Contributor

<h2>What is Alcohol Detox?</h2>
According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), AUD involves a pattern of alcohol use that causes significant impairment and distress.3 Alcohol dependence (and the associated withdrawal syndrome) is a key feature of many cases of AUD and is one of the most frequently encountered problems in medical settings, second only to depression.1 

A period of supervised alcohol detox is often the first part of treatment or rehabilitation for AUD. It involves a set of interventions, which often includes medication, that is designed to help you stop drinking and safely withdraw from alcohol. In addition to keeping you stable throughout withdrawal; detox programs help prepare you for additional treatment for AUD.1 

The course of any given individual’s alcohol withdrawal symptoms is sometimes unpredictable. Additionally, it is not always easy to identify those at risk for an eventually severe or complicated withdrawal. The Substance Abuse and Mental Health Services Administration (SAMHSA) indicates that, in addition to these reasons, given the ever-present possibility of an adverse withdrawal experience, hospitalization (or some form of 24­ hour medical care) is commonly the preferred setting for acute alcohol detoxification.2 
<h2>Alcohol Detox Process</h2>
Alcohol detox may be the first step in the recovery process before you enter an ongoing treatment program. Though alcohol detox can occur on an <a href="https://alcoholrehab.com/alcohol-treatment/types-of-treatment/inpatient/">inpatient</a> or <a href="https://alcoholrehab.com/alcohol-treatment/types-of-treatment/outpatient/">outpatient</a> basis, an inpatient medical setting may be advisable for people who are heavy alcohol users, or those with a history of significant alcohol withdrawal symptoms, a history of withdrawal seizures or delirium tremens, or co-occurring serious medical or psychiatric illnesses.1 

In many detox programs, you can expect to experience three important elements of care, which include:2 
<ul>
 	<li>Evaluation. You receive a comprehensive evaluation to assess your overall health and the severity of the problem to determine the appropriate detox setting for your needs.</li>
 	<li>Stabilization. This is the active detox phase where you undergo withdrawal with medications, medical supervision, and support.</li>
 	<li>Fostering entry to treatment. You receive assistance with entering the appropriate substance abuse treatment setting once detox is complete.</li>
</ul>
<h2>Alcohol Detox and Withdrawal</h2>
People may experience different symptoms during the detox phase. In some cases, the <a href="https://alcoholrehab.com/alcoholism/withdrawal/">symptoms of alcohol withdrawal</a> will be relatively mild, while others may experience severe and possibly life-threatening withdrawal complications.1 

The acute alcohol withdrawal syndrome may include:2,6 
<ul>
 	<li>Autonomic hyperactivity (sweating, elevated heart rate, increased blood pressure).</li>
 	<li>Tremors</li>
 	<li>Anxiety</li>
 	<li>Headaches</li>
 	<li>Insomnia</li>
 	<li>Gastrointestinal upset (nausea and vomiting).</li>
 	<li>Appetite loss.</li>
 	<li>Impaired concentration.</li>
 	<li>Poor judgment and poor memory</li>
 	<li>Increased sensitivity to light or noise.</li>
 	<li>Delusions (meaning you believe something that isn’t true).</li>
 	<li>Hallucinations (meaning you see, feel, or hear things that aren’t there).</li>
 	<li>Grand mal seizures (the kind most people think of when they think of seizures).</li>
 	<li><a href="https://americanaddictioncenters.org/alcoholism-treatment/delirium-tremens-symptoms-and-treatment">Delirium tremens (DTs),</a> a severe and potentially deadly form of withdrawal that may involve a cluster of symptoms including hallucinations, severe disorientation, and agitation.</li>
</ul>
In some cases, people may also develop a more protracted withdrawal syndrome, which involves persistent symptoms that last beyond the more typical duration for alcohol withdrawal.7 These protracted symptoms can include tremor, insomnia, anxiety, depression, and lack of energy, as well as increased breathing rate, body temperature, blood pressure, and pulse.7 In some cases, these symptoms can last up to a year or more. Though not everyone experiences them, they remain a particular concern in those who do, since they can promote relapse as an attempt to mitigate their troublesome nature long after drinking first stops.7
<h2>How Long Does it Take to Detox From Alcohol?</h2>
An exact timeline for alcohol withdrawal symptom onset, severity, and symptom resolution can vary from person to person. In many cases, physically uncomfortable symptoms such as insomnia, tremors, gastrointestinal upset, or nausea start between 6-12 hours after your last drink.1 Hallucination can start 12-24 hours after your last drink; seizures can start 24-48 hours after the last drink; more rarely, DTs can start anywhere from 1-4 days after the last drink, should they develop.1, 7 

It is important to note, people can progress through symptoms at different rates.2 Generally speaking, symptoms start to subside after a few days, but DTs can last up to 5 days.7 ,8 

Undergoing detox with medical supervision can not only help you remain safe and comfortable, but it can also provide immediate medical care if you develop serious and potentially dangerous complications like seizures or DTs.

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<h2>What Happens During Alcohol Detox?</h2>
People often want to know <a href="https://americanaddictioncenters.org/withdrawal-timelines-treatments/alcohol">how long does it take to detox</a>, but this timeline is different for everyone.2 Your age, health, nutritional factors, and any co­occurring medical or psychiatric conditions can affect the character and severity with which you experience withdrawal.2 For some people, mild to moderate symptoms might resolve almost right away, while other symptoms, such as seizures, can remain a risk for longer periods of time.2 Below is a general timeline of what you can expect during the detox process.
<h3>Day 1 of Alcohol Detox</h3>
Between 6-12 hours after your last drink, you may experience mild symptoms such as insomnia, tremors, mild anxiety, gastrointestinal upset, headache, sweating, or loss of appetite. These symptoms tend to resolve in a few days.7  Between 12-24 hours after your last drink, you can have a risk of developing hallucinations. Hallucinations usually resolve in 48 hours.7,2
<h3>Day 2 of Alcohol Detox</h3>
During the second day of detox, you may experience continued symptoms from day 1 that could possibly worsen. You may have an increased risk of developing hallucinations as well as additional withdrawal symptoms such as seizures or DTs.1,7  
<h3>Day 3-7 of Alcohol Detox</h3>
Over the course of the week, your symptoms may fluctuate. Certain withdrawal symptoms may slowly improve, while others may resolve quickly.2 The risk for DTs can be higher starting at 48 hours after your last drink, and seizures can also occur and recur, which is why it’s important to receive medical supervision during detox.1 
<h3>After 1 Week of Alcohol Detox</h3>
Many of your symptoms may begin to taper off by this point.6 However, some people may experience more persistent symptoms as part of a more protracted withdrawal syndrome.7 
<h2>Alcohol Detox Medications</h2>
During the course of acute alcohol withdrawal, many troublesome symptoms can be medically managed.1 

Some of the medications that are currently used to treat alcohol withdrawal include:1, 6 
<ul>
 	<li>Benzodiazepines, such as diazepam or chlordiazepoxide. Benzodiazepines are often used in treatment of alcohol withdrawal and can help to minimize symptoms and decrease the likelihood for and severity of withdrawal complications. For example, they are helpful for decreasing seizure and delirium risks.</li>
 	<li>Anticonvulsants like carbamazepine. These can help minimize withdrawal symptoms and reduce the potential for seizures.</li>
 	<li>Adrenergic medications like clonidine. These can be used as adjunct therapy to manage autonomic withdrawal symptoms like increased blood pressure and rapid heart rate, but do not prevent seizures or delirium.</li>
</ul>
Beyond the acute withdrawal period, additional FDA-approved medications may be initiated to help people prevent relapse and maintain abstinence during treatment for alcohol use disorder.2 These drugs are not considered detox medications, as they are typically not started until a period of abstinence from active drinking has first been achieved.5 Medications that may be used in the longer-term to manage AUD include:2, 5, 9 
<ul>
 	<li>Naltrexone. By blocking some of the rewards associated with alcohol use, <a href="https://alcoholrehab.com/alcohol-treatment/types-of-treatment/naltrexone-assisted-recovery/">naltrexone</a> can help people maintain abstinence from drinking.</li>
 	<li>Acamprosate. Through a mechanism thought to involve a balancing of certain brain chemistry previously disrupted by chronic alcohol use, <a href="https://alcoholrehab.com/drug-addiction/treatment/gaba-agonist-acamprosate/">acamprosate</a> can help prevent relapse and reduce urges to drink.</li>
 	<li>Disulfiram. Although <a href="https://alcoholrehab.com/alcohol-treatment/types-of-treatment/disulfiram-to-treat-alcoholism/">disulfiram</a> doesn’t reduce cravings, when used daily, it discourages drinking by resulting in unpleasant symptoms when you ingest alcohol.</li>
</ul>
<h2>What Happens After Alcohol Detox?</h2>
Alcohol detox is often the first step on the path to recovery .10 <a href="https://alcoholrehab.com/alcohol-recovery/">Recovery</a> is an ongoing, lifelong process that requires commitment and dedication. This is why it’s important to have a treatment plan in place once detox is complete. Treatment can address the underlying issues that may have contributed to the addiction, prevent relapse, and help you regain control of your life.

Depending on your unique needs, you may enter inpatient or outpatient treatment. Inpatient treatment means you live onsite and receive round-the-clock care. It can be helpful for anyone who needs highly supportive care, people with more severe addictions or co-occurring mental health disorders, or those without supportive home environments.10 

Outpatient treatment means you live at home but travel to a rehab facility anywhere from one to several times per week.10 Some people first start out in inpatient treatment and transition to outpatient care as their recovery journey progresses.

If you’re ready to take back control of your life, American Addiction Centers is ready to help you find a treatment option that’s suited to your needs. Call our free, confidential, 24/7 helpline at 1-888-966-8152 to find out more about your rehabilitation options.
<h3>Sources</h3>
<ol>
 	<li>Sachdeva, A., Choudhary, M., &amp; Chandra, M. (2015). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606320/">Alcohol withdrawal syndrome: benzodiazepines and beyond</a>. Journal of clinical and diagnostic research, 9(9), VE01–VE07.</li>
 	<li>Center for Substance Abuse Treatment. (2015). <a href="https://store.samhsa.gov/sites/default/files/d7/priv/sma15-4131.pdf">Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131</a>. Rockville, MD: Center for Substance Abuse Treatment.</li>
 	<li>American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.</li>
 	<li>National Institute on Alcohol Abuse and Alcoholism. (2021, April). <a href="https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder">Understanding alcohol use disorder</a>.</li>
 	<li>Substance Abuse and Mental Health Services Administration and National Institute on Alcohol Abuse and Alcoholism. (2015). <a href="https://store.samhsa.gov/sites/default/files/d7/priv/sma15-4907.pdf">Medication for the treatment of alcohol use disorder: A brief guide. HHS Publication No. (SMA) 15-4907</a>. Rockville, MD: Substance Abuse and Mental Health Services Administration.</li>
 	<li>Bayard, M., McIntyre, J., Hill, K. R., &amp; Woodside, J., Jr (2004). <a href="https://www.aafp.org/afp/2004/0315/p1443.html">Alcohol withdrawal syndrome</a>. American family physician, 69(6), 1443–1450.</li>
 	<li>Trevisan, L. A., Boutros, N., Petrakis, I. L., &amp; Krystal, J. H. (1998). <a href="https://pubs.niaaa.nih.gov/publications/arh22-1/61-66.pdf">Complications of alcohol withdrawal: pathophysiological insights</a>. Alcohol health and research world, 22(1), 61–66.</li>
 	<li>Rahman A, Paul M. (2021, August 27). <a href="https://www.ncbi.nlm.nih.gov/books/NBK482134/">Delirium Tremens</a>. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing.</li>
 	<li>Winslow, B. T., Onysko, M., &amp; Hebert, M. (2016). <a href="https://www.aafp.org/afp/2016/0315/p457.html">Medications for alcohol use disorder</a>. American family physician, 93(6), 457–465.</li>
 	<li>Substance Abuse and Mental Health Services Administration. (2019, October). <a href="https://findtreatment.gov/content/treatment-options/types-of-treatment/">Treatment options: Types of treatment</a>.</li>
</ol>

