What are the Options for Treating Alcoholism?

Choosing to seek help for an alcohol use disorder is a decision that must be commended, as accepting that you have a problem and actively making the decision to recover is likely one of the most difficult things you have ever had to do.

Many people find that selecting a treatment option can be overwhelming – between inpatient and outpatient, CBT or DBT, it can be difficult to know where to begin. This article aims to give an overview of the most common treatment options for alcoholism so that you can make an informed decision about your recovery.

What is inpatient treatment for alcoholism?

If an individual has been struggling with an alcohol use disorder on a long-term basis, inpatient treatment may be the safest and most effective method of recovery. This involves living full-time at a rehabilitation centre for the entirety of the treatment programme with regular routines, therapy sessions and healthy activities along with 24/7 medical care available for the duration of the patient’s stay.

This form of treatment is entirely personalised and immersive and therefore can benefit many patients, particularly those who are dealing with a co-occurring mental health disorder and/or poor general health. This allows medical professionals to carefully monitor any symptoms and promptly treat if necessary, allowing the patient to completely focus on recovering from their alcohol use disorder.

An inpatient treatment programme typically lasts for 30, 60 or 90 days and involves complete medical detoxification as well as regular counselling sessions and an effective aftercare programme, with medications prescribed if required.

What is an outpatient treatment for alcoholism?

For many people, removing themselves from their daily life for up to three months is simply not a viable option. A large percentage of people dealing with an alcohol use disorder have full-time employment, schooling and/or families and therefore attending an inpatient facility is not a practical option. In these cases, outpatient treatment is an effective option for recovery.

Outpatient treatment programmes involve a number of meetings that patients can attend around their daily lives and activities. These can involve medically-assisted detoxifications, individual and group counselling sessions or other activities that can assist in their recovery.

If a patient has been struggling with a severe alcohol use disorder then outpatient treatment may not be the most effective option, as they are more suited to individuals with a less severe form of this disorder.

These less-intensive treatment programmes help to make treatment for an alcohol use disorder more accessible for patients with lower incomes and/or responsibilities that may otherwise prevent them from seeking help.

Medically-assisted detoxification for alcoholism treatment

Before tackling the root problems that may have caused the patient to develop an alcohol use disorder, it is first necessary to purge the body of alcohol over a period of time under close medical supervision. This is known as medically-assisted detoxification and can be a dangerous process if not properly managed and monitored.

A medical professional will first assess the patient, taking into account their history of alcohol use as well as any co-occurring mental health conditions and their general health. In the majority of cases, the patient will then be instructed to slowly decrease the amount of alcohol and the frequency of their dosage over a period of time, usually around one week.

This gradual tapering-off method can help to avoid many of the more unpleasant or dangerous side effects that accompany the detoxification process.

Depending on the length and severity of the alcohol addiction, some patients will notice more intense withdrawal effects than others. In extreme cases, they may experience seizures, dehydration and heart failure which can be extremely dangerous or even fatal if the detoxification phase is not closely monitored and assisted by medical professionals. [1]

Potential symptoms of alcohol withdrawal during detoxification:

Visual, auditory or tactile hallucinations
Excessive perspiration
Insomnia and nightmares
Nausea and vomiting
Convulsions
Involuntary tremors
Anxiety and depression
Seizures
Heart failure
Lack of appetite
Extreme mood swings
Agitation and restlessness

Many of the above symptoms can be avoided if the dosage is slowly tapered off, but patients with a long-running/ or more severe addiction will likely experience some side effects. These symptoms will usually begin within 8 hours of the last drink and in the majority of cases will peak and begin to abate within 24 to 72 hours.

Counselling for alcoholism treatment

Counselling can help to address the deeper problems and potential causes behind an alcohol use disorder, giving patients the opportunity to open up and unburden themselves. It can also be a practical exercise, providing practical and mental tools and techniques and allowing them to change any detrimental mindsets while challenging negative beliefs.

