Alcohol Addiction Treatment

Alcohol use disorders (AUDs) affect nearly 18 million people in America.¹  There are 11 clinical criteria indicating that alcohol has a negative influence on your life. Some of those criteria include spending an increasing amount of time on alcohol-related behaviors, such as recovering from using alcohol, or experiencing withdrawal symptoms when you stop drinking, such as sleep disturbances, sweating, and anxiety.²

The level of alcohol rehab treatment that is right for you may depend on which symptoms you experience, as well as other factors such as your medical and mental health history.

Medical Detox

Medical detox is a type of alcohol rehab program that gives you around-the-clock medical supervision and care during the initial phase of detox when withdrawal symptoms can range from mild to severe. When you enter medical detox, your doctor can prescribe a wide range of FDA cleared medications to ease the symptoms associated with withdrawal.

By reducing the intensity of or eliminating your cravings and physical discomfort, your care team empowers you to complete your tailored treatment plan, giving you a higher chance of achieving long-term sobriety.³   Medications used in medical detox include:³

• Disulfiram (Antabuse)—Disulfiram triggers unpleasant symptoms if you drink alcohol. Within 10 minutes of consuming alcohol, you may experience nausea, vomiting, and skin flushing. Some individuals find these symptoms to be a valuable deterrent during early recovery.
• Naltrexone (Vivitrol and Revia)—Naltrexone works by inhibiting, or “blocking,” the pleasure and reward receptors in the brain that trigger positive sensations and emotions when you drink. It can also reduce cravings.
• Benzodiazepines—These include Valium and Xanax, and others. Benzodiazepines treat anxiety and panic withdrawal symptoms, as well as seizures.
• Anticonvulsants—If you are at high risk of or have experienced seizures and convulsions during withdrawal, you may be prescribed a non-benzodiazepine anticonvulsant (NBAC).
• Behavioral health medicines—If you have a co-occurring mental health condition or are experiencing intense mental health symptoms during withdrawal, your doctor may prescribe antidepressants, antianxiety medications, antipsychotics, or other short- or long-term behavioral health medication.

If you have trouble sleeping, which is a common withdrawal symptom, your doctor may prescribe medicine to help. If you have headaches, nausea, or any other physical discomfort, you can be treated for those, too.³

Many people in a medical detox program experience significant improvement in their first week. ⁴  However, detox is just the first step in a treatment program that can promote long term recovery. During your program, you can work with mental health professionals to transition into the next level of treatment that addresses the underlying circumstances that affect your addiction.

Inpatient Rehab

After detox, you are typically still vulnerable to relapse. Although alcohol is no longer in your system, you often still have cravings and physical discomfort that can last weeks or months after detox. This is Post Acute Withdrawal Syndrome (PAWS). Medical detox also does not focus on providing you with the tools you need to maintain recovery long-term.⁴

Inpatient rehab, often called residential rehab, provides you with 24-hour care and supervision, evidence based therapy, medication management and education. Inpatient rehab activities teach you early recovery skills, relapse prevention skills, communication skills, and conflict resolution skills. Through individual and group therapies, recovery education, and family therapy, you develop recovery skills to use when you return home.⁴

Rehab programs use a variety of behavioral therapies to help you progress in your recovery. Behavioral therapies include the following:⁵

• Cognitive-behavioral therapy (CBT)—CBT is a form of talk therapy that teaches you how to change negative, inaccurate thinking to view situations realistically so that you can respond to them more effectively.⁵
• Contingency-management therapy (CMT)—CMT is a form of therapy that incentivizes and rewards you for making positive changes and progress.⁵
• Motivational-enhancement therapy—Motivational therapy, including motivational interviewing (MI), helps you recognize how alcohol impacts your life and find personally meaningful motivation for recovery activities.⁵
• 12-step facilitation—12-step facilitation, which may be through an organization like Alcoholics Anonymous (AA), gives you guidelines and principles to overcome your AUD.⁵

Aftercare planning is a crucial part of your rehab program.  It creates a structured plan for ongoing support—such as counseling, support groups, medication management, and relapse prevention strategies—to help maintain recovery after your formal treatment is completed. Aftercare planning may include: ⁶

• Alternative housing, such as a sober living home
• Vocational counseling
• Medical appointments and medication management
• Community support groups
• 12-step groups
• One-on-one, group, and family therapy
• GED or other educational counseling
• Legal assistance

Your aftercare plan may also include stepping down to an intensive outpatient program for continued recovery therapy, education, and support.

Intensive Outpatient Program

When you complete inpatient rehab, you and your counselors determine the type of continued treatment that’s necessary, which can include an intensive outpatient program (IOP).⁷ In some cases, a partial hospitalization program (PHP) may be recommended if your needs are similar to when you were in residential treatment—such as requiring close medical supervision—but you have stable sober housing. PHP is significantly more intensive than IOP.

