What is Alcohol Addiction Treatment?
If you’ve ever wondered about alcohol addiction treatment, you may have found yourself being skeptical about whether it works. Perhaps you have heard stories of people who go in and out of alcohol rehab or have only seen it portrayed in TV and movies.
Because alcoholism is a complex disease, there is not a one-size-fits-all approach to treatment. However, studies have shown that alcohol addiction treatment can be effective in managing symptoms of alcoholism. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) found “that about 1/3 of people who are treated for alcohol problems have no further symptoms 1 year later.”1
It is important to stay in treatment long enough for it to be effective. Longer addiction treatment stays have shown to allow for improved treatment outcomes.2 Research indicates that most people need 3 months of substance abuse disorder treatment to achieve optimal outcomes from treatment.2
Aftercare such as participation in mutual-help groups (e.g., Alcoholics Anonymous) or even online support forums have been shown to help improve recovery outcomes and help to prevent relapse following treatment.3,4
Learn more about alcoholism treatment, what it entails, which therapies are used and how aftercare support can help individuals maintain a life of sobriety in the future.
What Is Alcoholism?
Drinking frequently and continuing to do so, even when alcohol causes negative consequences, may be a sign of an alcohol use disorder (AUD). The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines 11 criteria medical professionals to use to diagnose an AUD. If a person meets at least two of the criteria within a 12-month period, it may point to a need for professional treatment. Some signs include:1
- Drinking more than you originally intended.
- Unsuccessful attempts to cut back or stop drinking.
- Drinking even when it makes a psychological or physical problem worse.
- Drinking in high-risk situations, such as driving.
- Drinking that interferes with fulfilling responsibilities at work, home or school.
- Giving up hobbies or pleasurable activities to drink.
What is Alcohol Addiction Treatment?
If you believe that you need alcohol addiction treatment, there are a number of treatment options available to you. Effective treatment may include group and individual therapy, case management services, substance abuse education, medication management, and relapse prevention techniques.2
Whether beginning an inpatient or outpatient program, the first phase in overcoming a physiological dependence on alcohol typically begins with detoxification. Detox can be completed on an inpatient or outpatient basis. Inpatient detox is typical for people with high levels of alcohol dependence, those who have a history of seizures, or people who have had prior detox and treatment episodes.5
Some facilities offer continuing inpatient treatment in the same facility while others may offer detox services only. In those cases, ongoing treatment is then continued elsewhere, either in an inpatient or outpatient setting. Detoxification alone is not considered sufficient treatment to achieve long-term abstinence.2
Types of Alcoholism Treatment
Inpatient/Residential:6 Inpatient programs often consist of different phases of treatment, varying in length with 30-, 60- or 90-day programs. This type of setting allows patients to receive 24/7 supervision and have access to on-call medical staff throughout their stay. Individuals participating in inpatient settings may transition to lower levels of care (such as outpatient) once they complete their program.
Partial hospitalization Program (PHP):7 This level of care typically offers programming 5 days a week for 4-8 hours per day. A PHP can be a person’s first approach to treatment for alcohol use disorders, but it is often a step down from inpatient/residential treatment. Individuals can return home following treatment each day.
Intensive outpatient program (IOP):8 Another type of outpatient treatment, IOPs can also be a person’s first approach to treatment or a step down from either a PHP or an inpatient program. An IOP will usually meet 2-3 days per week for 2-3 hours at a time and require less time in therapy than PHPs.
Outpatient:6,7 Outpatient services can be either a step down from inpatient/residential, PHP or IOP treatment or the primary course of treatment for an alcohol use disorder. Outpatient treatment typically consists of less than 9 hours a week and can occur once a week or at more intensive levels.