Alcohol Detox

Secular Alternatives to Alcoholics Anonymous (AA)

<h2>How Much Alcohol Is Recommended?</h2>
There is not a universally recognized “safe level” of alcohol consumption. Even moderate levels of drinking may pose a health risk, according to some studies. 2

However, the 2020-2025 Dietary Guidelines for Americans recommend that adults of legal drinking age can choose not to drink, or to drink at moderate levels, which is defined as limiting intake to 2 drinks or less in a day for men or 1 drink or less in a day for women, on days when alcohol is consumed.4

It is important to note, the Centers for Disease Control (CDC) and National Institute on Alcohol Abuse and Alcoholism both define a standard drink contains around 0.6 ounces of pure alcohol, which roughly translates to 12 ounces of 5% ABV (alcohol by volume) beer, 5 ounces of 12% ABV wine, or 1.5 ounces of 40% ABV distilled spirits (e.g., gin, vodka, rum, tequila, whiskey).2 ,3

Some people are advised to avoid alcohol altogether, including:2 
<ul>
 	<li>Women who are pregnant or may become pregnant</li>
 	<li>If you are under the legal age for drinking.</li>
 	<li>People with certain medical conditions.</li>
 	<li>People who take medication that may interact with alcohol.</li>
 	<li>If you are in recovery from alcohol use disorder (AUD) or can’t control the amount you drink.</li>
 	<li>If you plan to drive, operate machinery, or participate in any activity that requires alertness and coordination.</li>
</ul>
Research indicates that excessive drinking can significantly increase the risk of short-term harm, such as injuries, as well as the risk of long-term health problems. 2,18 <a href="https://alcoholrehab.com/alcoholism/signs-of-alcoholism/binge-drinking/">Binge drinking</a> can increase an individual’s risk of developing an alcohol use disorder.18
<ul>
 	<li>Binge drinking is a pattern of drinking alcohol that brings a person’s blood alcohol concentration (BAC) to 0.08 percent or higher. This pattern corresponds to an average adult consuming 5 or more drinks (male), or 4 or more drinks (female), in about 2 hours.</li>
 	<li>Heavy drinking is defined as consuming 15 or more drinks a week (male) or 8 or more drinks a week (female).</li>

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</ul>
<h2>Effects of Alcohol on the Cardiovascular System</h2>
Heavy daily alcohol consumption and binge drinking increase the risk of developing cardiovascular disease.

Some of the cardiovascular conditions associated with high levels of alcohol use include:
<ul>
 	<li>Increased blood pressure, or hypertension.</li>
 	<li>Alcoholic cardiomyopathy (weakened heart muscle).</li>
 	<li>Atrial fibrillation.</li>
</ul>
<h3>Increased Blood Pressure and Hypertension</h3>
Numerous studies have confirmed the association of drinking alcohol at higher than moderate levels with an increase in blood pressure. Binge drinking and chronic, heavy alcohol use is associated with high blood pressure or hypertension.

Consistently elevated blood pressure can cause your heart to have to work harder to pump blood, which can lead to increased stress on your heart.14 Over time, this can lead to a risk of serious cardiac problems such as stroke, heart attacks, heart failure, and coronary artery disease.15 
<h3>Weakened Heart Muscle</h3>
Long-term heavy alcohol consumption can induce cardiomyopathy, a weakening and thinning of the muscles of the heart. When your heart muscle is weakened, it can’t pump blood to your organs efficiently. This can lead to shortness of breath, fatigue, weakness, muscular atrophy, swelling in the hands and feet, and can eventually lead to heart failure. 1,6,7,19

Continuing to drink, particularly heavily, can lead to worsening symptoms, arrhythmias, clots in the cerebral arteries, and ultimately heart failure. Survival is directly associated with the amount of alcohol use and duration of use, and data suggests that abstaining from drinking can result in improved outcomes and reduced inpatient hospital admissions.
<h3>Atrial Fibrillation</h3>
Atrial fibrillation is a form of arrhythmia, which is an irregular, and often rapid or quivering heart rhythm.8 Binge drinking episodes are associated with a higher risk for more severe atrial fibrillation.10 Atrial fibrillation resulting from alcohol use typically resolves following abstinence, with additional episodes of heavy or binge drinking associated with more severe cardiovascular consequences, such as stroke or heart failure.18
<h2>Alcohol and Heart Disease</h2>
The conditions mentioned above can increase your risk of severe cardiovascular complications, including heart disease. While individual factors can play a role in cardiac conditions, binge drinking, and heavy alcohol use can significantly increase the risk of developing heart problems such as:
<ul>
 	<li>Heart attack, or myocardial infarction. A heart attack can occur when part of the heart muscle isn’t getting enough blood. The more time that passes without blood flow to the heart, the greater the damage to the heart muscle. 1,6</li>
 	<li>Stroke. A stroke can happen when blood supply to part of the brain is interrupted, which prevents the brain tissue from getting oxygen. Heavy drinking increases the risk for both hemorrhagic and ischemic strokes. 1,15</li>
 	<li>Heart failure. Heavy alcohol use can lead to cardiomyopathy and atrial fibrillation, which can, over time, lead to heart failure.1,6</li>
</ul>
Studies suggest that continuing to drink when cardiovascular symptoms appear, particularly heavily, can increase the likelihood of more severe symptoms and death.1,19 Conversely, when faced with cardiovascular conditions arising from alcohol, abstinence can provide numerous benefits to your heart, including lowering high blood pressure, resolving atrial fibrillation, and improving cardiac function and prognosis.7  It is recommended to discuss your health situation with your primary care physician, who can conduct an evaluation to help determine the appropriate level of care and treatment for your specific needs.16
<h2>Finding Alcoholism Treatment</h2>
Choosing to <a href="https://alcoholrehab.com/alcohol-treatment/">start treatment for an alcohol use disorder</a> can be an important step to improve your overall health and wellbeing. This can be especially important if you or someone you care about are struggling with alcohol misuse and have pre-existing or alcohol-associated heart conditions. As previously mentioned, chronic alcohol use can negatively impact your heart, increase your risk for many heart conditions, and potentially lead to death.7 

Treatment can look different for everyone but often includes a combination of <a href="https://alcoholrehab.com/alcohol-treatment/types-of-treatment/alcohol-detox/">detox</a>, <a href="https://alcoholrehab.com/alcohol-treatment/types-of-treatment/inpatient/">inpatient</a> or <a href="https://alcoholrehab.com/alcohol-treatment/types-of-treatment/outpatient/">outpatient</a> rehab, and continued care or <a href="https://alcoholrehab.com/alcohol-recovery/aftercare/">aftercare</a>. Most people benefit from some form of treatment.17 More than 30%  of people who receive treatment for alcohol use disorder report no further symptoms one year later, while other people can reduce their alcohol use and report fewer alcohol-related problems, according to the NIAAA.16
<h3>Sources</h3>
<ol>
 	<li>Piano, M. R. (2017). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513687/">Alcohol's effects on the cardiovascular system</a>. Alcohol research: Current reviews, 38(2), 219–241.</li>
 	<li>Centers for Disease Control and Prevention. (2020, December 29). <a href="https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm">Dietary guidelines for alcohol</a>.</li>
 	<li>National Institute on Alcohol Abuse and Alcoholism. (n.d.). <a href="https://pubs.niaaa.nih.gov/publications/practitioner/PocketGuide/pocket_guide2.htm">What is a standard drink?</a></li>
 	<li>Spaak, J., Tomlinson, G., McGowan, C. L., Soleas, G. J., Morris, B. L., Picton, P…&amp; Floras, J. S. (2010). <a href="https://journals.physiology.org/doi/full/10.1152/ajpheart.00700.2009">Dose-related effects of red wine and alcohol on heart rate variability</a>. American journal of physiology. Heart and circulatory physiology, 298(6), H2226–H2231.</li>
 	<li>Brunner, S., Drobesch, C., Herbel, R., &amp; Sinner, M. F. (2021). <a href="https://academic.oup.com/europace/article/20/suppl_1/i16/4929951">Effects of acute alcohol consumption on cardiac excitation, conduction, and repolarization: results from the Munich Beer Related Electrocardiogram Workup Study (MunichBREW)</a>. Clinical research in cardiology, 110(6), 916–918.</li>
 	<li>Zakhari, S. (1997). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826791/">Alcohol and the cardiovascular system: molecular mechanisms for beneficial and harmful action</a>. Alcohol health and research world, 21(1), 21–29.</li>
 	<li>Maisch B. (2016). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013142/">Alcoholic cardiomyopathy: The result of dosage and individual predisposition</a>. Herz, 41(6), 484–493.</li>
 	<li>Centers for Disease Control and Prevention. (2021, September 27). <a href="https://www.cdc.gov/heartdisease/atrial_fibrillation.htm">Atrial fibrillation</a>.</li>
 	<li>Chiva-Blanch, G., &amp; Badimon, L. (2019). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7020057/">Benefits and risks of moderate alcohol consumption on cardiovascular disease: Current findings and controversies</a>. Nutrients, 12(1), 108.</li>
 	<li>American Heart Association. (2016, September 30). <a href="https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/tachycardia--fast-heart-rate">Tachycardia: Fast heart rate</a>.</li>
 	<li>Gopinathannair, R., &amp; Olshansky, B. (2015). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4447058/">Management of tachycardia</a>. F1000prime reports, 7, 60.</li>
 	<li>American Heart Association. (2020, October 14). <a href="https://www.heart.org/en/health-topics/cardiomyopathy/what-is-cardiomyopathy-in-adults">What is cardiomyopathy in adults?</a></li>
 	<li>American Heart Association. (2016, October 31). <a href="https://www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure/how-high-blood-pressure-can-lead-to-heart-failure">How high blood pressure can lead to heart failure</a>.</li>
 	<li>Husain, K., Ansari, R. A., &amp; Ferder, L. (2014). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4038773/">Alcohol-induced hypertension: Mechanism and prevention</a>. World journal of cardiology, 6(5), 245–252.</li>
 	<li>National Blood Clot Alliance. (n.d.). <a href="https://www.stoptheclot.org/about-clots/afib-2/">Atrial fibrillation (afib) and clot-provoked stroke</a>.</li>
 	<li>National Institute on Alcohol Abuse and Alcoholism. (2021, August). <a href="https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help">Treatment for alcohol problems: Finding and getting help</a>.</li>
 	<li>Chikritzhs T, Fillmore K, Stockwell T. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19594799">A healthy dose of skepticism: four good reasonsto think again about protective effects of alcohol on coronary heart disease</a>. Drug Alcohol Rev2009;28:441–4.</li>
 	<li>National Institute on Alcohol Abuse and Alcoholism. (May 2021). <a href="https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/binge-drinking">What is Binge Drinking?</a></li>
 	<li>Shaaban, A., Gangwani, M., Pendela, V. and Vindhyal, M., 2021. <a href="https://www.ncbi.nlm.nih.gov/books/NBK513322/">Alcoholic Cardiomyopathy</a>.</li>
</ol>

Alcohol and the Heart: Effects and Treatments

<h2>What are Free Rehab Programs?</h2>
Free rehab programs are designed to provide treatment and rehab services to people who are unable to otherwise afford it. In most cases, these services are funded by taxpayers, federal and/or state programs, private donations, and grants.2 

Eligibility requirements and limitations may vary by a wide range of factors, including the type of grant, allocation of funding, and who administers it. There are numerous state funding sources and different states have different requirements.2 

