Alcohol Use Disorder (AUD) can be a struggle, but there are many treatment options available today that will help you recover and get back to living a healthy and fulfilling life. Having a support system and help from a team of medical specialists can help celebrate your successes and work with you through any challenges.
Alcohol-related problems — which result from drinking too much, too fast, or too often — are among the most significant public health issues in the United States.
Many people struggle with controlling their drinking at some time in their lives. Approximately 17 million adults ages 18 and older have an alcohol use disorder (AUD) and 1 in 10 children live in a home with a parent who has a drinking problem.
Does Treatment Work?
The good news is that no matter how severe the problem may seem, most people with an alcohol use disorder can benefit from some form of treatment.
Research shows that about one-third of people who are treated for alcohol problems have no further symptoms 1 year later. Many others substantially reduce their drinking and report fewer alcohol-related problems.
Alcohol use disorder (AUD) is a medical condition that doctors diagnose when a patient’s drinking causes distress or harm. The condition can range from mild to severe and is diagnosed when a patient answers “yes” to two or more of the following questions.
In the past year, have you:
- Had times when you ended up drinking more, or longer than you intended?
- More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
- Spent a lot of time drinking? Or being sick or getting over the aftereffects?
- Experienced craving — a strong need, or urge, to drink?
- Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
- Continued to drink even though it was causing trouble with your family or friends?
- Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
- More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
- Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
- Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
- Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?
If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more urgent the need for change. A health professional can conduct a formal assessment of your symptoms to see if an alcohol use disorder is present.
For an online assessment of your drinking pattern, go to RethinkingDrinking.niaaa.nih.gov.
Options for Treatments
When asked how alcohol problems are treated, people commonly think of 12-step programs or 28-day inpatient rehab, but may have difficulty naming other options. In fact, there are a variety of treatment methods currently available, thanks to significant advances in the field over the past 60 years.
Ultimately, there is no one-size-fits-all solution, and what may work for one person may not be a good fit for someone else. Simply understanding the different options can be an important first step.
Also known as alcohol counseling, behavioral treatments involve working with a health professional to identify and help change the behaviors that lead to heavy drinking.
Behavioral treatments share certain features, which can include:
- Developing the skills needed to stop or reduce drinking
- Helping to build a strong social support system
- Working to set reachable goals
- Coping with or avoiding the triggers that might cause relapse
Types of Behavioral Treatments
- Cognitive–Behavioral Therapy can take place one-on-one with a therapist or in small groups. This form of therapy is focused on identifying the feelings and situations (called “cues”) that lead to heavy drinking and managing stress that can lead to relapse. The goal is to change the thought processes that lead to excessive drinking and to develop the skills necessary to cope with everyday situations that might trigger problem drinking.
- Motivational Enhancement Therapy is conducted over a short period of time to build and strengthen motivation to change drinking behavior. The therapy focuses on identifying the pros and cons of seeking treatment, forming a plan for making changes in one’s drinking, building confidence, and developing the skills needed to stick to the plan.
- Marital and Family Counseling incorporates spouses and other family members in the treatment process and can play an important role in repairing and improving family relationships. Studies show that strong family support through family therapy increases the chances of maintaining abstinence (stopping drinking), compared with patients undergoing individual counseling.
- Brief Interventions are short, one-on-one or small-group counseling sessions that are time limited. The counselor provides information about the individual’s drinking pattern and potential risks. After receiving personalized feedback, the counselor will work with the client to set goals and provide ideas for helping to make a change.
Ultimately, choosing to get treatment may be more important than the approach used, as long as the approach avoids heavy confrontation and incorporates empathy, motivational support, and a focus on changing drinking behavior.
Three medications are currently approved in the United States to help people stop or reduce their drinking and prevent relapse. They are prescribed by a primary care physician or other health professional and may be used alone or in combination with counseling.
Alcoholics Anonymous (AA) and other 12-step programs provide peer support for people quitting or cutting back on their drinking. Combined with treatment led by health professionals, mutual-support groups can offer a valuable added layer of support.
