For many, taking the first step in seeking help for alcoholism can feel exceedingly overwhelming, especially if you are already feeling alone in your struggle. But the good news is, even at its most severe—with professional treatment and ongoing recovery efforts—this disease may be effectively managed.1 Research has even shown that 1 year later, about 1/3 of people who have completed alcohol addiction treatment have no further symptoms and fewer alcohol-related problems.1
In the U.S., approximately 14.8 million people aged 12 or older had an alcohol use disorder (AUD) in 2018.2 This accounts for 5.4% of the population or about 1 in 19 people.2 Yet, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), only around 6.5% of adults with AUD actually seek treatment.3
Whether it’s for you or someone you love, choosing where to seek treatment, what type of care you need, and what daily life will look like post-treatment can make the process seem even more challenging. However, there are a number of options available for those in need, ranging from medical detox to residential inpatient, partial hospitalization, intensive outpatient, and standard outpatient treatment programs.
AUD may be somewhat different for everyone, and for that reason, a variety of treatment approaches are available to better speak to each person’s individual needs. There is no one-size-fits-all solution, and often, understanding the different options can facilitate the choice.
Levels of Care to Treat Alcoholism
The type of treatment that will be most suitable for you may be determined by several individual factors such as your current alcohol use and corresponding level of physical alcohol dependence, any additional substance use, any previous attempts to quit, and any co-occurring medical and/or mental health conditions. However, regardless of your level of alcohol abuse, seeking the guidance of medical and mental health professionals can promote a better understanding of this chronic disease and help inform the course of treatment that you ultimately select.
Following a period of chronic and/or heavy alcohol use, and in anticipation of treatment, the initial step on the path to recovery commonly involves a detoxification or withdrawal management period. When a person has developed a significant physical dependence on alcohol and they decide to quit drinking, symptoms of alcohol withdrawal may develop.4
As it may be associated with an unpleasant and, in some instances, life-threatening withdrawal syndrome, medical detox is a challenging but necessary element of early alcohol recovery.4 This process allows the body to rid itself of the toxic influence of alcohol while keeping the individual as safe and comfortable as possible. While each detox facility has its own set of specialized plans and protocols, your medical detox plan may include medications, emotional support, nutrition, stress management, and other complementary therapeutic approaches.
Inpatient/residential alcohol treatment centers are able to provide 24-hour rehabilitation and care, while giving patients access to on-call medical and psychiatric services during their stay. Residential facilities vary in amenities and services, but all incorporate a variety of recovery programming such as individual and group counseling, coping skills education, and relapse prevention classes.
Most residential treatment facilities offer 30- to 90-day programs in order to allow patients to focus solely on their recovery without the distractions of their everyday lives. Research indicates that remaining in treatment for an adequate amount of time—based on the severity of addiction and other individual needs—can be critical to recovery.5 Research supports at least 90 days in treatment to optimize treatment outcomes.5
Partial Hospitalization Program (PHP)
A partial hospitalization program (PHP), also known as day programming, provides a relatively intensive level of care but in a slightly more flexible environment than residential inpatient treatment. This level of care allows patients to attend treatment during the day before heading back home when the day is over. In PHP, you’ll check in 5 days a week and will receive 4 hours of group therapy daily.
PHP treatment settings may be most appropriate for those individuals with relatively stable living environments and stronger support networks; eligibility for PHP treatment may be based on a physician’s assessment of a person’s needed level of care. This type of program may not be ideal for those with relatively severe cases of addiction or co-occurring disorders.
Intensive Outpatient Program (IOP)
Intensive outpatient programs (IOPs) focus on disorders or other dependencies that do not necessarily require 24-hour supervision or detoxification. These types of programs still allow patients to continue with their normal lives off-site and require less time weekly in therapies than PHPs. IOPs are designed to provide coping strategies, establish support mechanisms, and help with relapse management.
Although you could initially go through a detoxification phase elsewhere, you could still move into this level of treatment as you progress through your recovery programming. IOPs require that a person’s home environment be alcohol/drug-free and have a safe support system. They are also sometimes utilized after completion of an inpatient program (i.e., step-down treatment) as a way of easing the transition back to an individual’s everyday life.