Additionally, there can be limits based on demographic considerations that are stipulated in grants, such as programs that receive funding specifically for pregnant women, or the requirements based on the types of treatment and services offered (i.e., whether a person is eligible for childcare or residential care/housing due to homelessness, etc.).2

Different options are available to help cover the costs of inpatient and outpatient treatment. This can include:1, 3,4,5
<ul>
 	<li>Medicare. This is an option for people aged 65 and older, as well as people who are eligible to receive it due to disability. Generally speaking, Medicare Parts A and B cover inpatient and outpatient treatment, brief interventions, and screening, and part D typically covers medication.</li>
 	<li>Medicaid. Individuals with low income may qualify for medicaid. It covers substance abuse treatment services at a level equivalent to regular health care services. You can check the <a href="https://www.hhs.gov/answers/medicare-and-medicaid/who-is-eligible-for-medicaid/index.html">Medicaid eligibility website</a> to see if you qualify.</li>
 	<li>Substance Abuse and Mental Health Services (SAMHSA) block grants. These are different types of grants provided to states to help cover the cost of rehab for people in need, such as those without insurance or those whose coverage has been terminated.</li>
 	<li>State and locally funded addiction treatment programs. These programs receive different federal and state grants to help people who cannot afford to pay for the costs of treatment.</li>
 	<li>The Affordable Care Act (ACA). This stipulates that insurance providers must offer an equivalent level of coverage for substance abuse and mental health services as they do for medical and surgical care. The majority of health plans and insurers need to offer services like prevention, screening, brief interventions, and other forms of treatment for substance use disorders.</li>
 	<li>S. Department of Veterans Affairs (VA). The VA's healthcare program covers a wide range of rehab services for veterans enrolled with the VA's health care or who meet other eligibility requirements.</li>
</ul>
<h2>How do I Find Free Rehabs for Drugs and Alcohol?</h2>
If you or someone you care about are struggling with addiction, you can use SAMSHA’s online <a href="https://findtreatment.samhsa.gov/">Behavioral Health Treatment Services locator</a>, where you can search for rehab facilities by location and then see additional information, such as type of care, setting, payment, insurance, and funding accepted, by clicking on the name of the specific facility.

You can also use SAMHSA’s <a href="https://www.findtreatment.gov/">FindTreatment.gov</a> website and enter your ZIP code to see a list of facilities in your area. It also offers different information, such as types of programs, services offered, and payment options, but by clicking the section on the left that says “payment options,” you can narrow down your search to facilities that accept insurance or Medicaid, offer free or no-cost care, offer sliding scales, and more.

When applying for financial assistance for free drug rehab or free alcohol rehab, you should be prepared to provide financial details that can include an estimate of your yearly income, the number of people in your family, and insurance information, if applicable.6 
<h2>State-Funded Rehab Centers and Programs</h2>
State-funded rehabs receive government money to provide substance addiction services to people who cannot afford it. The Substance Abuse Prevention and Treatment (SAPT) Block Grant program is the main source of funding for these services. Services under the SAPT program typically include prevention services as well as inpatient rehab, outpatient treatment, detox, and follow up support.7 ,8

States receive SAPT funds to implement specific programs. Eligibility requirements vary and are determined by SAMHSA.8  SAPT is geared toward the following populations and services:8 
<ul>
 	<li>Pregnant women and women with dependent children</li>
 	<li>Intravenous drug users</li>
 	<li>Tuberculosis services</li>
 	<li>Early intervention services for HIV/AIDS</li>
 	<li>Primary prevention services</li>
</ul>
SAMHSA advises contacting your state agency for more information about eligibility requirements for state-funded rehab centers and programs, as every state has a different process. You can access SAMHSA’s state directory for contact information in your state <a href="https://www.samhsa.gov/sites/default/files/ssadirectory.pdf">using this link</a>.
<h2>Faith-Based Drug and Alcohol Rehab Centers</h2>
Faith-based rehab programs incorporate religious and spiritual beliefs into their treatment program and philosophy.9  Programs include:10 ,11,12
<ul>
 	<li>Salvation Army. Their addiction program incorporates holistic therapy, group and individual counseling sessions, spiritual direction, and life-skills development, and helps people learn to depend on God rather than substances.</li>
 	<li>Jewish Alcoholics, Chemically Dependent Persons and Significant Others (JACS). This is designed for Jewish people in New York City who are addicted to drugs or alcohol and their families, friends, and associates. It offers a resource center and information clearinghouse in a “nurturing Jewish environment.” It also offers JCS Recovery, an addiction and recovery support network for Jewish people with addictions.</li>
 	<li>Alcoholics Victorious. This is not a rehab center but rather a network of Christian support groups for people with addictions. It is based on the 12 steps of recovery and the Alcoholics Victorious creed; it is not intended as a replacement for treatment centers.</li>
</ul>
<h2>Alcoholics Anonymous and Narcotics Anonymous</h2>
Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are free mutual support groups that are not affiliated with specific religions or a set of religious beliefs, but are based on the concept of spirituality and reliance on a higher power (whatever that may mean to you).9 Both of these groups involve the support of others who are also in recovery and the guidance of a sponsor, who helps you work through the 12 steps of recovery. The 12-step model is based on acceptance, surrender, and participation in groups.13 
<h2>Additional Options for Addiction Treatment</h2>
State-funded programs may have long wait times and limited availability, but you have options if you’re not able to get into a free program. As previously mentioned, you could apply for Medicare or Medicaid if you’re eligible, or use insurance if you have it.1 You could also check the <a href="https://findtreatment.gov/results">FindTreatment.gov</a> website to see about programs that offer sliding scales, scholarships, or grants. You can also directly contact programs you’re interested in to see what types of financial assistance they might offer.6 

Financial difficulty should not be a reason to avoid taking charge of your health and well-being. Research has shown that rehabilitation treatment can be very effective in helping individuals maintain a life of sobriety. 13

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<h3>Sources</h3>
<ol>
 	<li>S. Department of Health and Human Services: Office of the Surgeon General. (2016). <a href="https://addiction.surgeongeneral.gov/sites/default/files/surgeon-generals-report.pdf">Facing addiction in america: The surgeon general’s report on alcohol, drugs, and health</a>. Washington, DC: U.S. Department of Health and Human Services.</li>
 	<li>Center for Substance Abuse Treatment. (2000). <a href="https://www.ncbi.nlm.nih.gov/books/NBK64279/">Integrating substance abuse treatment and vocational services. Chapter 6 --funding and policy issues. (Treatment Improvement Protocol (TIP) Series, No. 38.)</a>. Rockville, MD: Substance Abuse and Mental Health Services Administration (US); 2000.</li>
 	<li>Substance Abuse and Mental Health Services Administration. (2019). <a href="https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSSATS-2018.pdf">National survey of substance abuse treatment services (N-SSATS): 2018. Data on substance abuse treatment facilities</a>. Rockville, MD: Substance Abuse and Mental Health Services Administration.</li>
 	<li>Substance Abuse and Mental Health Services Administration. (2021, September 27). <a href="https://www.samhsa.gov/grants/block-grants">Substance abuse and mental health block grants</a>.</li>
 	<li>gov. (n.d.). <a href="https://www.benefits.gov/benefit/307">Veterans alcohol and drug dependence rehabilitation program</a>.</li>
 	<li>Substance Abuse and Mental Health Services Administration. (2019, October). <a href="https://www.findtreatment.gov/content/paying-for-treatment/if-you-dont-have-insurance">Paying for treatment: If you don't have insurance</a>.</li>
 	<li>Substance Abuse and Mental Health Services Administration. (2006). <a href="https://www.ncbi.nlm.nih.gov/books/NBK64106/">Detoxification and substance abuse treatment [Internet]. (Treatment Improvement Protocol (TIP) Series, No. 45.) 6: Financing and organizational issues</a>. Rockville, MD: Substance Abuse and Mental Health Services Administration.</li>
 	<li>Substance Abuse and Mental Health Services Administration. (2020, April 16). <a href="https://www.samhsa.gov/grants/block-grants/sabg">Substance abuse prevention and treatment block grant</a>.</li>
 	<li>Grim, B. J., &amp; Grim, M. E. (2019). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6759672/">Belief, behavior, and belonging: How faith is indispensable in preventing and recovering from substance abuse</a>. Journal of religion and health, 58(5), 1713–1750.</li>
 	<li>Salvation Army. (n.d.). <a href="https://www.salvationarmyusa.org/usn/rehabilitation/">Rehabilitation</a>.</li>
 	<li>Jewish Board of Family and Children’s Services. (n.d.). <a href="https://jewishboard.org/listing/jacs-jcsrecovery/">Jewish alcoholics, chemically dependent persons and significant others (JACS) and JCS recovery</a>.</li>
 	<li>Alcoholics Victorious Headquarters. (n.d.). <a href="https://www.alcoholicsvictorious.org/av-faq">Frequently asked questions about Alcoholics Victorious</a>.</li>
 	<li>National Institute on Drug Abuse. (2018, January). <a href="https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies/12-step">Principles of drug addiction treatment: A research-based guide (Third edition): 12-Step facilitation therapy (Alcohol, stimulants, opiates)</a>.</li>
</ol>