It is very difficult to recover from an alcohol use disorder without some form of counselling, and there are a number of types of therapy that have been proven to be extremely effective for people who are struggling with alcohol addiction.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy is a highly effective form of talking therapy that can help to identify detrimental and negative mindsets and behaviours. Working with a trained and experienced therapist, patients will learn healthy coping mechanisms that can allow them to manage unpleasant or distressing emotions and events without turning to alcohol

CBT allows patients to form a more positive mindset while challenging negative behaviours and beliefs, both about the world and one’s self. It may involve role-playing, individual or group sessions and completing specific worksheets and gives patients the necessary mental tools that they can carry with them for the rest of their lives. [2]

Dialectical behavioural therapy (DBT)

Dialectical behavioural therapy involves learning to be content with the present moment instead of worrying about or dwelling on the past or the future. Similarly to CBT, patients will learn healthy coping mechanisms that can allow them to manage their emotions and experiences without turning to alcohol or other substances.

DBT gives patients the tools to change their mindset and ultimately their life, helping them to deal with their emotions and communicate openly and honestly with others. It also can help them to embrace change, with the idea that everything is constantly changing and therefore accepting this fact can allow an individual to experience peace.

Psychotherapy

Psychotherapy is a form of talking therapy in which the patient is encouraged to speak to a therapist about their worries, traumas, emotions and past experiences. The therapist will work to provide a mental health diagnosis and potentially prescribe medication to treat any symptoms.

Speaking about your problems to a non-judgmental and experienced therapist can be a huge relief, and many people describe the sensation as though a burden has been lifted. Your therapist can also help you to understand the reasons why you may have developed an alcohol use disorder and provide advice and guidance on managing cravings and making healthier decisions.

Motivational interviewing

Many people dealing with an alcohol use disorder feel powerless in the face of this substance and their own cravings. As a result, they may be ambivalent about the idea of change simply because they do not believe it is possible, or because they have tried and failed in the past.

Motivational interviewing is a form of therapy that helps the patient to want to make a change, encouraging them to set specific goals and work towards them. It aims to remove the barriers between the patient and recovery, allowing them to develop willpower and determination in order to recover.

Aftercare for alcoholism treatment

Completing a treatment programme is a huge step, but the journey towards recovery must continue even as you step back into daily life and activities and potentially back into temptation.

Before patients leave a rehabilitation centre or treatment programme, they will be encouraged and helped to make an aftercare plan detailing their coping strategies for managing triggers and avoiding relapse. This can include a number of different factors, with the most common and effective listed below.

Ongoing counselling

While the counselling received during treatment is extremely beneficial, it can be even more effective when therapy is continued on an ongoing basis even after the programme has ended. Many people will have years of suppressed trauma and emotions which can take a long time to work through, and even those who feel they are ‘recovered’ from alcoholism may still attend therapy sessions after many years.

Local support groups

The majority of towns, cities and even more remote locations have at least one local support group for people recovering from an alcohol use disorder. These are regular meetings in which people with similar and shared experiences with alcohol can connect and discuss their emotions and struggles.

It can be extremely comforting to know that you are not alone, and it is highly recommended that anyone recovering from alcoholism should attend a regular support group.

12-Step programmes

Similar to local support groups, 12-Step programmes involve meeting regularly and learning from one another’s experiences. The meetings are based around the 12 Steps of Alcoholics Anonymous which involve accepting that you have a problem with alcohol and taking the necessary actions in order to forgive yourself, stop drinking and find inner peace. [3]

There are many strong communities based around these programmes and they can be an effective way to make connections and find social support.

Alumni programmes

Many rehabilitation centres and treatment programmes have an alumni programme, in which past residents can meet regularly and share their experiences and advice on maintaining sobriety over time. They can also engage in positive activities together, potentially reducing feelings of loneliness and isolation which can over time lead to a relapse.