What to Know About Alcohol Abuse Treatment

Alcohol use disorder (AUD) is a chronic, relapsing medical condition that causes someone to drink compulsively despite negative consequences to their life and health. It is sometimes called alcoholism, alcohol dependence, alcohol abuse, or alcohol addiction.

AUD can have serious implications for someone’s physical and mental health. In some cases, it may even be fatal. However, with the right supports in place, AUD is treatable. 

Learn about alcohol abuse treatment options, including counseling, medications, detox, support groups, alternative therapies, and lifestyle changes.

What Is Alcohol Use Disorder?

“Alcohol addiction” and “alcoholism” are not clinical diagnoses. Instead, the "Diagnostic and Statistical Manual of Mental Health Disorders, 5th Edition" (DSM-5) lists diagnostic criteria for the umbrella category of substance use disorder (SUD). AUD is one example of a substance use disorder.

AUD is a complex, chronic medical condition that causes someone to use alcohol compulsively despite adverse effects. It is considered a brain disorder because it involves changes to the parts of the brain that involve reward, pleasure, stress, self-control, and risk-taking.

Statistics on AUD

Alcohol abuse and addiction are extremely common. A 2019 U.S. government survey revealed that: 

• More than 14 million adults ages 18 and over (5.6% of the adult population) had AUD. 
• One in 10 children lived with a parent who had a drinking problem. 
• About 414,000 adolescents between the ages of 12 and 17 had AUD.

Side Effects of Alcohol Abuse

Alcohol abuse can have severe negative consequences for someone’s physical and mental health.

The possible short-term side effects of alcohol abuse include:

• Injuries and accidents
• Violence
• Alcohol poisoning (the percentage of alcohol in your blood is so high that it is toxic and may be deadly)
• Risky sexual behavior
• Changes in mood 
• Problems with sleep
• Disinhibition
• Lowered ability to fight off infections

The long-term health risks of alcohol abuse may include:

• Cancer, including breast cancer, liver cancer, head and neck cancer, esophageal cancer, and colorectal cancer
• Neurological problems and dementia (decline in memory and thinking ability)
• Damage to the liver, kidneys, heart, and pancreas
• Higher likelihood of contracting pneumonia (lung infection) and tuberculosis (a type of infection affecting the lungs and other organs)
• For pregnant people, stillbirths, miscarriages, and fetal alcohol spectrum disorders (FASDs)
  

Who Is At Risk?

While anyone can develop AUD, certain factors put someone more at risk. These may include:

• Environmental factors: Environmental factors, such as early exposure to alcohol, peer pressure, and stress, can contribute to compulsive drinking.
• Genetics: Children with at least one parent with AUD are approximately 2 to 6 times likelier to develop AUD themselves. 
• Effects on the brain: Chronic, excessive alcohol use changes parts of the brain. These neurological changes can lead someone to continue to drink compulsively, even when they understand the harm.
• History of trauma: People with a history of childhood trauma, such as sexual, physical, or emotional abuse, are more at risk of developing AUD as adults.
• Mental health conditions: People with psychiatric conditions such as depression, anxiety disorders, schizophrenia, personality disorders, and mood disorders are more at risk of developing AUD.
  

Signs and Symptoms of AUD

The signs and symptoms of AUD can include changes in someone’s mood, personality, physical appearance, and behavior, such as:

• Sudden change in hobbies, interests, or friends
• Impulsivity and risk-taking behavior
• Breaking laws as a result of using alcohol (i.e., drinking and driving)
• Feeling guilty about alcohol use
• Change in physical appearance
• Frequent hangovers
• Loss of consciousness while drinking

Diagnosis of AUD

A psychotherapist will use the criteria in the DSM-5 to diagnose someone with AUD. These criteria include:

• Amount: Drinking more and more often than intended
• Control: Being or feeling unable to quit using alcohol
• Time: Spending a lot of time drinking or planning to drink
• Cravings: Intense desire to drink
• Obligations: Neglect of obligations at home, work, or school
• Social: Negative effects on relationships
• Activities: Missing out on activities because of drinking
• Hazard: Dangerous behaviors due to drinking
• Harm: Continuing to drink despite negative outcomes
• Tolerance: Needing more alcohol to get the same effect over time
• Withdrawal: Experiencing withdrawal symptoms, such as tremors, headaches, and sweating, when not drinking

According to the DSM-5, someone is considered to have:

• Mild AUD if they meet two or three of the above criteria
• Moderate AUD if they meet four or five of the above criteria
• Severe AUD if they meet six or more of the above criteria
  

Alcohol and Depression

Excessive alcohol use has been linked to several other psychiatric conditions, including depression. 

Some people with depression, anxiety, and mood disorders may use alcohol as a means of “self-medicating” their stress, trauma, or depressive mood. Meanwhile, many people with AUD develop symptoms of depression as their alcohol dependence progresses. 

Other psychiatric conditions that have been linked to AUD include antisocial personality disorder (ASPD) and schizophrenia. Some research suggests that over one-third of people with a schizophrenia diagnosis also meet the criteria for AUD.

Alcohol Abuse Treatment

There are several methods of treating alcohol use disorder. Someone may undergo just one type of treatment or a combination of several on their way to recovery. Talk to your healthcare provider about the individualized plan that works best for you.

