FIND YOUR WAY TO QUALITY ALCOHOL TREATMENT

Individuals with opioid addiction should seek help from a medical professional who is specially qualified to treat this condition.  The medications, providers, qualifications, and regulations for opioid addiction treatment are different from those for alcohol use disorder treatment. 

Evidence-based care is treatment that is grounded in the best available scientific research, showing a clear link between improved patient outcomes and the use of medications, behavioral therapies, or other treatment components.

The NIAAA Alcohol Treatment Navigator^® recommends that people seeking alcohol treatment look for providers with five signs of higher-quality care: credentials, comprehensive assessment, customized treatment plan, evidence-based treatments, and continuing recovery support. These signs are based on a review of the addiction health services research literature and the consensus of health professionals who are experts in alcohol treatment.

Also known as counseling or “talk therapy,” behavioral treatments involve working with a health professional to identify and help change the behaviors that lead to alcohol use disorder (AUD). Behavioral treatments are offered by trained health professionals in a variety of settings, and may be provided in combination with prescribed medications.

Three medications have been approved by the US Food and Drug Administration to help people with alcohol use disorder (AUD) stop or reduce their drinking and avoid relapse:  

• Naltrexone works by blocking the receptors in the brain that are involved in craving alcohol or the rewarding effects of drinking. It comes either as a pill that is taken daily, or as an injection that can be given once per month.

• Acamprosate is prescribed to help people with AUD maintain abstinence from alcohol by alleviating some negative symptoms of prolonged abstinence. It is a pill that is taken three times per day.

• Disulfiram is a pill that causes unpleasant symptoms such as nausea and flushing of the skin when a person drinks. Wanting to avoid those unpleasant effects can help some people refrain from drinking.

Used in the context of a comprehensive treatment plan, medications for alcohol use disorder (AUD) can provide an opportunity for behavioral therapies (counseling) to be helpful by reducing craving or helping to maintain abstinence from alcohol. In that way, medications can give people with an alcohol problem some traction in the recovery process.

For persons with alcohol use disorder (AUD), abstaining from drinking (stopping altogether) is generally recommended, and provides the greatest chance of long-term success. Abstaining is especially important when the individual is pregnant or is trying to become pregnant; is taking medications that negatively interact with alcohol; or has a medical or psychiatric disorder that is made worse by drinking. However, decisions about the ultimate goal of AUD treatment should be determined in a dialogue between the patient and a credentialed treatment provider.

Medical detoxification (or “detox”) is the process of getting alcohol or drugs out of a person’s system. When someone who has been drinking heavily for a prolonged period of time suddenly stops drinking, the body can go into a painful or even dangerous process of withdrawal. Symptoms can include nausea, rapid heart rate, seizures, or other problems. Doctors can prescribe medications to address these symptoms and make the process safer and less distressing.

Detox alone is not the same as treatment. While detox helps to stabilize a person with an alcohol problem, it does not teach important skills such as how to identify and address situations that may lead to heavy alcohol use; how to refuse alcohol in social situations; or how to cope with stress in a way that does not involve drinking. All of these are the kinds of skills people learn in treatment that is delivered by health care professionals.

Based on what you might see on TV or in the movies, it would seem like most treatment happens in residential rehab programs. But most people do not use—and do not need—a residential program. Here’s why.

Generally, it is recommended that people with alcohol use disorder (AUD) seek the least intensive type of care first, and then move to a more intensive level only if they need it. Most people who get treatment for AUD start with outpatient counseling, either at a treatment program or in one-on-one sessions with a therapist or doctor. Outpatient treatment gives people the flexibility to continue living at home, and even to continue going to work. It’s also much less expensive than residential or hospital treatment.