Alcoholism or alcohol addiction is a chronic medical condition classified as a brain disorder. Its clinical term is alcohol use disorder or AUD, although these words are often used interchangeably.
The condition is characterized by the compulsive consumption of alcohol. Additionally, patients often feel negative emotions when they aren’t consuming alcohol and may end up acting upon those emotions in a destructive manner. Many who suffer from AUD also don’t have complete control over their use of the substance. In addition, AUD can affect familial relationships, physical health, and social interactions.
Sadly, alcoholism has become the most common form of addiction in the United States. In 2018 alone, more than 14.4 million American adults aged 18 and above were diagnosed with AUD. There were also more than 400,000 American youth aged 12 to 17 who met the criteria to be at-risk of AUD.
Common signs and symptoms of AUD comprise of mostly behavioral changes, although there are also physical indications. These include:
- Inability to stop drinking despite a strong desire to quit
- Drinking even in dangerous or non-ideal situations
- Gradual increase of the “required” amount of alcohol before becoming intoxicated
- Frequent and strong cravings to drink
- Neglecting responsibilities and/or social and recreational activities because of drinking
- Nausea, seizures, tremors and other physical withdrawal symptoms
Staging an Intervention
Being a common addiction, AUD has several treatment options and recovery methods available. These include safe medical detoxification, as well as counseling to help address the reasons behind the addiction.
It should be noted that there is no definite template for curing alcoholism. This means that some methods may work more effectively for some people, depending on several factors. Some of these can include their medical history, living conditions, age, and more. However, medical detoxification is usually the first step in treating severe cases of alcoholism. The key to successful AUD treatment is to first recognize the need for treatment. Once this first hurdle has been overcome, it may be easier for the patient to take the next steps.
From here, you or your loved one may need to check in at an inpatient facility or regularly visit an outpatient facility, depending on the severity of the condition. Afterwards, the patient should receive ongoing care from professionals and support from their friends and family to ensure long-term health and long-lasting sobriety.
Rehab Facilities for People with Alcohol Use Disorder
There are many rehab facilities across the United States that can help people with AUD overcome their addiction. A lot of them are designed for long-term rehabilitation, but there are also those that function more like clinics. To lessen the confusion, we can classify them as either inpatient or outpatient facilities.
Inpatient rehabilitation facilities, sometimes called residential rehab facilities, are those where patients can live for the entire duration of their treatment. They will not be able to leave the facility, except for a few brief periods, although friends and loved ones are definitely encouraged to visit.
Usually, an inpatient treatment program lasts for at least 30 days. Based on the results, the treatment supervisor may recommend further treatments and an extended stay.
Choosing an inpatient rehabilitation facility is the best path to take for those with severe AUD. In fact, it’s highly inadvisable for those with severe AUD to start treatment by themselves outside of a treatment center due to the possible serious health risks. Withdrawal symptoms alone can be difficult to deal with physically, and may also cause emotional distress.
At an inpatient facility, the patient will be closely monitored so that when detoxification begins, withdrawal symptoms can be reduced to tolerable levels. The patient also has immediate access to medications and counseling when needed.
Moreover, inpatient rehab removes as many potential triggers as possible. In addition, it’s extremely difficult to obtain alcohol in an inpatient setting. With these combined, there’s a minimized risk of relapse.
Outpatient rehabilitation can be compared to regular hospital or clinic visits, in that you only need to go to the facility when needed. Often, the patient is required to attend treatment sessions about 2 to 3 times a week, each visit lasting about an hour or so. After this, the patients are then free to go home until their next session.
Often, outpatient rehabilitation is recommended as the first stage of treatment for those with mild cases of AUD. Usually, they are those patients who were able to recognize their symptoms at an early stage (or whose friends or loved ones noticed the warning signs). In this case, the patient can undergo detoxification without experiencing severe withdrawal symptoms and therefore doesn’t need close-in monitoring.
Outpatient rehab can also be prescribed as a second stage of treatment for those who have successfully completed inpatient treatments.
What’s great about outpatient rehabilitation is that they can be designed to accommodate the patient’s routine. For example, if they have a job or attend school during the day, sessions can be scheduled during the evenings.
The main thing about outpatient treatment is that you’re expected to show up for the sessions religiously, including any group meetings and counseling sessions. Essentially, the patients are going to engage in the same activities as an inpatient client without the stay-in component. Attending the sessions will ensure the success of the treatment.
Alcohol Detoxification and Addiction Withdrawal Management
People who are recovering from AUD need to take multiple steps so that they can safely and successfully overcome their addiction to alcoholic substances. One of the first steps that they need to go through is alcohol detoxification. This refers to the body’s natural process of purging the waste products brought about by excessive and prolonged alcohol consumption. During this time, the patient is required to seriously cut back or stop consuming alcohol.