Due to the anonymous nature of mutual-support groups, it is difficult for researchers to determine their success rates compared with those led by health professionals.
The Importance of Persistence
Because an alcohol use disorder can be a chronic relapsing disease, persistence is key. It is rare that someone would go to treatment once and then never drink again. More often, people must repeatedly try to quit or cut back, experience recurrences, learn from them, and then keep trying. For many, continued followup with a treatment provider is critical to overcoming problem drinking.
Relapse Is Part of the Process
Relapse is common among people who overcome alcohol problems. People with drinking problems are most likely to relapse during periods of stress or when exposed to people or places associated with past drinking.
Just as some people with diabetes or asthma may have flare-ups of their disease, a relapse to drinking can be seen as a temporary set-back to full recovery and not a complete failure. Seeking professional help can prevent relapse — behavioral therapies can help people develop skills to avoid and overcome triggers, such as stress, that might lead to drinking. Most people benefit from regular checkups with a treatment provider. Medications also can deter drinking during times when individuals may be at greater risk of relapse (e.g., divorce, death of a family member).
Mental Health Issues and Alcohol Use Disorder
Depression and anxiety often go hand in hand with heavy drinking. Studies show that people who are alcohol dependent are two to three times as likely to suffer from major depression or anxiety over their lifetime. When addressing drinking problems, it’s important to also seek treatment for any accompanying medical and mental health issues.
Caring for a person who has problems with alcohol can be very stressful. It is important that as you try to help your loved one, you find a way to take care of yourself as well. It may help to seek support from others, including friends, family, community, and support groups. If you are developing your own symptoms of depression or anxiety, think about seeking professional help for yourself. Remember that your loved one is ultimately responsible for managing his or her illness.
However, your participation can make a big difference. Based on clinical experience, many health providers believe that support from friends and family members is important in overcoming alcohol problems. But friends and family may feel unsure about how best to provide the support needed. The groups for family and friends listed below under Resources may be a good starting point.
Remember that changing deep habits is hard, takes time, and requires repeated efforts. We usually experience failures along the way, learn from them, and then keep going. Alcohol use disorders are no different. Try to be patient with your loved one. Overcoming this disorder is not easy or quick.
Pay attention to your loved one when he or she is doing better or simply making an effort. Too often we are so angry or discouraged that we take it for granted when things are going better. A word of appreciation or acknowledgement of a success can go a long way.
- Generalized Anxiety Disorder (GAD): When Worry Gets Out of Control: A brochure on GAD that explains the signs, symptoms, and treatment
- Obsessive-Compulsive Disorder: When Unwanted Thoughts Take Over: A brochure on OCD that explains the signs, symptoms, and treatments
- Panic Disorder: When Fear Overwhelms: A brochure on panic disorder that explains the signs, symptoms, and treatments
- Social Anxiety Disorder: More Than Just Shyness: This brochure discusses symptoms, causes, and treatments for social anxiety disorder (also called social phobia).
- Watch: Bullying Exerts Psychological Effects into Adulthood – Once considered a childhood rite of passage, bullying is no longer seen as benign. Its effects linger well into adulthood. Bullies and victims alike are at risk for psychiatric problems such as anxiety, depression, substance abuse, and suicide when they become adults, according to a study partially funded by the NIMH that was published in the April 2013 issue of JAMA Psychiatry.
- See: Multimedia about Anxiety Disorders
- Anxiety Disorders MedlinePlus – also en Español
- Anxiety Disordersgov
- Specific Phobias:S. Department of Veterans Affairs
Research and Statistics
- Join a Study: Adults – Anxiety Disorders
- Join a Study: Children – Anxiety Disorders
- Journal Articles: References and abstracts from MEDLINE/PubMed (National Library of Medicine).
- Statistics: Anxiety Disorder in Adults
- Statistics: Anxiety Disorder in Children
Information courtesy of: National Institute of Mental Health : https://www.nimh.nih.gov/health/topics/index.shtml