Alcohol Help and Treatment: How to Stop Drinking and Start Recovery

Does alcohol treatment work?

There are no easy solutions to alcohol abuse and alcoholism. Relapses often happen, which can be frustrating and discouraging. But does alcohol treatment really work? It can- and does- for many people. There are many types of alcohol treatment for all levels of alcohol use, from attending peer support meetings to staying in a residential treatment facility.

Treatment is more than getting sober

While getting sober from alcohol is an important first step, it is only the beginning of alcohol recovery. Both your body and mind need some time to recover. In this period, depression and cravings to use can be intense and very hard to fight. Without support, relapse is very likely. Like it or not, you will most likely face alcohol again since alcohol use is so common in our society. Good treatment helps you develop new coping skills to deal with stressful situations and pressure to drink socially. Without these skills, stressful situations frequently trigger relapse.

Getting started

Realizing that you have a problem and that you need help is a tremendous first step. You might realize that you are an alcoholic, physically dependent on alcohol. Declining health, a job loss, a lost relationship, or trouble with the law over alcohol might also be a wake up call. Maybe you are concerned about binge drinking, or seem to be turning to alcohol more and more to manage your problems.

The following resources are a good place to start. Remember, the earlier you seek help if you have a drinking problem, the better. It is not a sign of weakness or an inability to “handle your liquor”.

Trusted friend or family. Trusted friends or family might be a good sounding board for concerns about alcohol abuse. Alcohol might be affecting you more than you think, since denial is a key part of alcoholism.
Peer support. Peer support groups like Alcoholics Anonymous (AA) provide a place to share experiences with alcohol abuse and others experiences in alcohol recovery. More information about these groups is below.
Therapy. If you are seeing a therapist, share your intentions with him or her. A therapist can be a good resource and support for alcohol treatment.
Medical professional. If you are an alcoholic, getting sober may cause withdrawal symptoms that require medical intervention. Your primary care doctor can be a good starting reference, and you may want to consider working with an addiction medicine specialist.

Roadblocks to recovery

I don’t have the time or money for alcohol treatment. Take a hard look at the time and money you spend on alcohol and recovering from its effects. It will most likely increase with time. Alcohol treatment is a short term investment to a better life.

I can quit myself. You probably have- many times- and are still drinking. Staying sober without help is extremely difficult. Alcoholism actually creates changes in the brain that reinforce cravings. Withdrawal symptoms test the strongest resolve. Even if you are not yet physically dependent on alcohol, the compulsion to drink can still be very strong without new coping skills.

Beginning alcohol recovery: getting sober

The start to alcohol recovery is getting sober, also called alcohol detox. Alcohol abuse and alcoholism lead to a physical dependence on alcohol. The more you drink, the more you need for the same effect. For example, if you need a drink in the morning to steady your nerves, you’ve built up a dependence on alcohol. During alcohol detox, which lasts roughly 1 to 5 days depending on how much you drink, you may experience withdrawal symptoms as your body adjusts to no alcohol. These symptoms can range from mild to severe depending on your level of drinking and your general health. They include:

Agitation, insomnia, irritability
Headache, nausea, vomiting, loss of appetite
Hand tremors
Increased blood pressure, low grade fever, rapid pulse, heart palpitations
In severe cases, seizures, hallucinations and delusions

Contact your doctor about an initial plan for alcohol detox. You may be prescribed medication to make you more comfortable during the withdrawal process. The plan might include outpatient monitoring, or, depending on the severity of drinking and other health concerns, an inpatient stay at the hospital. If you are considering residential treatment, some facilities allow alcohol detox on site, while others request that you complete the detox process before beginning residential treatment. More information about alcohol treatment programs is below.

Delirium tremens, a medical emergency

Besides being very uncomfortable, stopping alcohol abruptly if you are a heavy drinker can be dangerous. Although uncommon, delirium tremens, a medical emergency, can lead to confusion, seizures, hallucinations and delusions, and can be fatal. If you are heavy drinker, get medically evaluated before stopping alcohol. If you or someone you love is exhibiting any of these symptoms get medical help immediately.

Alcohol rehab programs

There are many types of alcohol treatment programs. When considering a program, remember that everyone’s needs are different. In general, the longer and more intense the alcohol use, the longer and more intense the treatment you may need. Regardless of a program’s length in weeks or months, follow-through and long-term follow-up are crucial to recovery. A quality treatment program should start to address that alcohol abuse often is masking emotional pain, and it needs to be addressed as treatment progresses.

