An alcohol use disorder (AUD) is a chronic yet treatable medical disease which can be effectively managed through ongoing treatment and continued recovery efforts.1 Though there is no single “cure” for AUD, individuals can participate in several different therapeutic interventions, such as inpatient or outpatient rehabilitation, medications, individual behavioral therapy, and support groups to prevent relapse in the future and live a self-directed, well-rounded and healthy life.2

What is Alcoholism?

Alcoholism, or AUD, occurs when a person can no longer control their use of alcohol, compulsively abuses it despite negative social, occupational, or health ramifications, and/or experiences emotional distress when they are not drinking.3

According to The Diagnostic Statistical Manual of Mental Disorders (DSM-5), individuals may be diagnosed with an AUD if they meet at least two of 11 outlined criteria within the past 12 months. Some of these include:4,5

  • Cravings for alcohol.
  • Continued use of alcohol even it is causing issues with friends or family or problems with work or school.
  • Persistent trouble with cutting down or controlling alcohol use.
  • Requiring more alcohol over time to achieve the same level of desired intoxication (i.e., developing tolerance).
  • Spending an excessive amount of time obtaining alcohol, trying to obtain alcohol, or recovering from drinking.

When it comes to understanding your own drinking habits, it can be difficult to know how much is too much, or whether your consumption puts you at risk for an AUD. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as a pattern of alcohol consumption that brings a person’s blood alcohol concentration (BAC) to 0.08% or higher.6 Typically, for adults, this would be around 5 or more drinks for males or 4 or more drinks for females in about two hours.6

Heavy alcohol use is considered more than 3 drinks for women and more than 4 drinks on any day for men.6 Drinking at these levels may put you at a higher risk of developing an alcohol use disorder; however, any amount of alcohol can have negative both short- and long-term negative effects.

Are Alcohol Dependence and Alcohol Use Disorder the Same?

Although sometimes used interchangeably, the phenomenon of alcohol dependence and the diagnosis of alcohol use disorder are not the same thing. Although physiological dependence is a common feature of addiction, it does not constitute addiction on its own.

 With regular drinking, the brain will adapt to persistently elevated blood alcohol levels. Afterwards, should an individual reduce their alcohol consumption or quit drinking altogether, they are likely to experience withdrawal symptoms that can range in severity as the brain attempts to balance itself chemically. This physical manifestation of heavy alcohol use is called dependence

If a person experiences withdrawal symptoms, they likely are dependent upon the substance, and such dependence—when present with other characteristic signs, symptoms, and behavioral changes—could be indicative of an alcohol use disorder.8

What is Alcohol Withdrawal?

Someone dependent upon alcohol may experience withdrawal symptoms when reducing or ceasing use. The more regularly a person drinks the more likely someone is going to experience alcohol withdrawal symptoms.9

Symptoms of Alcohol Withdrawal

Alcohol withdrawal symptoms include:4,8

  • Headache.
  • Anxiety.
  • Agitation.
  • Auditory and visual hallucinations.
  • Insomnia.
  • Nausea and vomiting.
  • Rapid heartbeat and palpitations.
  • Sweating.
  • Tremors.
  • Seizures.

Symptoms of withdrawal can range from minor to severe and/or life-threatening when quitting use.7 Because of this, a supervised medical detox can help individuals avoid unnecessary discomfort or complications.7

Treatment for Alcoholism

There are many effective forms of treatment for those suffering from alcohol addiction. Treatment may be highly intensive to minimally intensive, including:10

  • Medical detox.
  • Residential/inpatient.
  • Partial hospitalization programs (PHP).
  • Intensive outpatient programs (IOP).
  • Standard outpatient.

Although alcohol use disorder (AUD) is a chronic medical disease, it can be effectively managed—even at its most severe—with professional treatment and ongoing recovery efforts.11 Research has shown that about 1/3 of people who have completed alcohol addiction treatment have fewer alcohol-related problems and no further symptoms 1 year later.11

There is no one-size-fits-all solution for AUDs and treatment may be somewhat different for every person. The variety of treatment approaches allow treatment providers flexibility in meeting individuals at the place they are at on their path to recovery.

Regardless of the level of alcohol abuse, seeking the guidance of medical and mental health professionals is crucial in informing the course of treatment that will ultimately be selected.