Outpatient rehabs may operate in a variety of settings, including hospital clinics, counselor’s offices, community mental health clinics, or inpatient/residential rehab facilities.6 Treatment times may be limited to a few hours throughout the week, mostly in the evenings and on weekends.6 Attendance requirements vary by program, with some offering daily sessions and others only meeting 1 to 3 times per week.6
Patients are able to live at home while in treatment, allowing for a level of flexibility that many individuals need to fulfill family or work obligations. Those participating in outpatient treatment would need to have a stable home environment that is alcohol and drug-free.
Behavioral Therapies Used to Treat Alcohol Addiction
Since addiction is usually accompanied by pathological changes in thoughts and actions, treatment plans include behavioral therapies to modify maladaptive behaviors and attitudes related to alcohol abuse. Over the course of treatment, these therapies may be administered though several group and individual counseling sessions. With these types of behavioral interventions, patients learn to better handle triggers and situations that may lead to alcohol use.7
Some of the therapies you may experience include:7
- Cognitive-behavioral therapy: Seeks to help patients better understand how to identify, avoid, and cope with situations that can lead to substance use.8
- Family behavior therapy: Aims to address potential household influences on negative substance use patterns to improve the home environment and overall family functioning. It encourages families to apply beneficial behavioral strategies to everyday life.9
- Contingency management: Focuses on reinforcing positive behavioral change (such as attending counseling sessions or maintaining sobriety (as measured by negative urine tests, etc.) through rewards and special privileges.10
- Motivational enhancement: Helps individuals resolve their uncertainty about treatment and stopping alcohol use.11
- Twelve-step facilitation: Typically delivered in weekly sessions, twelve-step facilitation (TSF) is an active engagement strategy to prepare individuals to become engaged in 12-step programs as social and complementary support to treatments. It is hoped that TSF will encourage their acceptance of addiction as a disease, a surrender to a higher power of their choosing, and active involvement in 12-step meetings and other recovery programs.12
Utilizing Aftercare Programs
Aftercare is an important part of the recovery process that begins once a rehabilitation program has been successfully completed. Once you leave a rehabilitation program, you may face challenges and temptations that can lead to relapse. Aftercare programs are designed to give individuals ongoing assistance and continued support to maintain long-term sobriety.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 84% of treatment facilities offer aftercare services.13 Those that don’t, however, can typically work with you to devise a plan using other outlets prior to program completion.
Aftercare efforts vary but include sober-living arrangements, continued sessions with a therapist, and ongoing participation in peer support groups such as:
- 12-step programs
- Alcoholics Anonymous
- Narcotics Anonymous
- SMART Recovery
- Al-Anon and Nar-Anon
Find Out If Your Insurance Covers Alcohol Rehab
If you’re ready to chat with someone today about treatment, American Addiction Centers’ (AAC) Admissions Navigators are available 24/7 to discuss your options today. Find out if you or your loved one’s insurance covers treatment at an AAC facility by filling out the form below:
. National Institute on Alcohol Abuse and Alcoholism. (2014). Treatment for Alcohol Problems: Finding and Getting Help.
. Substance Abuse and Mental Health Services Administration. (2019). The 2018 National Survey on Drug Use and Health (NSDUH).
. National Institute on Alcohol Abuse and Alcoholism. (2019). Alcohol Facts and Treatment.
. MedlinePlus (2016). Alcohol Withdrawal.
. National Institute on Drug Abuse. (2018). Principles of Effective Treatment. Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).
. Substance Abuse and Mental Health Services Administration. (2008). What Is Substance Abuse Treatment? A Booklet for Families.
. National Institute on Drug Abuse. (2018). Treatment and Recovery. Drugs, Brains, and Behavior: The Science of Addiction.
. National Institute on Drug Abuse. (2018). Cognitive-Behavioral Therapy (Alcohol, Marijuana, Cocaine, Methamphetamine, Nicotine). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Ed.).
. National Institute on Drug Abuse. (2018). Family Behavior Therapy. Principles of Drug Addiction Treatment: A Research-Based Guide (Third Ed.).
. Petry N. M. (2011). Contingency management: what it is and why psychiatrists should want to use it. The psychiatrist, 35(5), 161–163.
. National Institute on Drug Abuse. (2018). Motivational Enhancement Therapy (Alcohol, Marijuana, Nicotine). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Ed.).
. National Institute on Drug Abuse. (2018). 12-Step Facilitation Therapy (Alcohol, Stimulants, Opiates). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Ed.).
. Substance Abuse and Mental Health Services Administration. (2014). The N-SSATS Report: Recovery Services Provided by Substance Abuse Treatment Facilities in the United States.