Free Drug and Alcohol Rehab

<h2>What is Drug Addiction?</h2>
Drug addiction is a chronic medical disease characterized by compulsive substance seeking and drug use that persists despite the detrimental effects of drug use.1 Addiction is considered to be a disease because of the brain changes that are accompanied by ongoing exposure to drugs.1 These brain changes may themselves be associated with changes in a person’s ability to make decisions or control their actions, which contributes to an inability to stop using the substance even if they it is causing harm.1
Taking drugs affects the brain’s key reward chemical, known as dopamine, which contributes to developing a self-reinforcing cycle of drug use.1 Over time, as dopamine activity subsides; the person may experience a subsequent low or crash, which can cause them to want to use again to feel good.1 Alternating between intense highs and lows fuels the cycle of abuse, because with repeated exposure, the brain becomes desensitized to dopamine and it needs more of the substance to experience previous results (known as tolerance).1
While the decision to start using drugs may be voluntary, the resulting brain changes contributes to an individual losing their ability to resist drugs over time.1 Not everyone who takes drugs will become addicted, there are numerous other factors that can contribute to developing a drug addiction, including genetics, the environment a person functions in, and developmental factors or individual lifetime experiences. Drug addiction is a complex disease, but it is also treatable and can be successfully managed. 
<h3>Drug Addiction Facts &amp; Stats</h3>
Drug addiction is a worldwide problem. According to the World Health Organization (WHO), 270 million people (or 5% of the world's population) between the ages of 15 and 64 have used psychoactive drugs (including alcohol and nicotine) in the past year.2 Among them, 35 million people suffer from drug use disorders.2 About half a million people worldwide are estimated to die from drug-abuse related reasons every year.2
In the United States, 49.2% of people aged 12 and over reported having used illicit drugs during their lifetime; 19.4% said they had used illicit drugs in the past year, and 11.7% of people aged 12 and older reported that they were current drug users (meaning they reported using illicit drugs in the past month) in 2018, according to the National Survey of Drug Use and Health.3 
In addition to the risk of addiction, taking drugs also carries with it a risk of life-threatening overdose. According to preliminary data released by the CDC, there were 71,327 drug overdoses in the United States in 2019, up 5.1% from the previous year.4
Substance abuse places a tremendous financial burden on society. According to the National Institute on Drug Abuse (NIDA), alcohol, tobacco, and illicit drug abuse costs “more than $740 billion annually related to crime, lost work productivity, and health care [expenses].”5
Additionally, people who have mental health disorders like anxiety or depression may turn to drugs as a way of easing or reducing their symptoms.6 But people with these disorders can also develop substance use disorders. The Anxiety and Depression Association of America reports that around 20% of people with anxiety or depression also have a substance use disorder, and around 20% of people with a substance use disorder also struggle with anxiety or depression.6
<h2>Risk Factors Contributing to Addiction </h2>
Many factors can increase a person’s risk for drug addiction. While none guarantees an addiction will develop, they may increase a person’s chances for drug abuse. Most individuals at risk for drug abuse do not start using drugs or become addicted, and a risk for one person may be a protective factor for another. General risk factors for drug addiction include:1,7,8 
<ul>
<li>Biological factors such as genetics, family history of substance abuse, gender, ethnicity, and whether a person has other mental health disorders.</li>
<li>Environmental factors such as poverty, an unsafe living environment, peer pressure, abuse, stress, lack of parental guidance or supportive role models, or childhood exposure to drugs or alcohol.</li>
<li>Developmental factors, meaning the ways that biological and environmental factors intersect at critical moments during development. For example, peer pressure and developmental brain changes in teenagers can lead to poor decision-making and excessive risk-taking behaviors.</li>
</ul>
<h2>Warning Signs of Addiction </h2>
While the <a href="https://alcoholrehab.com/drug-addiction/signs-of-addiction/">warning signs of addiction</a> can vary from person to person, the American Psychiatric Association defines diagnostic criteria for a person struggling with drug addiction. Although only a doctor or appropriately trained mental health clinician can diagnose a substance use disorder, the criteria are useful warning signs that may indicate a problem with substance use.
According to the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5), some warning signs of drug abuse to look for include:9
<ul>
<li>Having times when you used the substance more (or longer) than intended.</li>
<li>Wanting to stop or cut down on use but aren’t able to do so.</li>
<li>During or after using drugs, getting into situations where you increased your risk for getting hurt (driving a car, for example).</li>
<li>Spending a considerable amount of time getting drugs or getting over the effects of them.</li>
<li>Spending less time or giving up activities that are important or interesting to you or that gave you pleasure for the purpose of doing drugs.</li>
<li>Wanting drugs so much that it’s hard to think about anything else.</li>
<li>Using drugs (or being high) has hindered your ability to meet home, school, or job obligations.</li>
<li>Continuing to use drugs, despite them causing problems with family or friends.</li>
<li>Continuing to do drugs, despite them making you feel anxious, depressed, or contributing to a separate health problem, or after having experienced a memory blackout.</li>
<li>Needing more drugs to achieve the desired effect or the regular amount that you drink, no longer has the same effect.</li>
<li>Experiencing withdrawal symptoms when the effects of the drugs wear off, like restlessness, sweating, sleeping, seizure, or racing heart.</li>
</ul>
Anyone who has experienced at least 2 of the listed criteria within the same 12-month period may be diagnosed with a substance use disorder.9 
<h2>Effects of Drug Addiction </h2>
<a href="https://alcoholrehab.com/drug-addiction/effects/">Drug abuse and addiction have many negative effects</a> on a person’s life including their physical health, social life, career, finances, and family. It can also begin to affect your loved ones and those around you.
Some detrimental effects of drug abuse and addiction include:10 
<ul>
<li>Poor physical health and an increased risk of diseases such as lung or heart disease, stroke, cancer, nerve damage, and mental health conditions.</li>
<li>Dental problems (particularly among people who use methamphetamine).</li>
<li>An increased risk of bloodborne disease infections (particularly among injection drug users), such as hepatitis C or HIV, as well as infections of the heart and skin.</li>
<li>Worsened mental health, especially if you have a co-occurring psychiatric condition such as schizophrenia, anxiety, or depression.</li>
<li>Risk of overdose or death.</li>
<li>Harm to others, such as:
<ul>
<li>Negative impact on your unborn baby or to your child if you are breastfeeding. This includes neonatal abstinence syndrome, a condition that occurs when your baby goes into withdrawal after birth. Symptoms can include problems sleeping or feeding, tremors, or seizures. Children who were exposed to drugs in the womb may also experience developmental problems such as disturbances in attention, behavior, and thinking.</li>
<li>Increased risk of motor vehicle accidents. Nearly 12 million people aged 16 and older reported driving while under the influence of illicit drugs in 2016, according to NIDA.</li>
</ul>
</li>
</ul>
<h2>Treatment for Drug Addiction </h2>
Drug addiction is similar to other chronic relapsing diseases like heart disease or asthma. It cannot be cured, but it can be successfully managed and treated. Treatment is designed to help people learn to abstain from drug use and develop effective coping mechanisms for common triggers, such as stress, so they can lead clean and sober lives. According to NIDA, treatment can help counteract the negative effects of substance abuse on your brain and behavior.11
The <a href="https://alcoholrehab.com/drug-addiction/treatment/">type of treatment you receive can vary based on your individual needs</a>. People often start with medical detox, which helps clear the substance from your body in a safe and supervised setting. They then move on to participate in some form of inpatient (or residential) care—especially if they have serious or long-standing addictions—or outpatient treatment. Outpatient treatment may be used as either a step down from inpatient care or as of the first line of treatment for people whose addictions are less severe or for those who may do well in a less supportive environment.
Depending on the substance of addiction, you may receive medications as a way to help manage withdrawal and addiction symptoms.11 Most inpatient and outpatient rehabs also implement a variety of individual and group therapies. These usually include:11,12
<ul>
<li>Cognitive-behavioral therapy, which is designed to help change negative and unhealthy thoughts and behaviors.</li>
<li>Contingency management, which relies on positive reinforcement for meeting goals, usually through a type of reward system.</li>
<li>Motivational enhancement therapy, which is designed to increase motivation and willingness to change.</li>
<li>Family therapy, because addiction doesn’t just affect you—it impacts everyone in your family. Additionally, if the family environment influenced the development of your addiction, it often plays a critical role in recovery.</li>
<li>12-step, or mutual-help group participation, is a highly structured, individual, manual-guided approach where a person works through their history of substance use and learns how it is negatively impacting their life. It also helps to identify triggers of substance abuse and encourages you to engage in 12-step or other mutual help support groups as a form of social support both during and after treatment.</li>
</ul>
Like other chronic conditions such as diabetes and hypertension, relapse is normal and may occur anytime during addiction recovery. However, it does not mean that treatment has failed, but it may suggest the need for a different type of treatment or an adjustment to your current treatment plan. According to NIDA, addiction relapse rates are as high as 60%. 11 As a comparison, relapse rates for hypertension and asthma are estimated to be 50% to 70%.11
Finally, it’s important to engage in some form of aftercare; recovery doesn’t end once treatment has been completed. <a href="https://alcoholrehab.com/alcohol-recovery/aftercare/">Aftercare is supportive care</a> designed to help you stay sober and avoid relapse. It may consist of 12-step mutual help groups such as Narcotics Anonymous, non-12-step groups like SMART Recovery, or individual and/or group counseling. Some people benefit from supportive living environments, known as sober living homes, which can help them transition from formal treatment back to their normal lives.

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<h2>Seek Help for Addiction</h2>
As operator of Alcoholrehab.com, American Addiction Centers (AAC) offers a <a href="https://alcoholrehab.com/hotline/">toll-free hotline</a> so that you may speak with our admissions navigators about your treatment options any time of day. AAC operates a nationwide network of treatment centers and is dedicated to making recovery accessible to all persons in need.
With locations across the country, we’re able to provide a number of unique settings as your backdrop for recovery.  If you’d like to learn more about our approach to treatment, facility locations and/or what treatment may involve, call us today. All calls are 100% confidential and there’s no pressure to make a decision right away. We’re excited to discuss your path to recovery with you!




[sources] [1]. National Institute on Drug Abuse. (2018). <a href="https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction" target="_blank" rel="noreferrer noopener">Understanding drug use and addiction DrugFacts</a>.



[2]. World Health Organization. (n.d.). <a href="https://www.who.int/health-topics/drugs-psychoactive#tab=tab_2" target="_blank" rel="noreferrer noopener">Drugs (psychoactive): Impact</a>.



[3]. National Institute on Drug Abuse. (2019). <a href="https://www.drugabuse.gov/drug-topics/trends-statistics/national-drug-early-warning-system-ndews/national-survey-drug-use-health" target="_blank" rel="noreferrer noopener">National survey on drug use and health: Trends in prevalence of various drugs for ages 12 or older, ages 12 to 17, ages 18 to 25, and ages 26 or older; 2016 - 2018 (in percent)</a>.



[4]. Centers for Disease Control and Prevention. (2020). <a href="https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm" target="_blank" rel="noreferrer noopener">Provisional drug overdose death counts.</a> National Center for Health Statistics.



[5]. National Institute on Drug Abuse. (2020). <a href="https://www.drugabuse.gov/drug-topics/trends-statistics/costs-substance-abuse" target="_blank" rel="noreferrer noopener">Costs of substance abuse</a>.



[6]. Anxiety and Depression Association of America. (n.d.). <a href="https://adaa.org/understanding-anxiety/related-illnesses/substance-abuse" target="_blank" rel="noreferrer noopener">Substance use disorders</a>.



[7]. Centers for Disease Control and Prevention. (2020). <a href="https://www.cdc.gov/healthyyouth/substance-use/index.htm" target="_blank" rel="noreferrer noopener">High-risk substance use among youth</a>.



[8]. National Institute on Drug Abuse. (2011). <a href="https://www.drugabuse.gov/publications/preventing-drug-use-among-children-adolescents/chapter-1-risk-factors-protective-factors/what-are-risk-factors" target="_blank" rel="noreferrer noopener">Preventing drug use among children and adolescents (in brief): What are risk factors and protective factors?</a>



[9]. American Psychiatric Association. (2013). Substance Use Disorder.&nbsp;Diagnostic and Statistical Manual of Mental Disorders, Vol 5; 483-485.



[10]. National Institute on Drug Abuse. (2020). <a href="https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/addiction-health" target="_blank" rel="noreferrer noopener">Drugs, brains, and behavior: The science of addiction: What are the other health consequences of drug addiction?</a>



[11]. National Institute on Drug Abuse. (2020). <a href="https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery" target="_blank" rel="noreferrer noopener">Drugs, brains, and behavior: The science of addiction: Treatment and recovery</a>.



[12]. Mee-Lee D, Shulman GD, Fishman MJ, Gastfriend DR, Miller, eds.&nbsp;(2013). The ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions. 3rd ed. The American Society of Addiction Medicine. [/sources]

What is Drug Abuse and Addiction?

<h2>What is Aftercare?</h2>



Recovery from <a href="https://alcoholrehab.com/alcoholism/">alcoholism</a> is a lifelong process that doesn’t end once professional treatment is complete. Aftercare is an essential component of recovery and a form of continuing care that takes place any time you switch from different levels of care (such as when you move from inpatient to outpatient treatment or after you’ve completed outpatient treatment).