Treating mental illness and alcohol abuse: Dual Diagnosis

Dual diagnosis is when you or a loved one has an alcohol abuse problem and is coping with a mental illness at the same time. Treatment can be a special challenge, especially since alcohol abuse is often an attempt to self-medicate for mental illness symptoms. The most effective treatment addresses both of these problems at once.

See Dual Diagnosis for more information.

An overview of alcohol addiction treatment programs
Residential treatment	Residential treatment involves living at a treatment facility while undergoing intensive treatment during the day. Residential treatment normally varies from 30-90 days.
Partial hospitalization	This relapse prevention treatment program usually meets 3-5 days a week, 4-6 hours/day and is often for people who require medical monitoring on an outpatient basis and have a stable living situation
Intensive Outpatient Program (IOP)	Usually meets at least 3 days a week, 2-4 hours/day or more. These relapse prevention treatment programs are often scheduled around work or school
Counseling (Individual, Group, Couple or Family Therapy)	Works best in conjunction with other types of treatment or as follow up support. Looking at your issues from a different perspective can help to identify the root causes of your alcohol use and can be beneficial in helping you learn how to make more constructive choices in your life.
Sober living	Normally done after an intensive treatment like residential treatment. Sober living facilities are useful if returning home too soon is a strong trigger for relapse or the recovering alcoholic has no home. Sober living homes are comprised of recovering alcoholics and addicts who support each other, and provide an alcohol and drug free environment.
Brief intervention	Only appropriate for those at risk for alcohol abuse or alcoholism. Consists of several visits to a healthcare professional discussing the harmful effects of alcohol abuse and strategies and community resources for cutting down.

Choosing an alcohol treatment program

How do I find a program?

The Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. Department of Health and Human Services offers an extensive listing of licensed, certified drug and alcohol treatment facilities by location through its Substance Abuse Treatment Facility Locator. SAMHSA also operates a helpline: (800) 662-HELP (4357) with help in English and Spanish, or TDD at (800) 487-4889.

Another place to look is your local state substance abuse agency. States often have their own listings, toll-free hotlines, and information about accreditation.

If you are working with a doctor or therapist, you can also ask them about programs in your area; they might be a good starting resource.

What should I look for in an alcohol treatment program?

When you start looking for alcohol treatment, you may see advertisements for programs in tranquil settings with gorgeous views. While amenities like that are nice to have, they also will probably come with a big price tag. Focus on what is truly important; appropriate licensing, quality of care during the program and follow up, and staff credentials. Things to check include:

Program accreditation and licensing. Several national accreditation agencies evaluate detox and aftercare facilities, checking whether they offer effective elements of treatment and a well-documented patient complaint process.
Studies measuring the effectiveness of the program's treatment methods. Treatment effectiveness is a new field of study, but treatment centers should at least have some statistics on their success rates, preferably from an objective external agency.
Type of aftercare program to prevent relapse. Intensive treatment requires follow-up. Programs should offer a well-run aftercare program, with referrals to appropriate self-help groups. It’s important that a staff member collaborate with you to create a discharge plan before you leave the program.

How much does alcohol treatment cost? How will I afford it?

Alcohol treatment costs can vary widely because each individual has different treatment needs and insurance coverage. Is there a hospital or medical facility stay, and for how long? Will there be 30, 60, 90 day residential treatment? Outpatient treatment can vary from almost a full day daily to a few hours weekly. For an idea of costs involved, visit SAMSHA’s Alcohol and Drug Services Study (ADSS) Cost Study.

Check your insurance. If you have insurance, call the number on the back of your medical I.D. card to access your mental health and substance abuse benefits, obtain pre-authorization for services, and learn what out-of-pocket costs will be, including deductible and co-payment amounts.

Check for programs that offer sliding scale or reduced payment options. SAMSHA recommends to check with your local state substance abuse agency for any leads on affordable programs.

What about medication?

There are some medications available that are used to help recovering alcoholics stay sober. Some medications, such as Disulfiram (Antabuse) work by making it very unpleasant to drink. Others, such as Naltrexone, block the brain’s receptors for feeling pleasure, although recent studies have shown it is not effective in all people. However, medications are not a magic pill. Many people can and do stay sober without it. Without coping skills and social support, medications will not be effective. To learn more about medications and their effects, visit the links at the end of this article. Talk to your doctor- preferably an addiction medicine specialist- to learn more about medication options.