Those who have been drinking heavily for a long time—be it a period of weeks, months, or years—may experience alcohol withdrawal. This condition can be mild to serious, often depending on how much and how long the patient has been consuming alcohol.
Withdrawal symptoms happen because continuous exposure to alcohol changes one’s brain chemistry. To compensate for the sedative effects of alcohol, which is a depressant, the brain ramps up the production of stimulating chemicals like serotonin. As a result, people with AUD can feel overstimulated once they stop drinking. This leads to physical and mental symptoms, the most common of which are:
These symptoms can be felt in as little as 6 hours after the patient last consumed alcohol. In more serious cases, the patient can experience hallucinations within 24 hours or seizures within 2 days of stopping. The symptoms often start to abate after 5 days, though some people can continue to experience alcohol withdrawal for weeks.
Severe cases of alcohol withdrawal can lead to delirium tremens, a serious condition that’s characterized by dehydration, rapid heartbeats, reduced blood flow to the brain, and high blood pressure, among other symptoms.
Delirium tremens only happens to 5% of those who are undergoing alcohol withdrawal, but it can be fatal to 1 of 20 people who suffer from it. This is why it is advised for patients who have experienced intense withdrawal symptoms in the past to detox in a treatment setting where they can access immediate medical attention.
It’s important to note that even patients who are experiencing mild alcohol withdrawal symptoms can benefit from the guidance of an expert. Doctors, therapists, counselors, and other types of professionals who are trained and experienced in dealing with addiction disorders can offer patients medical care and treatment options that are most suited to their particular needs. This, in turn, can provide them with the best chance of successfully completing their treatment program.
Alcohol Addiction Treatment Medications
The good news is that there are medications that have been proven to help patients who are recovering from alcohol use disorder. Medicines can be taken to alleviate the symptoms of alcohol withdrawal. They can also be prescribed to allow the patient to reevaluate their relationship with alcohol and ease psychological changes that can help the person consume considerably less alcohol or stop drinking alcoholic beverages altogether.
Unfortunately, while some of these medications have been approved for use for more than a few decades now, they’re still not widely known to patients. This is because some primary physicians refrain from prescribing these medicines, as many had not been taught to do so during their training. As such, only 10% of the people who can benefit from taking these medications use them as a part of their treatment program.
These are some of the most commonly prescribed medications for patients who are recovering from alcohol use disorder:
Paired with counseling and supportive treatments, acamprosate is a medication that’s used specifically to manage alcohol use disorder. It’s one of the most commonly recommended medications for the treatment of AUD in the United States and in other countries. The mechanism by which the medication affects the brain is not yet fully understood, but studies have shown that it impacts the glutamate and gamma-aminobutyric acid systems.
Acamprosate works by restoring the imbalance in the brain brought about by prolonged alcohol consumption. It does this by decreasing the patient’s craving for alcohol, making it easier for the person to actively lower their alcohol consumption and quit drinking entirely. However, the medication is not used to treat or manage the symptoms of alcohol withdrawal. It’s also not shown to work on patients who continue to drink alcohol or use and abuse other addictive substances.
Compared to other medications, acamprosate has less severe side effects, a fact that contributes to its popular use. By itself, though, it still has a number of potentially serious unwanted effects such as hypersensitivity, diarrhea, insomnia, nausea, renal impairment, irritability, loss of appetite, and extreme feelings of sadness or emptiness.
Acamprosate is a prescribed medication that is only taken after the patient has gone through the initial detox and has stopped drinking alcohol. It often comes in the form of a tablet, which is taken 3 times daily. It can also be taken in conjunction with other medications that are used to address AUD.
A man-made drug that blocks the effects of other narcotics, naltrexone is often used as a component of comprehensive treatment plans for alcohol use disorder as well as opioid use disorder. When used for the treatment of AUD, the medicine works by binding with the endorphin receptors in the body and blocking the effects that one usually experiences due to drinking alcohol. As a result, the patient can find it easier to control their cravings for alcoholic substances. Once the patient stops drinking, taking naltrexone can help them maintain their sobriety.
The medicine is not addictive and it’s not an opiate; it belongs to a class of drugs known as opiate antagonists. This is why it is not recommended for patients who are younger than 18 years of age as well as those who are experiencing other health conditions. Naltrexone is associated with side effects that commonly include nausea, dizziness, vomiting, sleepiness or trouble sleeping, decreased appetite, painful joints, muscle cramps, cold symptoms, and headache.