The planning for aftercare starts at the very beginning of the treatment process, starting with the transition from <a href="https://alcoholrehab.com/alcohol-treatment/types-of-treatment/alcohol-detox/">detox</a> to inpatient treatment (or another form of care if appropriate for you). A variety of aftercare options can help you avoid relapse and maintain your hard-earned sobriety by promoting awareness of triggers and providing you with ongoing support, such as through brief check-ups, individual and group therapy, telephone counseling, and support group meetings.1



Aftercare supports the positive effects of the initial forms of treatment, meaning that it helps cement the skills you learned during each phase of rehab. While more research is needed, most evidence supports the idea that aftercare interventions that have a “longer planned duration of therapeutic contact” are more effective than briefer interventions.1



Additionally, active approaches that engage the person in recovery (such as outreach services or telephone contact), and are more convenient for them, may be better and more feasible alternatives for some people than traditional types of aftercare, such as 12-step groups or group therapy, although this can vary from person to person.1



<h2>What is a Relapse?</h2>



Relapse is prevalent among people with alcohol use disorders and, for many, is a common feature of their recovery. A <a href="https://alcoholrehab.com/alcohol-recovery/aftercare/risk-of-relapse/">relapse</a> can be said to have taken place when a person no longer maintains their goal of abstinence and resumes previous levels of drinking behavior.2



While there are many potential contributing factors, people often relapse because they have difficulty handling or responding to various triggers, such as ongoing stress, emotional or psychological problems, financial issues or housing concerns, social issues such as rejection by peers, or other types of personal problems.2



However, treatment may reduce your chance of relapse. Studies examining relapse rates have had varied results, so more research is needed; yet, the available studies tend to show that treatment can have a positive effect on a person’s ability to maintain abstinence. One meta-analysis showed that average short-term abstinence rates have been estimated at “21% for untreated individuals in waiting-list, no-treatment or placebo conditions, compared to 43% for treated individuals.”3 Among those treated individuals who have maintained short-term abstinence, estimated long-term relapse rates have ranged from 20% to 80%.3



<h3>Phases to Relapses</h3>



Relapse tends to happen over time and in phases. Different researchers have posited their ideas about the stages of relapse. For example, the addiction researcher Terence Gorski has outlined 11 phases of relapse, and while this can be helpful for addiction professionals who want to examine the relapse process in their clients, it can be overwhelming to fully understand.



One addiction expert, medical doctor, and researcher Dr. Steven Melemis, explains that relapse can more easily be understood in terms of 3 stages—the emotional, mental, and physical stages.4 Dr. Melemis explains the 3 stages as follows:4



<ul>
<li>The emotional stage of relapse is characterized by denial. During this stage, you are not actively thinking about using, but you may start to experience emotional issues such as bottling up your emotions, isolating yourself from others, avoiding recovery meetings, going to meetings but not sharing, placing more attention on other people and their problems (instead of your own), and neglecting self-care (which includes poor sleep habits).</li>
<li>The mental stage of relapse is characterized by an inner war between wanting to use and wanting to stay sober. You may experience increased cravings for alcohol, have increasing thoughts about people, things, or places that are related to your previous alcohol use, trivialize the consequences of your previous alcohol use (i.e. having thoughts such as, “It wasn’t really that bad, I wasn’t drunk every day”), start bargaining (meaning you make deals with yourself such as “I can just have 1 drink and then stop again”), lie to yourself or others, try to come up with ideas of how you can control your drinking if you start again, seek out opportunities to relapse, and actively start planning your relapse.</li>
<li>The physical stage of relapse occurs when you start drinking again.</li>
</ul>



<h2>Relapse Warning Signs</h2>



Some common emotional and mental <a href="https://alcoholrehab.com/alcohol-recovery/aftercare/signs-of-relapse/">relapse warning signs</a> are indicated in the above stages of relapse. However, everyone also has their own unique triggers for relapse that cause or exacerbate these feelings and thoughts. Learning to recognize what makes you want to start drinking again is crucial for preventing relapse.



What causes someone else to relapse may not affect you, and vice versa. For example, you may not be as affected if you’re at a dinner party with friends who are drinking, but another person may be unable to tolerate it. Or you may have no trouble walking by the beer aisle in the grocery store, but another person may be unable to resist the temptation to make a purchase.



With that being said, being aware of relapse warning signs may help you stay sober by alerting you to when it’s time to reach out for help. If you feel a temptation to drink, you can then take action, such as by reaching out to your sponsor or counselor or other sober supports.



Keep in mind that there might be more than one warning sign in relapse; often, people experience multiple warnings that build on top of each other until they are no longer able to resist the urge to drink.
<h3>Common Warning Signs of Alcohol Relapse</h3>



Common relapse warning signs can include:2,5



<ul>
<li>Exposure to stressful events, people, or situations.</li>
<li>Exposure to alcohol or alcohol-related stimuli.</li>
<li>Anxiety, depression, or other mental health issues.</li>
<li>Trauma.</li>
<li>Violence.</li>
<li>Loss (i.e. death of a family member, divorce, loss of your home, etc.)</li>
<li>Poor social support.</li>
<li>Problems at work.</li>
<li>Interpersonal conflict.</li>
<li>Social stigma.</li>
<li>Poor physical health.</li>
<li>Guilt due to a one-time slip-up (i.e. you may continue drinking as a way to cope with your feelings of shame of having had “that one drink”).</li>
<li>Increasing negative thoughts, usually in the form of self-criticism, catastrophizing, or all-or-nothing thinking.</li>
<li>Fear of alcohol recovery (meaning that you don’t believe you are capable of recovering from your addiction or that you aren’t able to live an alcohol-free life).</li>
<li>Feeling resentful that you can’t “have fun” in the ways that you are used to (i.e. by drinking).</li>
</ul>



<h2>What Do I Do If I Relapse?</h2>



If you relapse, it is important to practice self-compassion and avoid judging yourself harshly. Relapse does not mean that treatment didn’t work; it means that you’ve experienced a common setback that many people in recovery deal with at some point. And sometimes, at multiple points.



It also means that you need to adjust your current treatment plan; perhaps even a different approach or form of treatment. Learning from your setbacks during alcohol recovery is also important because they don’t need to always end in relapse. For example, if things don’t work out the way you want them to in your life or you experience frustrations, you don’t need to give up and start drinking again.



One goal of treatment is to help people understand that relapse is a gradual process that starts way before you have the first drink. It’s important to understand your relapse as much as possible. Take a look at the reasons that you relapsed and think about them in the context of the above-mentioned stages of relapse and triggers.



Try to pinpoint when you started experiencing the first cravings to drink and think about what was going on in your life at that time. Developing an awareness of the specific warning signs that preceded your relapse may allow you to prevent a relapse in the future. It's crucial to be aware of the early warning signs because that is when it’s easiest to reduce the risk of relapse.4



<h2>Developing an Aftercare Plan</h2>



The risk of relapse is the main reason why it’s necessary to have a comprehensive aftercare plan in place even before you’ve completed treatment. Aftercare is designed to help you stay sober in the early alcohol recovery period and to help you achieve your other life goals long-term.



Aftercare programs include:



<ul>
<li><a href="https://alcoholrehab.com/12-steps-aa/">12-step groups</a> like Alcoholics Anonymous (AA).</li>
<li>SMART Recovery.</li>
<li>12-step facilitation efforts designed to help you better engage with 12-step groups, such as Making AA Easier and Systematic Encouragement and Community Access procedures.</li>
<li>Individual therapy.</li>
<li>Group counseling.</li>
<li>Sober living homes.</li>
<li>Regular telephone contact with a counselor or sponsor.</li>
<li>Home visits from a nurse or other medical practitioner.</li>
<li>Case management services (usually provided by a social worker).</li>
<li>Social clubs.</li>
<li>Family support, such as through family counseling, one-on-one counseling sessions for partners, children, or other family members, educational programs about addiction for family members, and 12-step groups for family members, such as Al-anon.</li>
</ul>



Continued therapy and <a href="https://alcoholrehab.com/alcohol-treatment/types-of-treatment/outpatient/">outpatient</a> services are important tools in the transition from or “step down” to less intensive forms of treatment. You may be able to continue these services at the facility where you first received treatment, or you may switch to a different facility if that works better for your needs.



Certain situations should be avoided in aftercare planning, such as households or places where you may experience triggers or be offered alcohol. For those whom may need extra residential support, sober living homes provide alcohol- and drug-free residences designed to support you as you transition back to your regular life.



Or you may consider bumping up your attendance of 12-step meetings during stressful times or engaging in individual therapy in addition to self-help groups. Your counselor or care provider must understand and take into account your unique triggers when formulating your aftercare plan so that you are well-equipped to recognize the signs of and avoid a relapse before it occurs.



<h2>Treating an Alcohol Relapse</h2>



If you’ve recently experienced a relapse and are ready to adjust your treatment plan, American Addiction Centers (AAC) can help. As operator of AlcoholRehab.com, AAC’s admissions navigators can discuss your treatment options with you today.



Remember, a relapse doesn’t mean you have failed, don’t let it keep you from getting the help you deserve. Call our hotline 24/7 to speak with one of our admissions navigators; all calls are 100% confidential. Or, fill out the form below to see if your insurance covers treatment within an AAC facility.

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[sources]
[1]. McKay, J. R. (2009). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670779/" target="_blank" rel="noreferrer noopener">Continuing care research: what we have learned and where we are going</a>. Journal of Substance Abuse Treatment, 36(2), 131–145.



[2]. Alcohol and Drug Foundation. (n.d.). <a href="https://adf.org.au/reducing-risk/relapse/" target="_blank" rel="noreferrer noopener">Relapse</a>.



[3]. Moos, R. H., &amp; Moos, B. S. (2006). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1976118/" target="_blank" rel="noreferrer noopener">Rates and predictors of relapse after natural and treated remission from alcohol use disorders</a>. Addiction, 101(2), 212–222.



[4]. Melemis, S. M. (2015). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/" target="_blank" rel="noreferrer noopener">Relapse prevention and the five rules of recovery</a>. The Yale Journal of Biology and Medicine, 88(3), 325–332.



[5]. Sinha R. (2008). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2732004/" target="_blank" rel="noreferrer noopener">Chronic stress, drug use, and vulnerability to addiction</a>. Annals of the New York Academy of Sciences, 1141, 105–130.
[/sources]

Alcoholism Treatment Aftercare

Helping a loved one with an alcohol addiction is never easy, and it can even feel like you’re on an emotional rollercoaster at times. If you’re concerned that someone you care about might be struggling with alcoholism, it’s important to know that help and support are available. Keep in mind, though, that you can’t make someone seek treatment when they’re not ready to do so. But that doesn’t mean you should put off the conversation.

It may take several tries before your loved one is willing to hear you, but with the right tools and education, you’ll feel more prepared for the conversation that may help your loved one take action.
<h2>Where to Begin</h2>
It’s never easy to know where to begin when you want to help a person struggling with alcohol. One of the first ways you can help is to learn more about alcoholism. Educating yourself can help you understand the disease and develop compassion for the struggles your loved one is going through. The more you know and understand about alcohol addiction, the better equipped you will be to help them and yourself.

Read about alcoholism from reputable online sources such as the <a href="https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help" target="_blank" rel="noopener noreferrer">National Institute on Alcohol Abuse and Alcoholism</a>, talk to your healthcare provider, or call an addiction information hotline to learn more.