Regardless of the type of program you attend, your treatment plan will include practices rooted in evidence-based research to increase your chances of successful recovery.9 Common evidence-based approaches for the treatment of alcohol use disorder include:10, 11
- Cognitive behavioral therapy (CBT) is a widely used treatment approach that helps a person use thoughts to control their emotional impulses.12 Learning to recognize and change reactions to various situations, such as stressors that trigger alcohol use, is an important component of CBT.12
- Dialectical behavioral therapy (DBT) is a newer evidence-based practice that helps a person substitute destructive behaviors, such as excessive drinking, with goal-oriented behaviors such as sobriety.13 The practice focuses on four behavioral skills: mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation.13
- Motivational enhancement therapy incorporates techniques that enhance a person’s motivation toward recovery and sobriety. Motivational enhancement therapy focuses on reducing ambivalence toward stopping the use of alcohol or other substances.14
- Contingency management interventions are an approach that incorporates various incentives to increase motivation and commitment to sobriety.15 Participants may receive vouchers for items such as movie tickets, gift cards, or prizes after achieving a certain goal, such as a certain number of days of sobriety.15
- 12-step facilitation is a treatment approach that incorporates the concepts of 12-step groups such as Alcoholics Anonymous (AA) into treatment.16 Participants often go to 12-step meetings as part of treatment and they are encouraged to find a sponsor and continue going to 12-step meetings after leaving treatment.16
Medications are frequently in alcohol addiction treatment to help control withdrawal and ongoing alcohol dependence and seizures associated with the cessation of alcohol use.
Benzodiazepines—a category of medications that includes Valium and Librium—are a class of FDA-approved sedative medications used to treat alcohol withdrawal symptoms during detox.17
Benzodiazepines can significantly reduce the risk of seizures in those suffering from alcohol withdrawal symptoms.6
The following FDA-approved medications may also be administered while undergoing care in order to treat alcohol dependence:18
- Acamprosate (Campral) is thought to restore balance to certain types of brain activity in the post-acute withdrawal period to help with symptoms such as anxiety, insomnia, restlessness, and depression. It may be more effective in people with higher levels of alcohol dependence. It has been shown to help increase abstinence for weeks or months.
- Disulfiram (Antabuse) interferes with the breakdown of alcohol in the body, which in turn leads to a buildup of a chemical called acetaldehyde. When acetaldehyde builds up in the body, a person experiences nausea, heart palpitations, and flushing. Disulfiram can be effective among those who are committed to using it as prescribed. Some patients use it occasionally for high-risk situations, such as a social situation where alcohol is available.
- Naltrexone (Vivitrol, Revia) blocks opioid receptors that are involved in the craving for and rewarding effects of drinking alcohol. Vivitrol is an extended release version which can be administered once a month.
Benefits of Alternative Therapies
While more research is need regarding the effectiveness of alternative therapies used to treat alcoholism, these types of programs may increase retention in rehab by offering patients a broader array of services.19 Studies indicate that the higher a person’s overall satisfaction with their programming, the more likely they are to stay in treatment and have better outcomes.19
Art and music therapies are commonly featured in alcohol and other addiction treatment programs, with research supporting their usefulness when paired with more traditional forms of treatments.20 Additionally, yoga has been used frequently in numerous substance abuse treatment programs and has shown to reduce stress, anxiety, and improve physical and mental health in conjunction with standard recovery programming.21
Further, mindfulness and meditation have some of the strongest research support for effectiveness among alternative and holistic treatments. One meta-analysis indicated that mindfulness practices decreased cravings and increased abstinence rates for substance use at a rate equivalent to numerous evidence-based practices.22
Equine therapy, in which horses are incorporated into therapy, is a growing field. Some limited research regarding its effectiveness is available; though most research at this time is qualitative and anecdotal. One study researching the benefits of equine therapy found that the patient–horse relationship was an emotional support and important facilitator of a positive self-construct while in treatment.23
What is Aftercare?
Once a person has completed an inpatient or outpatient treatment program, having an aftercare plan is essential part of the recovery process. Aftercare reinforces the skills learned in treatment to help the recovering person avoid relapse.
At times, aftercare planning can be folded into a person’s treatment program and begins on the first day of treatment. Research has found that longer aftercare interventions were more effective in individuals remaining sober than shorter ones.24 However, even shorter intervals of aftercare can have a positive impact on sobriety. 24
A relapse can be triggered by simply associating with the people and places that were previously part of the substance use. Stress and physical health issues can also trigger a relapse.25 It is critical to have a strong network and support to help avoid relapse.25
Common aftercare services and peer support groups include:
- Sober living houses.
- 12-step programs such as Alcoholics Anonymous (AA) and/or Narcotics Anonymous (NA).
- Mutual-help groups.
- SMART Recovery.
- Al-Anon and Nar-Anon.
Get Help for Alcoholism
If you or someone you care about is ready to seek help for alcoholism, American Addiction Centers’ (AAC) admissions navigators are available 24/7 to provide you with answers to your questions and concerns. AAC operates AlcoholRehab.com and is a nationwide provider of addiction treatment centers.