Levels of Care

The level of care an individual may need is determined by several factors, including current alcohol use and corresponding level of physical alcohol dependence, as well as any co-occurring medical and/or mental health conditions, any additional substance use, and any previous attempts to quit or detox.

Medical Detox

The initial step on most people’s path to recovery is a period of detoxification or withdrawal management. Medical detox focuses on alleviating alcohol withdrawal symptoms resulting from chronic abuse. Though each detox facility includes its own set of specialized plans and protocols, a medical detox plan may include medications, nutrition, stress management, emotional support, and other complementary therapeutic approaches.12

Although medical detox is often a necessary part of treatment for those suffering from alcohol dependence and AUD, it alone is typically not enough to keep someone from relapsing on alcohol or effectively change their long-term habit of drug abuse in any significant way. Once someone is finished detoxing from alcohol, their treatment provider will strongly recommend an inpatient or outpatient program that will include behavioral health treatment focusing on sobriety and long-term maintenance of AUD.

Residential Inpatient Treatment

Residential and/or inpatient treatment programs typically provide 24/7 supervision to patients suffering from addiction.12 Staff members closely monitor patients for signs of progress, remission, and relapse and adjust their treatment plans according to their progress. Treatment may include group and individual therapy, medication management, substance abuse education, relapse prevention techniques and case management services.

Inpatient programs often consist of different phases of treatment and can vary in duration, offering 30-, 60- or 90-day programs. Patients in residential treatment may transition to lower levels of care once they complete an inpatient program.

Partial Hospitalization Program (PHP)

Partial hospitalization programs (PHP) is an intensive form of outpatient treatment where a person in recovery attends treatment for around 4 to 8 hours a day but can live at home or in a sober living environment. PHPs typically require at least 20 hours of programming at their care facility per week.

Eligibility for PHP treatment may be based on a physician’s assessment of a person’s needed level of care. This type of care may be most appropriate for those with relatively stable living environments and strong support networks.

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Intensive Outpatient Program

Intensive outpatient programs (IOP) require less time weekly in therapies than PHPs and still allow patients to continue with their normal lives off-site. IOPs are designed to provide coping strategies, help with relapse management, and establish support mechanisms.13

IOPs require that a person’s home environment offers a safe support system and is alcohol/drug-free.13 They are also sometimes utilized once inpatient programs have been completed (i.e., step-down treatment) to ease the transition back to an individual’s everyday life.

Standard Outpatient Treatment

Operating in a variety of settings—such as hospital clinics, counselor’s offices, community mental health clinics, or inpatient/residential rehab facilities—outpatient programs are most suitable for those with mild forms of AUD.12 Patients are able to live at home while in treatment in order to fulfill family or work obligations. Those participating in this level of care would need to have a drug/alcohol-free home environment.

Attendance requirements vary by program and treatment times may be limited to a few hours throughout the week in the evenings and on weekends. Some offer daily sessions and others only meet 1 to 3 times per week.

How Common is Relapse After Rehab?

Like other chronic medical diseases, the nature of addiction means that relapsing is not only possible but also likely.14 This is similar to other chronic medical illnesses with both physiological and behavioral components such as diabetes, hypertension, and asthma.14

When a person finishes treatment, they may continue to participate in aftercare programs to help maintain their sobriety. Aftercare efforts, such as attendance of 12-step meetings (e.g., Alcoholics Anonymous and Narcotics Anonymous) or other mutual-support groups can be of significant help in keeping individuals on their recovery trajectory.15

Even if you’ve followed your medical treatment plan completely, relapse may still occur—but that doesn’t mean failure. It does mean you need to speak with your treatment provider, who will provide a recommendation on how to best move forward, whether that is to resume rehab, modify your aftercare plan, or try another treatment.8,15

What Types of Aftercare Programs/Support is Available?

Aftercare programs and continuing care options exist to support people in recovery after they leave treatment. Mutual help groups are helpful to a broad array of people and effective and efficient extensions of professional medical treatment.16

Many facilities also offer continuing care support to help their patients plan for how they will maintain their recovery after they leave treatment. Many of these resources are low-cost or completely free and only require earnest participation.

These include sober living houses and 12-step programs or mutual help groups:

With a goal of lifelong sobriety, aftercare programs can help prevent relapse after treatment and can further support the progress made during rehabilitation.