The next step is to <a href="https://alcoholrehab.com/drug-addiction/treatment/what-to-consider/">research addiction facilities</a> in your area and out-of-state. Some people prefer to attend treatment close to home, while others can benefit from leaving behind their environment and the distractions that may have led to addiction in the first place. Your family doctor or other healthcare professional can be a good place to start; they should be able to offer referrals and information about rehabs and addiction counselors in your area.1

Read reviews of different addiction centers and take a look at the information offered on the website of the rehab facility itself. You might want to call an <a href="https://alcoholrehab.com/hotline/">addiction hotline</a> as well and ask questions to get additional information, such as:
<ul>
 	<li>What type of treatments do you offer? Are your therapies evidence-based?</li>
 	<li>How long is your treatment program? Do you offer short- and long-term programs? Can program length change based on needs?</li>
 	<li>Does my loved one need inpatient or outpatient treatment? What about detox?</li>
 	<li>Do you offer additional amenities?</li>
 	<li>How soon can my loved one start treatment?</li>
 	<li>What additional services do you offer to support people in recovery once treatment ends?</li>
 	<li>Do you offer services for people with physical and/or mental health conditions?</li>
 	<li>Do you accept insurance or offer payment plans?</li>
</ul>
<h2>Talking to Your Loved One</h2>
Next, you’ll want to make a plan to talk to your loved one. Consider the following before you have the actual conversation:1,2
<ul>
 	<li>Plan a time to talk when your loved one is sober. If they’re intoxicated, they won’t be in any shape to hear your message. You both may end up feeling sad, angry, or frustrated. Consider what you want to say in advance so that you are prepared for the conversation. Remember that your loved one might not be ready to hear you; you may need to make multiple attempts.</li>
 	<li>Stay calm and avoid getting drawn into a fight. If things get heated, take a step back and let them know you’re going to take some time out.</li>
 	<li>Avoid labeling the person as an alcoholic or addict.</li>
 	<li>Stick to “I” statements instead of accusations. Say, “I am concerned about your drinking.” Let them know how their addiction affects you and makes you feel. Express your concern and love for them. Let them know that you are willing to help them, but don’t make ultimatums, threaten, or try to force them to do anything they are not ready to do.</li>
 	<li>Explain that you’re worried about their health and the effects of alcohol on your relationship.</li>
 	<li>Let them know that you want to share some things that you’ve learned about alcohol treatment. Share with them that you have researched treatment centers and anything else you think might be helpful. Or, ask them if they would be willing to talk to an addiction specialist or their primary care provider about it first (some people feel more comfortable with a practitioner they already know). Let them know that you are willing to go with them to the appointment if they want.</li>
 	<li>Suggest attending mutual-support meetings like Alcoholics Anonymous (AA). This can be a non-threatening first step because all members of the group have been in the same shoes as your loved one.</li>
 	<li>Take care of yourself and remember your own needs. Consider joining a support group for family and friends of alcoholics, such as Al-Anon.</li>
</ul>
<h2>Understanding &amp; Recognizing Alcoholism</h2>
Knowing that alcoholism is a chronic disease of the brain may help you understand the struggle your loved one is going through. <a href="https://alcoholrehab.com/alcoholism/">Alcoholism</a> is not a choice; though your loved one made the decision at some point to have the first drink, but they are unable to just stop drinking when alcoholism takes over. You might wonder, “Why can’t they just stop drinking?” but it’s not as simple as that.

Unfortunately, if they’ve developed a physical dependence on alcohol, they are no longer in control of their use.3 Over time, problematic drinking patterns may develop in association with certain brain changes that affect a person’s self-control and ability to make smart or healthy choices.3 These changes can be persistent and long-lasting. The compulsion to drink may remain long-after quitting, which is why alcoholism is called a relapsing disease and why recovery from alcohol is a life-long process.3

On a neurotransmitter level, brain changes are also responsible for tolerance, which develops as a result of repeated alcohol exposure.3 Your loved one may need to drink more to experience previously desired effects.3 They may also develop alcohol dependence, which means that their brains have adapted to the persistent presence of alcohol essentially to the point of needing it to feel and function normally.4 When they try to stop drinking, they can experience mild to severe withdrawal symptoms that can be difficult to withstand and, in some cases, be life-threatening.4

[self-assessment type=”alcohol”]
<h2>Alcoholism Warning Signs</h2>
Based on diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorder (DSM-5), <a href="https://alcoholrehab.com/alcoholism/signs-of-alcoholism/am-an-alcoholic/">warning signs</a> of an alcohol use disorder (AUD) may include:5
<ul>
 	<li>Drinking alcohol in larger amounts or for longer periods than originally intended.</li>
 	<li>A persistent desire to cut back on alcohol use but being unable to do so.</li>
 	<li>Failing to meet obligations at home, work, or school because of alcohol use.</li>
 	<li>Continuing to drink despite having ongoing interpersonal or social problems that are probably due to alcohol use.</li>
 	<li>Giving up activities they once enjoyed in order to drink.</li>
 	<li>Drinking in situations where it is dangerous to do so (such as driving or operating machinery).</li>
 	<li>Continuing to drink despite knowing that they have a physical or mental health problem that is caused by, or exacerbated by, their alcohol use.</li>
</ul>
<h2>How Much is Too Much?</h2>
It’s important to note that alcoholism is not defined by how much or how often a person drinks, but by the effect that alcohol has on their life. A person does not have to drink every day to have an AUD.1

The U.S. Department of Health and Human Services outlines moderate drinking as up to 1 drink per day for women and up to 2 drinks per day for men.6 The National Institute on Alcohol Abuse and Alcohol Addiction (NIAAA) defines binge drinking as “a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 percent” or higher.6 This usually means 5 or more drinks for a man or 4 or more drinks for a woman within about 2 hours.6

NIAAA defines heavy drinking as more than 4 drinks a day for men and more than 3 drinks for women.6 The Substance Abuse and Mental Health Services Administration defines heavy drinking as binge drinking on 5 or more days in the past month.6 Both binge drinking and heavy alcohol use can increase a person’s risk of alcoholism.6
<h2>Risk Factors in the Development of Alcohol Dependence</h2>
While the amount of alcohol consumed can play a part in addiction, there are other factors that can affect whether a person develops an AUD. The presence of these contributing factors doesn’t guarantee that a person will become addicted to alcohol, but they can increase the likelihood.

Some of the factors that may play a role in alcoholism include:7,8
<ul>
 	<li>Gender. Though not all studies support this as a risk factor, some research has shown that men may have a higher risk of alcohol dependence since they often start drinking at an earlier age.</li>
 	<li>Family history. Genetics is not destiny, so a person with a family history of alcoholism is not necessarily going to become addicted to alcohol. However, studies have shown that “offspring of alcoholics are approximately 4 times more likely to develop alcoholism than people without such a history.”</li>
 	<li>Psychiatric comorbidity. This means that a person has a higher chance of AUD if they also suffer from another psychiatric disorder, such as depression or anxiety disorders.</li>
 	<li>Comorbid substance abuse. Using other substances in addition to alcohol and having another substance use disorder can increase the risk of AUD. Research has shown that people with an AUD are 7.5 times likelier than others to have a drug dependence diagnosis.</li>
 	<li>Age. Research shows that people who start drinking before age 15 have a higher risk of AUD.</li>
</ul>
Life circumstances and stresses can sometimes make it harder for your loved one to avoid alcohol addiction. While the above risk factors play a role, you may also notice other issues in their life that could increase their risk for developing an AUD, such as:8, 9
<ul>
 	<li>High levels of anxiety.</li>
 	<li>Antisocial behavior or high impulsivity.</li>
 	<li>Unemployment.</li>
 	<li>A history of abuse.</li>
 	<li>Marital problems.</li>
 	<li>Financial problems.</li>
</ul>
It's good to be aware of these factors so that you don't oversimplify the person's disorder. It's not just about putting the drink down. A person's family history, trauma, comorbidities and other factors can lead to a compulsion to drink that needs treatment attention to manage.

<hr />
Not sure if your insurance covers alcohol treatment?
Check your insurance coverage or text us your questions for more information.
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<h2>What is Addiction Treatment?</h2>
Even if your loved one has a severe addiction, know that help is available. <a href="https://alcoholrehab.com/alcohol-treatment/">Addiction treatment</a> has been shown to help people make a significant reduction in their drinking and alcohol-related problems; with research showing that “about 1/3 of people who are treated for alcohol problems have no further symptoms 1 year later.”10 Addiction treatment can help people stop drinking and teaches them the skills they require to remain sober and avoid relapse.10

Different <a href="https://alcoholrehab.com/alcohol-treatment/types-of-treatment/">treatment approaches are effective in managing alcohol withdrawal and treating AUD</a>. They include:10
<ul>
 	<li>Medications can help your loved one stay safe and comfortable during the detoxification phase; after successful withdrawal management, other medications can decrease additional drinking behavior and help them avoid relapse.</li>
 	<li>Behavioral treatments, or various forms of counseling, are designed to help them change their behaviors and stop drinking.</li>
 	<li>Self-help groups such as AA or other 12-step groups.</li>
</ul>
There are different types of treatment programs, including inpatient, where the person lives and receives treatment at the facility, or outpatient, where they live at home and travel to the facility on a regular basis for treatment.10 Inpatient treatment is helpful for a number of reasons, especially because it removes the person from their usual environment and offers them a safe, alcohol-free place to focus on recovery. Inpatient especially benefits people with moderate or severe addictions or those who require a high level of support.

Outpatient treatment settings may be most appropriate for a person with a strong social support system who is equipped to effectively manage drinking triggers. For many, outpatient programs are utilized as step-down care after completion of an inpatient program or for those who can make strides in recovery without the supervision and round-the-clock care offered by inpatient treatment.

Regardless of the setting, your loved one will receive support and monitoring (including testing) by addiction treatment experts and participate in a wide range of therapies such as group, individual, and family counseling (when appropriate). Some facilities offer additional treatments—such as vocational rehabilitation, recreational therapy, nutritional counseling, or alternative therapies—depending on the facility.10
<h2>What Happens After Treatment?</h2>
Recovery is an ongoing process that doesn’t end once treatment has been completed. It is important for both you and your loved one to continue to receive support. This is why an <a href="https://alcoholrehab.com/alcohol-recovery/">aftercare plan</a>, which may include continued counseling or attending AA (for people in recovery) and Al-anon meetings (for family and friends of alcoholics), is crucial to obtaining ongoing help and guidance and preventing relapse.11

Relapse is a common part of the recovery process.11 Relapses occur for many reasons, including stress, problems at work, rejection by friends, exposure to triggers (such as meeting former drinking buddies or being in places where they drank in the past), pre-existing mental health conditions, or poor physical health.11 Some people also experience relapse because of guilt—if they start drinking one time, they may feel guilty and continue drinking to avoid feeling bad.11

It’s important to keep in mind that relapse does not mean that treatment has failed; it does mean, however, that the person may need an adjustment in their aftercare strategies or require a different form of treatment.11

[sources]

[1]. MedlinePlus. (2018). <a href="https://medlineplus.gov/ency/patientinstructions/000815.htm" target="_blank" rel="noopener noreferrer">Helping a loved one with a drinking problem</a>.

[2]. National Institute on Aging. (2017). <a href="https://www.nia.nih.gov/health/how-help-someone-you-know-drinking-problem" target="_blank" rel="noopener noreferrer">How to Help Someone You Know with A Drinking Problem</a>.

[3]. National Institute on Drug Abuse. (2018). <a href="https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction" target="_blank" rel="noopener noreferrer">Drug Facts: Understanding Drug Use and Addiction</a>.

[4]. Becker H. C. (2008). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860472/" target="_blank" rel="noopener noreferrer">Alcohol dependence, withdrawal, and relapse</a>. Alcohol Research &amp; Health, 31(4), 348–361.

[5]. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

[6]. National Institute on Alcohol Abuse and Alcoholism. (n.d.). <a href="https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking" target="_blank" rel="noopener noreferrer">Drinking Levels Defined</a>.

[7]. Gilbertson, R., Prather, R., &amp; Nixon, S. J. (2008). <a href="https://pubs.niaaa.nih.gov/publications/arh314/389-399.htm" target="_blank" rel="noopener noreferrer">The role of selected factors in the development and consequences of alcohol dependence</a>. Alcohol Research &amp; Health, 31(4), 389–399.

[8]. Poikolainen, K. (2000). <a href="https://academic.oup.com/alcalc/article/35/2/190/152693" target="_blank" rel="noopener noreferrer">Risk factors for alcohol dependence: a case-control study</a>. Alcohol and Alcoholism, 35(2), 190–196.

[9]. Cheng, A. T., Gau, S. F., Chen, T. H., Chang, J. C., &amp; Chang, Y. T. (2004). <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/481956" target="_blank" rel="noopener noreferrer">A 4-year longitudinal study on risk factors for alcoholism</a>. Archives of general psychiatry, 61(2), 184–191.

