Types of Treatment For Alcohol Addiction
Several therapeutic approaches can be used to treat alcoholism or alcohol use disorders (AUD). Comprehensive recovery efforts commonly include some combination of behavioral therapy, medications, and mutual-support group participation, for example.1 While there is no one-size-fits-all solution to recovery, as a part of a comprehensive treatment plan, a combination of these three approaches has helped many individuals maintain sobriety long-term.
Various types of behavioral therapy for alcohol addiction help people to modify their problematic drinking behaviors. Some may do so by providing rewarding incentives for remaining sober while others help people to identify maladaptive patterns of thought and alter their behaviors in response to them.2 What’s learned as a result of different behavioral therapies can also be beneficial in giving patients the tools necessary to combat stressful situations that may trigger cravings and/or use in the future.2
Below are effective behavioral therapies used to address substance abuse:
- Cognitive behavioral therapy (CBT) helps patients identify, avoid, and cope with situations that can lead to substance use.3
- Contingency management focuses on reinforcing positive behavioral changes through rewards and special privileges such as attending counseling sessions or maintaining sobriety (measured by negative urine tests, etc.).4
- Motivational enhancement helps individuals in resolving their uncertainty about treatment and stopping alcohol use.5
- Twelve-step facilitation (TSF) is an active engagement strategy that promotes patient participation in 12-step meetings and other recovery programs.6
- Family behavior therapy addresses potential household influences on negative alcohol use patterns in order to improve overall family functioning and the home environment.7
Along with behavioral therapies, medications may be used to treat alcoholism by helping people to decrease their drinking behavior to better maintain sobriety. The three FDA-approved medications to treat alcohol use disorder (AUD) are disulfiram, naltrexone, and acamprosate. Although not everyone will respond to these medications, for some individuals, they can be an important tool in managing their alcohol dependence.1
Disulfiram inhibits an enzyme which metabolizes alcohol.8 When taken regularly, disulfiram discourages drinking by giving rise to unpleasant effects in individuals when they consume even small amounts of alcohol.8 When used as prescribed, its effects may begin to be felt within 10 minutes after consuming alcohol.8 In turn, an association between drinking and the unpleasant symptoms is made, which can further discourage additional drinking.
Naltrexone was approved in 1994 by the FDA as treatment for alcohol dependence.9,10 As an opioid receptor antagonist drug, naltrexone was originally used in treating individuals with opioid use disorders. Though the way naltrexone works to decrease drinking behavior isn’t entirely understood, those who’ve been treated with the drug suggest that its effects include reducing the desire to drink, therefore helping them remain abstinent.11
Used alongside social support and counseling, acamprosate appears to work by restoring a balance in the central nervous system between the glutamate and gamma-aminobutyric acid (GABA) systems, excitatory and inhibitory neurotransmitters, respectively.12,13 However, it doesn’t prevent symptoms of alcohol withdrawal and may not be effective in those who abuse other substances, haven’t quit drinking, or drink in large amounts.12 Though effective, acamprosate doesn’t appear to be more successful than disulfiram or naltrexone in reducing drinking behavior.12
Mutual Support Groups
Following successful completion of a rehabilitation program, an aftercare plan may be established in order for those in recovery to benefit from ongoing assistance and continued support in maintaining long-term sobriety. Because addiction is a lifelong struggle for so many people, aftercare is an important part of the recovery process that can aid in helping individuals avoid relapse when faced with challenges and temptations in their everyday lives.
Aftercare efforts vary but may involve sober-living residences, continued work with a therapist and attendance of mutual support groups or 12-step programs such as:
- Alcoholics Anonymous (AA).
- Narcotics Anonymous (NA).
- SMART Recovery.
- Al-Anon and Nar-Anon.
Combined with treatment led by health professionals, mutual support groups provide additional accountability and peer-based encouragement for people seeking to quit drinking and stay sober.1 As many mutual support groups are anonymous, it has been historically difficult for researchers to gather empirical data regarding their effects on those in recovery.1,14 However, some studies have shown higher rates of abstinence in those participating in mutual support groups than in those who do not.14
Get Help for Alcoholism
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. National Institute on Alcohol Abuse and Alcoholism. (2014). Treatment for Alcohol Problems: Finding and Getting Help.
. National Institute on Drug Abuse. (2018). Behavioral Therapies. Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).
. National Institute on Drug Abuse. (2018). Cognitive-Behavioral Therapy (Alcohol, Marijuana, Cocaine, Methamphetamine, Nicotine). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Ed.).
. National Institute on Drug Abuse. (2018). Contingency Management Interventions/Motivational Incentives (Alcohol, Stimulants, Opioids, Marijuana, Nicotine). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Ed.).
. National Institute on Drug Abuse. (2018). Motivational Enhancement Therapy (Alcohol, Marijuana, Nicotine). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Ed.).
. National Institute on Drug Abuse. (2018). 12-Step Facilitation Therapy (Alcohol, Stimulants, Opiates). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Ed.).
. National Institute on Drug Abuse. (2018). Family Behavior Therapy. Principles of Drug Addiction Treatment: A Research-Based Guide (Third Ed.).
. MedlinePlus. (2017). Disulfiram.
. National Institute on Alcohol Abuse and Alcoholism. (1995). Answers to Frequently Asked Medication Questions. Guidelines for the Use of Naltrexone in the Treatment of Alcoholism; 5(1).
. MedlinePlus. (2017). Naltrexone.
. Substance Abuse and Mental Health Services Administration. (2009). Incorporating Alcohol Pharmacotherapies into Medical Practice. Treatment Improvement Protocol (TIP) Series, No. 49(4), 27-35.
. U.S. National Library of Medicine. (2012). Acamprosate For Treatment of Alcohol Dependence: Mechanisms, Efficacy, and Clinical Utility. Therapeutics and clinical risk management; 8, 45-53.
. MedlinePlus. (2016). Acamprosate.
. Tracy, K., & Wallace, S. P. (2016). Benefits of peer support groups in the treatment of addiction. Substance abuse and rehabilitation, 7, 143–154.