Group support programs for alcohol recovery

12–Step Programs

12-step programs, such as Alcoholics Anonymous , are the most common type of group support programs. These free programs, facilitated by peers, use group support and a set of guided principles, the 12 steps, to obtain and maintain sobriety. The treatment recovery steps include admitting powerlessness over the addiction and surrendering to a “higher power,” which you can interpret according to your own beliefs. A key part of a 12-step program is choosing a sponsor. A sponsor is a former alcoholic who has time and experience remaining sober, and can provide guidance and assistance to you. A good sponsor helps you understand and work the 12 steps and is available to provide support if you are feeling the urge to drink.

Are 12 step programs right for me?

Some people have a strong philosophical objection to relying on a higher power. You do not have to believe in an organized religion to benefit from 12-step programs. Some people even interpret the higher power as the support of others who have been there. Remember, peer support is critical in maintaining recovery. If you are strongly opposed to the philosophy or are looking for different support, you can try peer support groups without this component. They are not as numerous as traditional 12 step programs. Groups include SOS (Secular Organizations for Sobriety) and SMART Recovery.

If you have a dual diagnosis and are taking medication for your psychological issues, make sure you find a group where you feel supported in taking care of your psychological issues, including medication. Visit Dual diagnosis for more information.

Maintaining alcohol recovery

Life without alcohol

The road to recovery is not easy. It takes time to readjust. Drinking might have been your way of coping with the many challenges of life, such as social, emotional or financial problems. When you first become sober, those problems come sharply into focus- and can feel overwhelming. Maintaining alcohol recovery includes identifying triggers to drinking, learning more adaptive coping skills, and making better decisions when dealing with life’s challenges.

Stay involved in a support group. Your chances of staying sober improve if you are participating in a social support group like Alcoholics Anonymous, have a sponsor, or are involved in an Intensive Outpatient Program or individual therapy.
Start or maintain healthy lifestyle practices. Basic self care practices are essential to good mental and physical health. Eating right gives you plenty of energy and helps prevent mood swings. Make sure you are getting enough sleep- 7½ to 8 hours a night for most. Exercise releases endorphins and improves your mood.
Continue to work on healthy coping skills. When life stresses occur, having healthy coping skills helps prevent turning to alcohol. Stress management skills go a long way towards preventing relapse. Skills to build healthier emotional awareness help keep you in balance and cope with adversity.
Identify people, places or things that are triggers for you. Building healthier associations is critical in the long run. Surround yourself with positive influences and people who make you feel good about yourself. A good support network can help you in this as well.
Practice how you will handle alcohol in social situations. Although you can avoid some situations, social situations involving alcohol will inevitably come up. You might want to role play with your sponsor or trusted friend or family as to how you will respond.

Managing intense feelings and emotional pain

Feelings that may have been masked by the drugs will resurface, and when they do, you will need to do something different because you won’t have alcohol to fall back on. Building stress management and emotional awareness skills will help you manage these intense times. Although peer groups can provide emotional support, therapy can also provide a solid base to build on if you find the feelings overwhelming. Alcohol use might have been masking an emotional condition such as anxiety or depression as well.

Helping a family member or friend

You might be heaving a sigh of relief if a family member or friend has agreed to alcohol treatment. However, treatment is just the first part to alcohol recovery. You and your family might still be coping with the financial and legal ramifications of alcoholism. Your loved one might feel overwhelmed with now dealing with the day to day aspects of life previously overshadowed with all the energy it took to drink. Feelings of depression and hopelessness are not uncommon.. The best way to help is to educate yourself on the process of recovery, and make sure you get the support you need for yourself as well.

Get support for yourself

Free family peer groups can provide support through all parts of the recovery process, including if there is a painful relapse. A common group is Al-Anon, a support group for families, and Alateen, for teenagers coping with an alcoholic parent. Listening to others with the same challenges can be a tremendous source of comfort and support.

Encourage your family member or friend to build outside support

You might be used to being the sounding board for your loved one’s problems. However, the stronger the network of support your loved one has, the greater the chance for recovery. Some alcohol treatment programs even severely limit contact with family for the first part of the program, so that the person can focus on what recovery means to them and what they will have to do. Even after the initial period of obtaining sobriety, encourage your family member to continue attending meetings and working with a sponsor if they have one.

Expect change to be a little unsettling

As your loved one adjusts to sobriety, you are also adjusting as well. Change can be unsettling, even if it is a positive change. You might end up taking a look at patterns in your life and what you want to change. Don’t be surprised if feelings of resentment or anger bubble up if you have been suppressing them while dealing with your loved one’s alcohol problems. Reach out for support in working through this process.

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