[10]. National Institute on Alcohol Abuse and Alcoholism. (2014). <a href="https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help" target="_blank" rel="noopener noreferrer">Treatment for Alcohol Problems: Finding and Getting Help</a>.

[11]. Alcohol and Drug Foundation. (2019). <a href="https://adf.org.au/reducing-risk/relapse/" target="_blank" rel="noopener noreferrer">Relapse</a>.

[/sources]

How to Help an Alcoholic

Am I An Alcoholic? Know The Signs

<h2>What is Alcoholics Anonymous?</h2>
Alcoholics Anonymous (AA) is a self-help fellowship designed to provide mutual support to people in recovery from alcohol addiction. According to its website, members “share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism.”

Groups are found almost everywhere across the globe; in fact, there are currently more than 115,000.1 AA meetings gather regularly to discuss their experiences with alcohol and its effects on their lives. They provide support to each other as they work through the 12 steps of recovery. Groups consist of men and women from different cultural, social, and economic backgrounds. They all have different experiences and histories with alcohol, so there’s no standard type of member.2

There are no requirements to attend an AA meeting other than having a desire to quit drinking. It is also not associated with any organization, sect, politics, denomination, or institution. Those attending AA make a commitment to join voluntarily, via court-mandated rehab, or as a continuation of therapy.
<h2>The 12 Steps of AA</h2>
AA is based on the 12 steps of recovery; it has a spiritual foundation that involves turning over your life to a “higher power." According to AA, the 12 steps are as follows:3
<ol>
 	<li>We admitted we were powerless over alcohol—that our lives had become unmanageable.</li>
 	<li>We came to believe that a Power greater than ourselves could restore us to sanity.</li>
 	<li>We made a decision to turn our will and our lives over to the care of God as we understood Him.</li>
 	<li>We made a searching and fearless moral inventory of ourselves.</li>
 	<li>We admitted to God, to ourselves, and to another human being the exact nature of our wrongs.</li>
 	<li>We were entirely ready to have God remove all these defects of character.</li>
 	<li>We humbly asked Him to remove our shortcomings.</li>
 	<li>We made a list of all persons we had harmed and became willing to make amends to them all.</li>
 	<li>We made direct amends to such people wherever possible, except when to do so would injure them or others.</li>
 	<li>We continued to take personal inventory and when we were wrong promptly admitted it.</li>
 	<li>We sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.</li>
 	<li>Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.</li>
</ol>
These 12 steps were originally laid out in the textbook of AA, which is known as “The Big Book.” The idea behind AA is that people attain sobriety by working through each of these 12 steps in order, and with the assistance of a sponsor (someone who has had a longer time in recovery who can guide the person in recovery through times of crisis) and the fellowship of the group. The more a person can fully work through these steps, the more effective AA is believed to be.4
<h2>Facilitating Participation in 12 Step Groups</h2>
People who are interested in participating in a 12-step group like AA may have doubts or be unsure of whether they are ready (or willing) to become a member of a group. To help people increase their motivation to join, a highly-structured type of treatment known as 12-Step Facilitation Therapy was developed.

According to the National Institute on Drug Abuse (NIDA), this therapy focuses on promoting 3 main principles:5
<ul>
 	<li>Acceptance, meaning helping the person understand that alcoholism is a progressive and incurable disease that cannot be resolved by willpower alone and that requires abstinence.</li>
 	<li>Surrender, or admitting helplessness over alcohol and turning yourself over to a higher power.</li>
 	<li>Encouraging active involvement in 12-step groups.</li>
</ul>
People who facilitate this type of therapy usually focus on helping someone with the first 5 steps of recovery. During treatment, participants are not only encouraged to join 12-step groups, but they are also advised to keep a journal of their experiences and attendance.

Therapy sessions generally follow the same format every week and involve “symptoms inquiry, review and reinforcement for AA participation, introduction and explication of the week’s theme, and setting goals for AA participation for the next week,” according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA).6
<h2>Does AA Work?</h2>
Because AA is anonymous, it can be difficult to research its effectiveness, which is why a variety of clinical reviews offer mixed results. For example, one clinical review published in the Journal of Addictive Diseases found that only 2 studies out of the many examined had a positive finding for AA effectiveness.7 This does not mean that Alcoholics Anonymous is not effective, but that it is difficult for researchers to examine.7

One clinical review from the Alcoholism Treatment Quarterly reported the results of a survey that examined the perception of AA’s helpfulness among people involved in “abstinence-based treatment programs, a moderation-based program, and individuals not in treatment,” and found that 42.3% of participants found AA helpful, 18.2% had mixed comments, 19.2% found it unhelpful, and 20.3% did not mention AA.8

Yet another clinical review shared the results of a long-term study that found that, by the 8-year follow-up, 46% of people in formal treatment reached abstinence compared with 49% of the AA-only group.9

An article published in Scientific American shared the results of a 2006 study that examined problem drinkers who tried to quit on their own, participated in AA, or sought the help of a professional therapist.10 The results found that among those who attended at least 27 weeks of AA meetings during their first year in recovery, 67% remained abstinent at the 16-year follow-up, compared with 34% of those who did not participate in AA.10
<h2>Can AA Take the Place of Addiction Treatment?</h2>
AA alone is not typically sufficient enough for people to recover from alcohol dependence because they also generally need additional support to detox safely from alcohol, as well as learning how to manage alcoholism and avoid relapse in the future.

Because alcoholism is a lifelong disease similar to other chronic medical conditions (e.g., cancer, asthma, diabetes), <a href="https://alcoholrehab.com/alcoholism/cure/">there is no cure for it</a>. However, with professional treatment and ongoing recovery efforts, it can be successfully managed.

<a href="https://alcoholrehab.com/alcohol-treatment/">Effective treatment for alcohol dependence</a> usually begins with detox, followed by inpatient or outpatient rehab, depending on the extent of your addiction.11 Different therapies are provided and may include:12
<ul>
 	<li>Behavioral treatments help you identify the reasons you developed an addiction and teach you the skills you’ll need to move forward in your life and prevent relapse.</li>
 	<li>Medications, which can help you stop drinking and prevent relapse.</li>
 	<li>Self-help groups, which are a way to obtain additional support.</li>
</ul>
Research shows that about one-third of people who receive treatment for alcoholism show no further symptoms one year later and have fewer alcohol-related issues.11 NIDA points out that self-help groups like AA can “complement and extend the effects of professional treatment,” and that most treatment programs encourage participating in these groups.13

<hr />
Wondering what type of alcohol treatment is right for you?
Check your insurance coverage or text us your questions for more information about your options.
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<hr />

<h2>FAQs About AA</h2>
Some of the most common questions about Alcoholics Anonymous include:14
<ul>
 	<li>Does AA cost money? No, AA is free of charge.</li>
 	<li>When should you go to AA? You can go to AA when you feel that alcohol has become a problem for you or even if you’re not yet sure. Anyone interested in AA is welcome at open meetings.</li>
 	<li>Can you just walk into an AA meeting? Most people start by just attending a group in their area, which you can find on their website. Be aware that there are two options for meetings. Open meetings are group meetings that any member of the community may attend, and closed meetings are for members of AA only.</li>
 	<li>Do you have to be religious? AA is not a religious society, though it is based on certain spiritual values. Individuals are free to interpret these values in the way that best suits their needs.</li>
 	<li>Once I stop drinking, can I stop going to meetings? Though you are able to stop going to meetings at any time, it can be beneficial to continue to attend meetings in order to reduce the risk of relapse.</li>
</ul>

<hr />

[accordion title="Treatment Centers"]
<ul>
 	<li><a href="/aac-facilities/laguna-treatment-hospital/">Laguna Treatment Hospital</a></li>
 	<li><a href="/aac-facilities/adcare-treatment-centers/">Adcare - Boston</a></li>
 	<li><a href="/aac-facilities/sunrise-house-treatment-center/">Sunrise House</a></li>
 	<li><a href="/aac-facilities/desert-hope-treatment-center/">Desert Hope</a></li>
 	<li><a href="/aac-facilities/greenhouse-treatment-center/">Greenhouse</a></li>
 	<li><a href="/aac-facilities/oxford-treatment-center/">Oxford Treatment Center</a></li>
 	<li><a href="/aac-facilities/recovery-first-treatment-center/">Recovery First</a></li>
 	<li><a href="/aac-facilities/river-oaks-treatment-center/">River Oaks</a></li>
</ul>
[/accordion]

<hr />

[sources]

[1]. Alcoholics Anonymous World Services. (2014). <a href="https://www.aa.org/assets/en_US/p-48_membershipsurvey.pdf" target="_blank" rel="noopener noreferrer">2014 membership survey</a>.

[2]. Alcoholics Anonymous World Services. (2017). <a href="https://www.aa.org/assets/en_US/p-1_thisisaa1.pdf" target="_blank" rel="noopener noreferrer">This is AA</a>.

[3]. Alcoholics Anonymous World Services. (2016). <a href="https://www.aa.org/assets/en_US/smf-121_en.pdf" target="_blank" rel="noopener noreferrer">The twelve steps of Alcoholics Anonymous</a>.

[4]. Center for Substance Abuse Treatment. (1999). <a href="https://www.ncbi.nlm.nih.gov/books/NBK64351/?report=reader#_NBK64351_pubdet_" target="_blank" rel="noopener noreferrer">Treatment of adolescents with substance use disorders. (treatment improvement protocol (TIP) series, no. 32.) Chapter 4—Twelve-step-based programs.</a> Rockville, MD: Substance Abuse and Mental Health Services Administration.

[5]. National Institute on Drug Abuse. (2018). <a href="https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies/12-step" target="_blank" rel="noopener noreferrer">Principles of drug addiction treatment: A research-based guide (third edition) 12-step facilitation therapy (alcohol, stimulants, opiates)</a>.

[6]. National Institute on Alcohol Abuse and Alcoholism. (1999). <a href="https://pubs.niaaa.nih.gov/publications/projectmatch/match01.pdf" target="_blank" rel="noopener noreferrer">Twelve step facilitation therapy manual: A clinical research guide for therapists treating individuals with alcohol abuse and dependence</a>.

[7]. Kaskutas, L. (2009). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746426/" target="_blank" rel="noopener noreferrer">Alcoholics anonymous effectiveness: faith meets science</a>. Journal of Addictive Diseases, 28(2), 145–157.

[8]. Krentzman, A. R., Robinson, E. A., Moore, B. C., Kelly, J. F., Laudet, A. B…Strobbe, S. (2010). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140338/" target="_blank" rel="noopener noreferrer">How Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) Work: Cross-Disciplinary Perspectives</a>. Alcoholism Treatment Quarterly, 29(1), 75–84.

[9]. Kelly, J. F., &amp; Yeterian, J. D. (2011). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860535/" target="_blank" rel="noopener noreferrer">The role of mutual-help groups in extending the framework of treatment</a>. Alcohol Research &amp; Health, 33(4), 350–355.

[10]. Lilienfeld, S. &amp; Arkowitz, A. (2011). <a href="https://www.scientificamerican.com/article/does-alcoholics-anonymous-work/" target="_blank" rel="noopener noreferrer">Does Alcoholics Anonymous work?</a> The Scientific American.

[11]. National Institute on Alcohol Abuse and Alcoholism. (2014). <a href="https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help" target="_blank" rel="noopener noreferrer">Treatment for alcohol problems: Finding and getting help</a>.

[12]. Saitz, R. (1998). <a href="https://pubs.niaaa.nih.gov/publications/arh22-1/05-12.pdf" target="_blank" rel="noopener noreferrer">Introduction to alcohol withdrawal</a>. Alcohol Health and Research World, 22(1), 5–12.

