don't recognize that they have a problem. An intervention from loved ones is needed to help some people recognize and accept that they need to get help. If you're concerned about a friend or family member, talk to a professional for advice about how to approach that person about his or her drinking.
Various treatments are available to help people with alcohol problems. Depending on the circumstances, treatment may involve a brief intervention, an outpatient program or counseling, or a residential inpatient stay.
The first step in treatment is to determine whether you're alcohol dependent. If you haven't lost control over your use of alcohol, treatment may involve reducing your drinking. If you're dependent on alcohol, simply cutting back is ineffective. Giving up alcohol entirely must be part of your treatment goal.
Treatment for alcoholism can include:
- Detoxification and withdrawal. Treatment for alcoholism may begin with a program of detoxification, which generally takes four to seven days. You may need to take sedating medications to prevent shaking, confusion or hallucination (delirium tremens) or other withdrawal symptoms. Detoxification is usually done at an inpatient treatment center or at a hospital.
- Learning skills and establishing a treatment plan. This usually involves alcohol-abuse specialists. It may include goal setting, behavior modification techniques, use of self-help manuals, counseling and follow-up care at a treatment center.
- Psychological counseling. Counseling and therapy for groups and individuals 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. An alcohol-sensitizing drug called disulfiram (Antabuse) may help prevent you from drinking. Disulfiram won't cure alcoholism, nor can it remove the compulsion to drink. But if you drink alcohol, the drug produces a physical reaction that includes flushing, nausea, vomiting and headaches. Naltrexone (ReVia), a drug long known to block the good feelings alcohol causes, reduces the urge to drink. Acamprosate (Campral) may help you combat alcohol cravings. Unlike disulfiram, naltrexone and acamprosate don't make you feel sick soon 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 alcoholism or alcohol abuse 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 psychological counseling (psychotherapy), medications, or other treatment for depression, anxiety or another mental health condition.
- Medical treatment for other conditions. Common medical problems related to alcoholism are high blood pressure, increased blood sugar, liver disease and heart disease.
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 and professional staff experienced in treating alcoholism.
- Gold MS, et al. Screening for and diagnosis of alcohol problems. http://www.uptodate.com/home/index.html. Accessed March 29, 2010.
- Kelly JF, et al. Alcohol-related disorders. In: Stern TA, et al: Massachusetts General Hospital Comprehensive Clinical Psychiatry. Philadelphia, Pa.: Mosby Elsevier. 2008. http://www.mdconsult.com/das/book/body/192040318-6/0/1657/241.html?tocnode=57542852&fromURL=241.html. Accessed March 29, 2010.
- FAQs about alcohol. Centers for Disease Control and Prevention. http://www.cdc.gov/alcohol/faqs.htm. Accessed March 29, 2010.
- FAQ for the general public. National Institute on Alcohol Abuse and Alcoholism. http://www.niaaa.nih.gov/FAQs/General-English/default.htm. Accessed March 29, 2010.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. March 31, 2010.
- Helping patients who drink too much: A clinician's guide. National Institute on Alcohol Abuse and Alcoholism. http://pubs.niaaa.nih.gov/publications/Practitioner/CliniciansGuide2005/guide.pdf.
- Alcohol dependence. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed March 29, 2010.
- Common questions about diet and cancer. American Cancer Society. http://www.cancer.org/docroot/PED/content/PED_3_2X_Common_Questions_About_Diet_and_Cancer.asp. Accessed March 29, 2010.
- Gold MS, et al. Psychosocial treatment of alcohol abuse and dependence. http://www.uptodate.com/home/index.html. Accessed March 29, 2010.
- Warne D. Alcoholism and substance abuse. In: Rakel D. Integrative Medicine. 2nd ed. Philadelphia, Pa.: Saunders Elseveier; 2007. http://www.mdconsult.com/das/book/body/192038080-3/0/1494/129.html?tocnode=54115695&fromURL=129.html. Accessed March 29, 2010.
- Make a difference: Talk to your child about alcohol. National Institute on Alcohol Abuse and Alcoholism. http://pubs.niaaa.nih.gov/publications/MakeADiff_HTML/makediff.htm. Accessed March 29, 2010.
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