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Treatment Options

Prevention

The nature of treatment depends on the severity of your alcoholism and available resources, and must address both medical issues and rehabilitation. Treatments may be provided in a hospital, a residential treatment setting, or on an outpatient basis.

Treatment Plan

To understand treatment and make the right treatment choices, it helps to have an overview. Treatment is often seen as having four general phases:

Getting started (assessment and evaluation of disease symptoms and accompanying life problems, making treatment choices and developing a plan)

Detoxification (stopping use)

Active treatment (residential treatment or therapeutic communities, intensive and regular outpatient treatment, medications to help with alcohol craving and discourage alcohol use, medications to treat concurrent psychiatric illnesses, 12-step programs, other self-help and mutual-help groups)

Maintaining sobriety and relapse prevention (outpatient treatment as needed, 12-step programs, other self-help and mutual-help groups)

Promising types of counseling and complementary alternative medicine teach people to identify situations and feelings that trigger their urge to drink and to find new ways to cope without using include alcohol use. In addition, because the involvement of family members is important to the recovery, many programs also offer marital counseling and family therapy as part of the treatment process. Some programs also link up individuals with community resources, such as legal assistance, job training, child-care, and parenting classes.

Here are 12 questions to consider when selecting an alcohol or substance abuse treatment or rehabilitation program, according to the Center for Substance Abuse Treatment (USA):
1. Does the program accept your insurance? If not, will they work with you on a payment plan or find other means of support for you?

2. Is the program run by accredited, licensed and/or trained professionals?

3. Is the facility clean, organized and well-run?

4. Does the program encompass the full range of needs of the individual (medical: including infectious diseases; psychological: including co-occurring mental illness; social; vocational; legal; etc.)?

5. Does the treatment program also address sexual orientation and physical disabilities as well as provide age, gender and culturally appropriate treatment services?

6. Is long-term aftercare support and/or guidance encouraged, provided and maintained?

7. Is there ongoing assessment of an individual's treatment plan to ensure it meets changing needs?

8. Does the program employ strategies to engage and keep individuals in longer-term treatment, increasing the likelihood of success?

9. Does the program offer counseling (individual or group) and other behavioral therapies to enhance the individual's ability to function in the family/community?

10. Does the program offer medication as part of the treatment regimen, if appropriate?

11. Is there ongoing monitoring of possible relapse to help guide patients back to abstinence?

12. Are services or referrals offered to family members to ensure they understand addiction and the recovery process to help them support the recovering individual?

Prognosis

Recovery from alcoholism is a life-long process. In fact, people who have suffered from alcoholism are encouraged to refer to themselves ever after as "a recovering alcoholic," never a recovered alcoholic. This is because most researchers in the field believe that, since the potential for alcoholism is still part of the individual's biological and psychological makeup, one can never fully recover from alcoholism. The potential for relapse (returning to illness) is always there, and must be acknowledged and respected. Statistics suggest that, among middle-class alcoholics in stable financial and family situations who have undergone treatment, 60% or more can be successful at an attempt to stop drinking for at least a year, and many for a lifetime.

Drug Therapies

Your provider may prescribe the following medications.

• Tranquilizers called benzodiazepines which are used during the first few days of treatment to help patients safely withdraw from alcohol

• Antipsychotic medications for people who do not respond to benzodiazepines

• Naltrexone, a recently approved medication to help people remain sober. When used in combination with counseling, this medication may lessen the craving for alcohol and help prevent a return to heavy drinking.

• Disulfiram, an older medication, which discourages drinking by causing nausea, vomiting, and other unpleasant physical reactions when alcohol is used

Medications for specific organ damage or for symptoms associated with alcohol withdrawal.

Complementary and Alternative Therapies

A comprehensive treatment plan for alcoholism may include a range of complementary and alternative therapies.

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