[13]. National Institute on Drug Abuse. (2018). <a href="https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/where-do-12-step-programs-fit" target="_blank" rel="noopener noreferrer">Principles of drug addiction treatment: A research-based guide (third edition): Where do 12-step or self-help programs fit into drug addiction treatment?</a>

[14]. Alcoholics Anonymous World Services. (2018). <a href="https://www.aa.org/assets/en_us/aa-literature/p-2-frequently-asked-questions-about-aa" target="_blank" rel="noopener noreferrer">Frequently Asked Questions About A.A.</a>

[/sources]

Alcoholics Anonymous & the 12 Steps to Recovery

<h2>What is Recovery?</h2>
Recovery is a lifelong process that starts when you decide to stop abusing alcohol. According to the National Institute on Drug Abuse (NIDA), recovery occurs when people begin to make changes that help improve their health and wellness, choose to live empowered, self-directed lives, and make decisions without the influence of substances that help them reach their full potential.1
People may benefit from viewing addiction similarly to other chronic illnesses like diabetes or high blood pressure. Like these illnesses, addiction is a chronic medical disease that can be <a href="https://alcoholrehab.com/alcohol-treatment/">successfully managed with the proper treatment</a>.2 In recovery, you voluntarily decide that you want to make positive changes to improve your social functioning and overall health.1 When this occurs and you are no longer using alcohol to handle negative feelings and emotions, you are said to be in remission.1
According to a study published by the American Society of Addiction Medicine (ASAM), that surveyed people who have been treated for substance use disorders, there are several key elements for a successful recovery. These include an ability to be honest with yourself, being able to enjoy life without the need to use substances, living a life that contributes to society, your family, or self-improvement, being the kind of person that people can rely on, giving back to the community, and aiming to live a life that is consistent with your beliefs and values through the activities you choose to engage in.3
The Substance Abuse and Mental Health Services Administration (SAMHSA) explains that 4 major areas of your life can help support your recovery efforts. These areas include:4
<ul>
<li>Health: Recovery means that you make decisions that are beneficial for your physical and emotional well-being.</li>
<li>Home: You need a supportive, stable and safe place to live to recover from addiction.</li>
<li>Purpose: You should engage in meaningful activities and have the means to participate in society.</li>
<li>Community: You should have a solid sense of social support and have relationships that provide support, friendship, and love throughout recovery.</li>
</ul>
<h2>Principles of Recovery</h2>
When it comes to the key principles of recovery, the American Psychological Association (APA) outlines the below 10 principles based on the 2004 National Consensus Conference on Mental Health Recovery and Mental Health Systems Transformation:5
<ul>
<li>Self-direction: You are responsible for deciding the best path to your recovery.</li>
<li>Individualized and person-centered: Recovery is based on your specific needs, strengths, background, and goals.</li>
<li>Empowerment: Recovery is designed to provide you with a sense of personal power because you choose the options that are best for you and participate in the decision-making process.</li>
<li>Holistic: Recovery involves all aspects of your life.</li>
<li>Nonlinear: Recovery isn’t a straight line forward but rather a series of steps in the right direction that can also include setbacks and continual growth.</li>
<li>Strengths-based: You focus on and develop your individual strengths in recovery.</li>
<li>Peer support: You rely on the support of others to help you through the recovery process.</li>
<li>Respect: It is important to be accepted by the community and society during recovery.</li>
<li>Responsibility: You take responsibility for your self-care and recovery journey.</li>
<li>Hope: Even though recovery can involve setbacks, you have a positive outlook on the future and believe that you can overcome roadblocks.</li>
</ul>
<h2>Stages of Treatment for Alcoholism</h2>
Recovery is a process that doesn’t just refer to the stage after treatment is completed. It is the entire process that starts when you admit to a problem using addictive substances, recognize the need for help, and continue to work on sobriety throughout your life.
A manual published by NIDA suggests that there are 4 stages of addiction treatment. These stages are only a theoretical model and individuals pass through their own stages of recovery at their own pace.6 Rather than being well-defined stages, the model is meant to be fluid, with each phase overlapping at various times.6 During recovery, individuals may go back and forth as they rework issues from previous phases.6
The 4 stages include:6,7
<ul>
<li>Treatment initiation: This is when you admit the need for help and decide to reach out to your doctor, an addiction professional, or a rehab facility. You may not be sure of how you feel about treatment, but you know that you need to make a change in your life. During this stage, you examine your patterns of alcohol use, the ways <a href="https://alcoholrehab.com/alcoholism/effects/">addiction has negatively affected your life</a>, and the reasons why you want to stop or cut back on your drinking. You may be assisted throughout this process by professionals who know how to guide people through recovery; and you may begin participating in group and individual counseling to address your resistance to treatment, receive education about recovery, and help you get started on the path to abstinence.</li>
<li>Early abstinence: This is the phase when you commit to treatment and decide to stop drinking. It can be a challenging phase because <a href="https://alcoholrehab.com/alcoholism/withdrawal/">you may experience symptoms of withdrawal</a>, which can be unpleasant, uncomfortable, or even dangerous in some cases. Medically supervised detox is often encouraged for cases of severe physical dependence to alcohol. Your doctor or counselor will help determine the level of detox that is appropriate before entering treatment. During early abstinence, you may receive support and counseling to help you deal with triggers and cravings, participate in self-help groups like <a href="https://alcoholrehab.com/alcohol-treatment/12-steps-to-recovery/">Alcoholics Anonymous (AA),</a> and receive ongoing education to help prevent relapse.</li>
<li>Maintaining abstinence: This phase begins after you’ve achieved abstinence and no longer use alcohol. You may continue to work on the underlying issues that led to the addiction, address related psychological issues like anger and codependency, develop improved coping skills, and receive ongoing education, counseling, and support to help you with your new substance-free lifestyle and to prevent relapse.</li>
<li>Advanced recovery: This is a lifelong phase that begins when you’ve completed treatment. Formal counseling may end at some point in this phase, although many people continue to participate in individual therapy or some form of organized aftercare (like 12-step or mutual help groups) to help maintain sobriety.</li>
</ul>
<h2>Rules of Recovery from Alcoholism</h2>
In a paper outlining an expert perspective published in the Yale Journal of Biology and Medicine, the author explains how 5 “rules of recovery” can help a person focus on sustaining recovery in an effort to prevent relapse. Individuals in recovery may find it helpful to incorporate these rules into their life during treatment which include:8
<ul>
<li>Change your life: Recovery involves significant adjustments in one’s life so that it is easier to not use drugs or alcohol to cope with negative thoughts or emotions. You do not change your life just by not using— you need to make changes such as identifying and replacing negative or unhelpful thought patterns and avoiding people, places, and things that make you feel like using.</li>
<li>Be honest: Don’t lie to yourself or others.</li>
<li>Ask for help when you need it: If you need help, it’s not a weakness to admit that to someone you trust. No one can handle everything on their own.</li>
<li>Practice self-care: Taking care of yourself and prioritizing your own needs is crucial to recovery.</li>
<li>Avoid bending the rules: Don’t make exceptions or look for loopholes. This can be a warning sign of relapse.</li>
</ul>
<h2>Does Recovery Mean Total Abstinence?</h2>
While some people believe in a moderation approach to alcohol use, the most effective way to achieve and maintain recovery is to abstain from alcohol all together, especially if you have a moderate to severe addiction.9 NIDA suggests that people in recovery often feel that abstinence is a “cardinal feature” of a recovery lifestyle.1 However, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) suggests that recovery differs per person and that complete abstinence fails to capture the multidimensional and varied paths to recovery.9
One study suggests that the most successful recovery efforts involve abstinence and more failed remission attempts are associated with moderation.10 The results of another study in the journal Addictive Behaviors found that people of all ages who practiced abstinence reported a significantly higher quality of life and showed that sobriety is the best route for long-term recovery.11 

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<h2>Is Alcohol Treatment Really Necessary for Recovery?</h2>
People who are addicted to alcohol cannot typically stop drinking through their own willpower alone. Addiction means that a person has lost control over their drinking and continues to abuse alcohol despite its negative consequences.2 This is where treatment can step in, as it is a beneficial and important component of recovery that teaches people how to live alcohol-free lives.12
Research has shown that one-third of people who receive alcohol addiction treatment have no symptoms a year later, and it also helps many others significantly reduce their alcohol use and have fewer alcohol-related problems.13 Alcohol addiction treatment generally involves a combination of medication, behavioral therapies, and self-help groups like AA.13 
<a href="https://alcoholrehab.com/alcoholism/signs-of-alcoholism/am-an-alcoholic/">If you are concerned about your drinking</a> but you’re not yet sure if you want to enter treatment, consider speaking to a counselor or your primary care physician and have a brief discussion about your drinking habits. This can be a 5- to 10-minute assessment that involves talking about your drinking patterns, receiving advice if you want to reduce the amount you drink, and discussing emotional support networks or treatment options that may help you reach your needs.13 Your doctor can also help formulate a treatment strategy, evaluate your overall health, and determine whether medication may be appropriate for your situation.13,14


[sources]
[1]. National Institute on Drug Abuse. (n.d.). <a href="https://www.drugabuse.gov/drug-topics/recovery">Recovery</a>.
[2]. American Society of Addiction Medicine. (2019). <a href="https://www.asam.org/Quality-Science/definition-of-addiction">Definition of Addiction</a>.
[3]. Lee Ann Kaskutas, Dr.Ph., Thomasina J Borkman, Ph.D., [...], and Jason Bond, Ph.D. (2014). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4211341/#!po=1.92308">Elements That Define Recovery: The Experiential Perspective</a>. Journal of Studies on Alcohol and Drugs, 75(6), 999–1010.
[4]. Substance Abuse and Mental Health Services Administration. (2020). <a href="https://www.samhsa.gov/find-help/recovery">Recovery and recovery support</a>.
[5]. American Psychological Association. (2012). <a href="https://www.apa.org/monitor/2012/01/recovery-principles">Recovery principles</a>.
[6]. Mercer, D. &amp; Woody, G. (1999). <a href="https://archives.drugabuse.gov/sites/default/files/manual3.pdf">Therapy Manuals for Drug Addiction Series: Individual Drug Counseling</a>. U.S. Department of Health and Human Services.
[7]. Center for Substance Abuse Treatment. (2005). <a href="https://www.ncbi.nlm.nih.gov/books/NBK64208/">Substance Abuse Treatment: Group Therapy. (Treatment Improvement Protocol (TIP) Series, No. 41.) 5 Stages of Treatment</a>. Substance Abuse and Mental Health Services Administration.
[8]. Melemis, S. M. (2015). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/">Relapse prevention and the five rules of recovery</a>. The Yale Journal of Biology and Medicine, 88(3), 325–332.
[9]. Katie Witkiewitz, Kevin S. Montes, Frank J. Schwebel, and Jalie A. Tucker, et. al. (2020). <a href="https://arcr.niaaa.nih.gov/recovery-aud/what-recovery">What is Recovery?</a> Alcohol Research, 40(3).
[10]. Laudet, A. B. (2007). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2083562/">What does recovery mean to you? Lessons from the recovery experience for research and practice</a>. Journal of Substance Abuse Treatment, 33(3), 243–256.
[11]. Subbaraman, M. S., &amp; Witbrodt, J. (2014). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164587/">Differences between abstinent and non-abstinent individuals in recovery from alcohol use disorders</a>. Addictive Behaviors, 39(12), 1730–1735.
[12]. National Institute on Drug Abuse. (n.d.). <a href="https://easyread.drugabuse.gov/content/why-does-person-need-treatment">Why does a person need treatment?</a>
[13]. National Institute on Alcohol Abuse and Alcoholism. (2014). <a href="https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help">Treatment for alcohol problems: Finding and getting help</a>.
[14]. NHS. (2018). <a href="https://www.nhs.uk/conditions/alcohol-misuse/treatment/">Treatment: Alcohol misuse</a>.
[/sources]

Stacy Mosel

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