Alcohol Treatment

Making the Decision To Begin Alcohol Treatment

Accepting the fact that you are an alcoholic may not be easy. But keep in mind that the sooner you get help, the better your chances for a long-term, successful recovery. There is a negative stigma associated with alcoholism in our society, and many fear that they will be socially or professionally disadvantaged if they admit to an alcohol problem. Many alcoholics who need to seek alcohol treatment feel embarrassed and shamed. These are all attitude-based judgments; the reality is that alcoholism is a disease that is no more a sign of weakness than having appendicitis, asthma, or migraine headaches.

Once you have admitted you have a problem with drinking and are ready to seek treatment for alcoholism, it is best to begin with a visit to your health care provider, especially if you have compromised your health from excessive drinking over a long period of time. Your doctor can help you decide whether a medically-based residential treatment center or out-patient program is best for you. The type of treatment you receive will depend on the length and severity of your alcoholism and the types of centers or programs that are available in your community.

Treatment may include

• detoxification (the process of safely getting alcohol out of your system);
• taking doctor-prescribed medications, such as disulfiram (Antabuse®) or naltrexone (ReVia), to help prevent a relapse once drinking has stopped; and
• individual and/or group counseling.

There are many types of counseling approaches that teach alcoholics new behavioral skills to identify situations and feelings that trigger the urge to drink and to find new ways to cope with life that do not include alcohol use. These treatments are often provided on an out-patient basis.

Because the support of family members is crucial to the recovery process, many programs also offer marital counseling and family therapy as part of the treatment process. Programs may also give the recovering alcoholic access to vital community resources, such as legal assistance, job training, childcare, and parenting classes.

Stages of Alcoholism Treatment

Detoxification. This stage involves stopping alcohol consumption. This is very difficult for an alcoholic and requires extreme discipline. It is often performed in an inpatient setting. Alcohol is not available in this setting. The person is treated with the same medications discussed in the treatment of alcohol withdrawal, namely, benzodiazepines. During detoxification the medication is measured carefully to prevent withdrawal and is then gradually tapered off until no withdrawal symptoms are evident. This usually requires a few days to a week. Recently, physician-assisted, outpatient detoxification has become popular. In the current managed health care setting, it is increasingly difficult to obtain coverage for in-hospital detoxification.

Rehabilitation. Short- and long-term residential programs aim to help people who are more severely dependent on alcohol develop skills not to drink, to build a recovery support system, and to work on ways to keep them from relapsing.

• Short-term programs last less than 4 weeks. Longer programs last for a month to a year or more. These are structured programs that provide therapy, education, skills training, and help develop a long-term plan to prevent relapsing.
  
  
• Outpatient counseling (individually, in groups, or with families) can be used as a primary treatment or as a "step-down" for people as they come out of a residential or structured day program.
  
  
• Outpatient counseling can provide education on alcoholism and recovery, can help the person learn skills not to drink, and spot early signs of potential relapse.
  
  
• There are several very effective individual treatments delivered by professional counselors in outpatient treatment clinics. These treatments are Twelve-Step Facilitation Therapy, Motivational Enhancement Therapy, and Cognitive-Behavioral Coping Skills. A well-known self-help program is Alcoholics Anonymous (AA). Other self-help programs (for example, Women for Sobriety, Rational Recovery, and SMART Recovery) allow alcoholics to stop drinking and remain sober on their own.
  
  
• People who deny or minimize their alcohol problem or who don't care about taking action benefit from brief interventions such as Motivational Enhancement Therapy or Motivational Interviewing.
  

Ongoing Treatment and Support. For long-term successful recovery, the alcoholic's work does not end with the treatment program. An ongoing commitment to stay sober is really only possible with support of one's family, friends, and social sphere. Alcoholics Anonymous meetings provide a social support network for recovering alcoholics worldwide. Many recovering alcoholics attend meetings on a regular basis for years after quitting; some for a lifetime. Be aware that AA alone may not be enough. Many recovering alcoholics who are helped by AA usually find that AA works best in combination with other forms of treatment, including counseling and medical care.