We are committed to making recovery accessible to everyone in need and accept many insurance plans or can work with you so that finances aren’t a roadblock to getting the help you need. Call our hotline to get your journey toward recovery started today; all calls are 100% confidential.
. National Institute on Alcohol Abuse and Alcoholism. (2014). Treatment for alcohol problems: Finding and getting help.
. National Institute on Drug Abuse. (2020). Principles of effective treatment.
. Moore, B. A., Fazzino, T., Garnet, B., Cutter, C. J., & Barry, D. T. (2011). Computer-based interventions for drug use disorders: a systematic review. Journal of substance abuse treatment, 40(3), 215–223.
. Katherine J Karriker-Jaffe, Jamie L Klinger, Jane Witbrodt, Lee Ann Kaskutas. (2018). Effects of Treatment Type on Alcohol Consumption Partially Mediated by Alcoholics Anonymous Attendance. Substance Use Misuse, 21;53(4):596-605.
. Substance Abuse and Mental Health Services Administration. (2015). Detoxification and substance abuse treatment. A Treatment Improvement Protocol TIP 45.
. Hugh Myrick, M.D., and Raymond F. Anton, M.D. (1998). Treatment of Alcohol Withdrawal. Alcohol Health & Research World; 22(1): 38-43.
. American Society of Addiction Medicine. (2015). What are the ASAM Levels of Care?
. Substance Abuse and Mental Health Services Administration. (2006). Intensive Outpatient Treatment and the Continuum of Care. Treatment Improvement Protocol (TIP) Series, No. 47. Chapter 3.
. University of Canberra. (2020). Evidence-based practice in health.
. National Institute on Drug Abuse. (2020). Evidence-based approaches to drug addiction treatment.
. Cavicchioli, M., Movalli, M., Vassena, G., Ramella, P., Prudenziati, F., & Maffei, C. (2019). The therapeutic role of emotion regulation and coping strategies during a stand-alone DBT Skills training program for alcohol use disorder and concurrent substance use disorders. Addictive Behaviors, 98.
. National Institute on Drug Abuse. (2018). Cognitive-Behavioral Therapy (Alcohol, Marijuana, Cocaine, Methamphetamine, Nicotine).
. University of Washington Center for Behavioral Technology. (n.d.). Dialectical Behavior Therapy.
. National Institute on Drug Abuse. (2018). Motivational Enhancement Therapy (Alcohol, Marijuana, Nicotine).
. National Institute on Drug Abuse. (2018). Contingency Management Interventions/Motivational Incentives (Alcohol, Stimulants, Opioids, Marijuana, Nicotine).
. National Institute on Drug Abuse. (2018). 12-Step Facilitation Therapy (Alcohol, Stimulants, Opiates).
. American Society of Addiction Medicine. (2020). Clinical practice guideline on alcohol withdrawal management.
. National Institute on Drug Abuse. (2018). Alcohol addiction.
. Yih-Ing Hser, Ph.D., Elizabeth Evans, M.A., David Huang, Dr.P.H., and Douglas M. Anglin, Ph.D. (2004). Relationship Between Drug Treatment Services, Retention, and Outcomes. Psychiatric Services; 55(7), 767-774.
. Aletraris, L., Paino, M., Edmond, M. B., Roman, P. M., & Bride, B. E. (2014). The use of art and music therapy in substance abuse treatment programs. Journal of Addictions Nursing, 25(4), 190–196.
. Kuppili, P. P., Parmar, A., Gupta, A., & Balhara, Y. (2018). Role of yoga in management of substance-use disorders: A narrative review. Journal of Neurosciences in Rural Practice, 9(1), 117–122.
. Korecki, J. R., Schwebel, F. J., Votaw, V. R., & Witkiewitz, K. (2020). Mindfulness-based programs for substance use disorders: a systematic review of manualized treatments. Substance Abuse Treatment, Prevention, and Policy, 15(1), 51.
. Kern-Godal, A., Brenna, I. H., Arnevik, E. A., & Ravndal, E. (2016). More than just a break from treatment: How substance use disorder patients experience the stable environment in horse-assisted therapy. Substance Abuse: Research and Treatment, 10, SART-S40475.
. McKay J. R. (2009). Continuing care research: What we’ve learned and where we’re going. Journal of Substance Abuse Treatment, 36(2), 131–145.
. Alcohol and Drug Foundation. (2020). Relapse.