Alcohol Use Disorder (AUD) Treatment

What is an alcohol use disorder?

An alcohol use disorder (AUD) is drinking that causes distress and harm. It is a medical condition in which you:

• Drink alcohol compulsively
• Can't control how much you drink
• Feel anxious, irritable, and/or stressed when you are not drinking

An AUD can range from mild to severe, depending on the symptoms. Severe AUD is sometimes called alcoholism or alcohol dependence.

What are the treatments for alcohol use disorder?

Most people with an alcohol use disorder can benefit from some form of treatment. Medical treatments include medicines and behavioral therapies. For many people, using both types gives them the best results. People who are getting treatment for AUD may also find it helpful to go to a support group such as Alcoholics Anonymous (AA). If you have an AUD and a mental illness, it is important to get treatment for both.

Some people may need intensive treatment for AUD. They may go to a residential treatment center for rehabilitation (rehab). Treatment there is highly structured. It usually includes several different kinds of behavioral therapies. It may also include medicines for detox (medical treatment for alcohol withdrawal) and/or for treating the AUD.

Which medicines can treat alcohol use disorder?

Three medicines are approved to treat AUD:

• Disulfiram causes unpleasant symptoms such as nausea and skin flushing whenever you drink alcohol. Knowing that drinking will cause these unpleasant effects may help you stay away from alcohol.
• Naltrexone blocks the receptors in your brain that make you feel good when you drink alcohol. It can also reduce your craving for alcohol. This can help you cut back on your drinking.
• Acamprosate helps you avoid alcohol after you have quit drinking. It works on multiple brain systems to reduce your cravings, especially just after you have quit drinking.

Your health care provider can help you figure out if one of these medicines is right for you. They are not addictive, so you don't have to worry about trading one addiction for another. They are not a cure, but they can help you manage AUD. This is just like taking medicines to manage a chronic disease such as asthma or diabetes.

Which behavioral therapies can treat alcohol use disorder?

Another name for behavioral therapies for AUD is alcohol counseling. It involves working with a health care professional to identify and help change the behaviors that lead to your heavy drinking.:

• Cognitive-behavioral therapy (CBT) helps you identify the feelings and situations that can lead to heavy drinking. It teaches you coping skills, including how to manage stress and how to change the thoughts that cause you to want to drink. You may get CBT one-on-one with a therapist or in small groups.
• Motivational enhancement therapy helps you build and strengthen the motivation to change your drinking behavior. It includes about four sessions over a short period of time. The therapy starts with identifying the pros and cons of seeking treatment. Then you and your therapist work on forming a plan for making changes in your drinking. The next sessions focus on building up your confidence and developing the skills you need to be able to stick to the plan.
• Marital and family counseling includes spouses and other family members. It can help to repair and improve your family relationships. Studies show that strong family support through family therapy may help you to stay away from drinking.
• Brief interventions are short, one-on-one or small-group counseling sessions. It includes one to four sessions. The counselor gives you information about your drinking pattern and potential risks. The counselor works with you to set goals and provide ideas that may help you make a change.

Is treatment for alcohol use disorder effective?

For most people, treatment for an AUD is helpful. But overcoming an alcohol use disorder is an ongoing process, and you may relapse (start drinking again). You should look at relapse as a temporary setback, and keep trying. Many people repeatedly try to cut back or quit drinking, have a setback, then try to quit again. Having a relapse does not mean that you cannot recover. If you do relapse, it is important to return to treatment right away, so you can learn more about your relapse triggers and improve your coping skills. This may help you be more successful the next time.

NIH: National Institute on Alcohol Abuse and Alcoholism