Typically, naltrexone is administered once the patient is no longer dependent on addictive substances or after completing the detoxification process. It is given in pill form and taken daily for the treatment of AUD, while it’s injected intravenously if used to treat opioid use disorder. Vivitrol is one of the brand names under which naltrexone is sold. This particular brand comes in a liquid solution and is injected to the patient by a medical professional once every 4 weeks.
An alcohol antagonistic drug, disulfiram comes in tablet form and is taken once a day. This medicine works best among patients who have completed the detoxification process and are undergoing appropriate supportive and psychotherapeutic treatments.
Disulfiram works by increasing the patient’s sensitivity to alcohol, leading to highly unpleasant reactions should the patient drink while also taking the medication. Within 10 minutes of consuming alcohol, the patient can experience nausea, headache, vomiting, sweating, weakness, flushing, blurred vision, and confusion, and these reactions can last for more than an hour.
The intensity of an episode depends on the amount of disulfiram and alcohol that the patient has ingested. This experience, in conjunction with counseling and other types of AUD treatments, can help patients control the urge to consume alcohol.
It should be noted that people who take disulfiram should not drink or use products with alcohol within 12 hours of their first dosage, as even just a small amount of alcohol can trigger the unpleasant symptoms. These products include mouthwash, cough syrup, vinegar variants, and sauces. At the same time, the medication can also increase the side effects of caffeine. Patients should also exercise care when consuming coffee or large amounts of chocolate while also taking disulfiram.
Primarily used to treat certain types of seizures, topiramate is an anticonvulsant that decreases abnormal activity in the brain. At the same time, this medication shows promise in managing AUD as a part of a well-rounded treatment program.
While topiramate is not currently approved by the FDA for this specific use, the medication is used in open-label studies to demonstrate how it can help improve drinking behavior and abstinence from alcohol.
There are studies that show that low doses of topiramate can be effective in reducing a patient’s craving for alcohol and abating symptoms of anxiety and depression. It has even been determined to be more effective when taken in conjunction with psychotherapeutic treatment. For these reasons, topiramate is considered as one of the most likely to be approved by the FDA for the treatment of AUD.
The medication comes in tablet form, a capsule that can be sprinkled on food, and a long-acting capsule that’s taken orally. Among the possible side effects of topiramate are drowsiness, dizziness, loss of coordination, loss of appetite, weight loss, diarrhea, and tingling of the hands and feet.
There are limited options when it comes to pharmacological interventions for AUD. In the US, only acamprosate, disulfiram, and naltrexone are approved by the FDA for the treatment of this condition. Many others, such as topiramate, are undergoing further investigation to see how they can be used and incorporated into treatment programs to benefit those with alcohol use disorder.
Benzodiazepines, also known as benzos, refer to man-made drugs that cause mild to severe depression of the nerves and drowsiness. It’s not fully understood how benzodiazepines work, but they are thought to enhance the effects of gamma-aminobutyric acid, a neurotransmitter that reduces the activity of the nerves in the brain. This class of medication is often used to treat illnesses and disorders that are caused by excessive brain activity, such as anxiety and seizures. In addition, benzodiazepines are also used to induce sedation to patients prior to surgery.
When it comes to treating alcohol use disorder, benzodiazepines are used during detoxification to manage severe symptoms of alcohol withdrawal. This class of medicine can be used to treat panic, anxiety, difficulty sleeping, irritability, restlessness, pain, vomiting, chills and sweats, and seizures.
Benzodiazepines come in different forms, as the medicine can be taken orally or injected. There are also several types of benzodiazepines used in AUD treatment settings, such as diazepam, chlordiazepoxide, oxazepam, and lorazepam. However, among the common side effects associated with benzodiazepines are sedation, lightheadedness, drowsiness, confusion, and memory impairment.
All benzodiazepines can cause physical dependence. Using them for a long time can increase tolerance, while stopping abruptly can cause agitation, insomnia, and feeling of loss of self-worth. As such, the dosage for this type of medication must be tapered slowly.
Alcohol Addiction Therapies, Counseling, and Training Sessions
In addition to taking medications to curb their cravings for alcohol, patients who are recovering from AUD also undergo different types of psychosocial interventions and lifestyle changes that will allow them to break free from their destructive habits. As part of the treatment process, the patient and their support system may have to attend one or more of the following activities so that they can maximize their chances of successfully overcoming AUD:
Cognitive Behavioral Therapies
A common type of talk therapy, cognitive behavioral therapy is designed to allow the patient to become more aware of the inaccurate and negative thinking processes that prevent them from effectively responding to challenging situations.
CBT, by itself or combined with other therapies, is used to address a wide range of issues, such as managing symptoms of mental illness, finding ways to cope with stressful situations, overcoming grief, and resolving relationship conflicts. While emotionally uncomfortable at times, CBT sessions come with very few risks. This type of therapy is typically structured by a mental health counselor and can take multiple sessions.