Transitioning out of a residential or inpatient program often requires an intensive outpatient program or PHP, since it is the first time you are sober in a less structured environment. While in inpatient rehab, you didn’t encounter the people, places, and things that are most likely to trigger a relapse. In an outpatient environment, the restrictions and rules of residential care are not present to provide structure and routine. You may encounter some of the triggers you have not been exposed to since you began treatment.

IOP rehab programs offer several hours of daily support throughout the week and help you create a recovery support plan for the weekend. An IOP often provides 10 hours a week of group and individual therapy, as well as recovery education and family therapy. ⁷ If your doctor has continued your medication, it can be managed through the IOP or transferred to a psychiatrist or your primary care doctor as appropriate.

Eventually, the amount of time you spend in a rehab program will decrease. Because you have spent months learning how to maintain sobriety, you will be more equipped for a successful recovery. Research has shown a correlation between the completion of your rehab treatment plan and positive recovery outcomes.⁵

Choosing a Level of Care

If you enter alcohol addiction treatment on the recommendation of a doctor, psychiatrist, or therapist, they may prescribe a level of care based on their observations. For example, if you enter rehab following a medical emergency in which you exhibit severe withdrawal symptoms, you are likely to be admitted to a medical detox center.

If you choose to enter rehab based on observations of your own AUD symptoms or the concerns of your loved ones, consider the physical and psychological signs for each level of care.

Medical Detox

Medical detox is needed if you experience the following symptoms when you go without alcohol:⁸

• Shaky hands and excessive sweating
• Headaches
• Stomachaches
• Vomiting and/or diarrhea
• Mood swings
• Sleep disturbances
• Delirium tremens, which is characterized by tremors, agitation, confusion, heavy sleep, excitement, delirium, and seizures

Symptoms can develop as early as six hours after your last drink. You may benefit from medical supervision during withdrawal, even if your symptoms are mild to moderate, if your doctor recommends it based on your medical history or if you feel medication may help reduce your risk of relapse.⁸

Inpatient Rehab

Inpatient or residential rehab is needed if you need support and structure to help you build your recovery skills. Indicators that you may benefit from inpatient rehab include that you: ⁹

• Have a co-occurring disorder, such as major depression
• Have completed medical detox before, but experienced a relapse
• Live in a home environment that does not facilitate recovery
• Have not achieved and maintained sobriety in a previous outpatient program
• Need a high level of medical care
• Need continuing medication management following detox
• Are facing legal consequences that caused you to seek alcohol addiction treatment, either because such treatment was court-mandated or because you must maintain sobriety to comply with the conditions of a legal arrangement

IOP

An intensive outpatient program is needed if you have work or family obligations that do not allow you to leave home for inpatient treatment. This program will be a good fit if you do not require medically-supervised detox, but significantly more therapy than weekly counseling sessions. IOP may also be a good treatment option if you need time to continue developing coping skills, working on co-occurring disorders, and building a support system. ¹⁰

Ongoing Support

Because recovery from an AUD is a process and not an endpoint, recovery extends past abstinence and avoiding relapse. Participating in activities to maintain long-term recovery is referred to by some as building “recovery capital,” which is the protective factors that support your progress. Protective factors enhance your motivation to stay sober, improve your coping skills, and expand or enhance the quality of your support systems.¹¹

Recovery capital can be gained through a variety of sober and recovery-focused activities, such as: ¹¹

• Attending 12-step and peer support groups, such as Alcoholics Anonymous (AA) and SMART Recovery
• Exploring mindfulness, spiritual, and religious practices or daily rituals that you find meaningful
• Filling your life with activities that give you a sense of purpose, which could include anything from volunteering to spending time with your children to nurturing your garden
• Expressing yourself creatively
• Practicing self-care, both in practical ways (e.g., good sleep hygiene, joyful movement, checking in with yourself emotionally) and in simply pleasurable ways (e.g., dedicated time for reading, bubble baths, saving up for a special trip)
• Prioritizing your health as it relates to recovery, such as continuing with medication management for co-occurring diagnoses

Are you, or someone you know, trying to figure out which alcohol rehab program is right for you? Do you need help in deciding where to start treatment? We can give you the answers. Call our treatment specialists 24/7 at 800-681-1058 (Sponsored) .

Resources

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3. Center for Substance Abuse Treatment. (2006). Chapter 4 – Physical Detoxification Services for Withdrawal from Specific Substances. Treatment Improvement Protocol (TIP) Series, No. 45. Detoxification and Substance Abuse Treatment. Rockville (M.D.): Substance Abuse and Mental Health Services Administration (U.S.).
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10. McCarty, D., Braude, L., Lyman, D. R., Dougherty, R. H., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014). Substance abuse intensive outpatient programs: assessing the evidence. Psychiatric services (Washington, D.C.), 65(6), 718-726.
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