Detox

If you have withdrawal symptoms related to AUD, you may need medical detox to avoid serious complications like seizures or dehydration. Short-term detox is available in both outpatient and inpatient medical settings.

Residential Treatment

Depending on the severity of your AUD, you might opt for inpatient treatment in a mental health facility. Residential treatment often involves a mix of intensive one-on-one behavioral therapy and psychotherapy for both AUD and any co-occurring conditions, as well as participation in peer support groups.

In most facilities, medical detox is also available for those who need it.

Alcoholism Medication

Your healthcare provider might prescribe medication to help you limit your alcohol intake or stop drinking. Some medications ease withdrawal symptoms, while others curb cravings or even make it unpleasant to drink. 

The Food and Drug Administration (FDA) has approved three medications aimed at treating AUD symptoms: Vivitrol (naltrexone), Campral (acamprosate), and Antabuse (disulfiram).

Support Groups

Support groups such as 12-step groups (including Alcoholics Anonymous) help people find support and advice in a non-judgmental atmosphere while staying accountable to a group of peers. While some mutual support groups promote abstinence, others are more focused on harm reduction or simply cutting back on drinking.

Individual Therapy

There are a number of individual therapy approaches that can help people with AUD develop better coping skills, reduce stress, and change their relationship to alcohol. 

• Psychotherapy, such as cognitive behavioral therapy (CBT), can help people change the patterns of thinking and behavior that contribute to their compulsive drinking. 
• Behavioral therapy, such as motivational enhancement therapy, aims to build confidence, increase the motivation to change, and devise a step-by-step plan to cut back on or stop drinking.
• Marital and family counseling can help address any relationship or family dynamics (such as enabling behaviors) that might be contributing to someone’s compulsive drinking.
  

Group Therapy

Group therapy can be helpful for people with AUD who want to build a stronger peer support system while receiving qualified care from a mental health and/or behavioral therapist. In group settings, people with AUD may also feel less alone or ashamed about their drinking.

Brief Interventions

Brief interventions, often led by a substance abuse counselor, can help someone with AUD learn about the risks and harms associated with their current drinking patterns. These individualized sessions are often driven by feedback from loved ones in an effort to encourage someone to start more intensive treatment as soon as possible.

Mindfulness and Meditation

Some early research suggests that mindfulness techniques, such as meditation, might help some people cut back on their drinking. Although there is still limited evidence on the role of mindfulness in treating AUD, it is proven to reduce stress. This could help with co-occurring mental health disorders like anxiety and depression.

Coping With Alcohol Use Disorder

In addition to seeking professional treatment, here are some of the ways you can help yourself or a loved one with AUD.

Recognize Triggers

Recognizing your own “triggers” for drinking can be an important step in limiting your alcohol intake. For example, many people who abuse alcohol tend to do so more when they’re under stress, deprived of sleep, dealing with work or relationship problems, or spending time in environments that promote heavy drinking.

If you take stock of what prompts you to start drinking in the first place, you can start to adapt your lifestyle.

Find Support

It’s important to have a strong support system in place as you seek to manage and treat AUD. Reach out to family and friends, join local groups, or look up alcohol-free events in your community to start building a strong network of people who can support you.

When to See a Healthcare Provider

If you think your alcohol use may be a problem, it’s best to seek help right away. You can also ask yourself these questions to reflect on whether your alcohol use is excessive:

• Do you often drink alone or in the morning?
• Do you sometimes drink to “steady your nerves” or deal with stress?
• Do you ever feel annoyed when others criticize your drinking?
• Do you feel guilty about your drinking?
• Do you feel like you drink too much but can’t cut back or stop?
• Do you often feel an intense desire for alcohol?

How to Find Help

If you’re looking for alcohol abuse treatment, here are just a few of the many resources available to you: 

• Talk to your primary healthcare provider. They can refer you to a specialist such as a substance abuse counselor or point you toward other resources, such as detox centers in your area. 
• Call SAMHSA’s National Helpline at 1-800-662-HELP (4357) for free, 24/7, confidential referrals and information in English and Spanish. They also have an online treatment locator.
• Use the online alcohol treatment navigator at the National Institute on Alcohol Abuse and Alcoholism to find treatment near you.
• Contact your state’s Department of Behavioral Health for assistance in finding local resources.
• Reach out to a support group such as Alcoholics Anonymous to attend an in-person or online meeting.

Long-Term Outlook

Unfortunately, many people with AUD do not seek treatment, in part due to stigma and a perceived lack of availability of quality care.

However, evidence-based treatment for AUD is highly effective for many people who do seek help. In fact, about one-third of people who start AUD treatment have no symptoms after a year. Many others can reduce the harm caused by their drinking and reduce their overall alcohol intake.

Summary

Alcohol use disorder (AUD), sometimes called alcohol addiction or alcoholism, is a complex medical condition that causes someone to drink compulsively despite the negative consequences to their life and health.

Alcohol abuse is serious and can even be fatal. However, most people with AUD can benefit from treatment. Alcohol abuse treatments include psychotherapy, medication, detox, group therapy, inpatient treatment, support groups, and mindfulness techniques.

A Word From Verywell

There is no one-size-fits-all treatment for AUD. Instead, talk to your healthcare provider about the treatment that would work best for you. Treatment for AUD can help you avoid relapse and improve your mental and physical health.