A session can help a patient who is recovering from AUD to identify and change the behaviors that can lead them to drink alcohol excessively. This often involves examining feelings, situations, and other internal and external factors that make it easy for the person to turn to alcohol.
Group and Individual Counseling
Individual counseling refers to one-on-one discussions between a patient and a counselor. This type of activity is designed to allow the patient to explore their feelings, beliefs, behaviors, and other factors that may be affecting their immediate or near-future concerns. The counselor provides a safe, caring, and confidential environment where the patient can better understand themselves and initiate changes that will allow them to pursue the goals they want to achieve.
Group counseling, on the other hand, is often conducted by 1 or more counselors and a group of 3 to 15 patients who share the same concerns. This activity is designed to achieve the same goals as individual counseling, but with the added benefit of social interaction with the members of the group. Through group counseling sessions, the members can learn from each other, give and receive support, and share their thoughts and perspectives.
Individual and group therapy sessions can take place in private practice, mental health clinics, rehabilitation and treatment centers, and hospitals, among other locations.
Health and Nutrition Training
Alcohol use disorder can lead to poor nutrition and take a heavy toll on one’s physical health as well. This, in turn, can cause anxiety, difficulty sleeping, fatigue, dental issues, skin problems, and a long list of other health concerns.
Nutritional therapy offers those who are recovering from AUD a well-balanced approach to rebuilding their physical health. This is done by educating the patient about proper nutrition, changing one’s diet, and using supplements. There are ongoing studies to see exactly how nutrition training can improve a patient’s chances of recovering from AUD. However, it’s apparent that this activity leads to improved mental and physical health, helps improve one’s mood, and reduces stress levels.
There is no single cure for alcohol use disorder. People who are recovering from this condition may require different treatment methods to effectively address all the issues that stem from and cause their unhealthy relationship with alcohol. They may also have to work with experts to come up with an individualized recovery program that meets all their needs and requirements.
Paying for Alcohol Addiction Rehab and Treatment
Medicaid and Medicare are some of the most accessible and commonly used payment methods for AUD treatment and rehabilitation programs in the United States. Medicaid is an insurance program that’s designed to cater to the health and medical needs of low-income families. Patients who are younger than 19 years old and older than 65 years old, parents, pregnant people, and those within a specific income bracket are eligible for this program. Medicare, on the other hand, is available to anyone who is over 65 years of age and those with disabilities. It’s possible for patients to qualify for both programs.
Those who qualify for Medicaid can expect the program to cover all or a portion of the cost of their screening, intervention, detox, maintenance and medication to control cravings, long-term residential care, outpatient visits, family counseling, and other mental health services. Medicare covers hospital stays and inpatient rehabilitation, outpatient care, and the cost of medications.
Patients or their family members can also find financial incentives and discounted options for treatment by checking out managed health care and insurance providers. This group refers to providers and facilities that offer healthcare services to their members at reduced costs. Managed care plans often come in the form of a health maintenance organization (HMO), preferred provider organization (PPO), and point of service (POS).
There are also non-profit centers that specialize in understanding, treating, managing, and preventing substance abuse disorders. These non-profit treatment centers are often funded by the state, faith-based organizations, or 12-step groups. Due to their non-profit status, they can claim exemptions for income and property taxes, and they can also apply for grants. As such, they are capable of offering their services and facilities at a much lower price point compared to their for-profit counterparts.
It’s also not unheard of for family and friends to choose to pool their resources together and ensure that their loved one can access all the help they need to control their alcohol consumption. These concerned people take it upon themselves to stage an intervention and convince the patient to join a rehabilitation program specifically designed for treating AUD. The group can also take it upon themselves to initiate and maintain crowdsourcing and fundraising initiatives so that their loved one can continue their journey to recovery.
Continuing Recovery after Alcohol Addiction Rehab
Recovery is a lifelong process for many people who have and continue to deal with alcohol use disorder, and it does not stop once the patient has completed the program prescribed to them. Patients can continue to seek support and renew their commitment to sobriety by attending programs like Alcoholics Anonymous (AA). Families and friends whose lives have been affected by alcohol use disorder can also seek support by joining groups that cater to people who share similar experiences, like Al-Anon. During meetings, patients and their support groups can receive continuing education about alcohol use disorder, including identifying the different stages of relapse and providing an environment that’s safe from triggers.
The first step is oftentimes the most challenging part in a person’s journey to freedom from AUD. Our team at Better Addiction Care aims to make this step easier for patients and families who want to lead productive and independent lives. This is why we continue to maintain an updated and localized directory of rehab facilities that specialize in treating alcohol use disorder. To get started on your recovery process, simply call (800) 429-7690.
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