What Alcohol Use Disorder Means
Alcohol use disorder is a medical condition marked by uncontrolled drinking. The signs are similar to those of other forms of addiction, including compulsive cravings that lead to negative consequences like strained personal relationships or legal issues. When alcohol use becomes problematic, it can cause physical health problems such as liver disease.
Symptoms of alcohol addiction vary from person to person but usually include:
- Drinking more than you intend
- Trying unsuccessfully to cut back on drinking
- Feeling a strong urge to drink or experiencing withdrawal symptoms when not drinking (such as sweating, shaking, nausea)
- Continued use despite knowing that it has caused problems in your life
Alcohol addiction is a disease. It is not caused by a lack of willpower or character; instead, it results from changes in brain chemistry. These changes cause an intense craving for alcohol even when people know they should stop drinking.
People with alcohol use disorder are likely to have other mental health issues such as depression and anxiety disorders which may contribute towards their addiction problem. Other factors that might lead someone down the path towards developing an alcohol addiction include genetics (having a family member who suffers from AUD), environmental influences like peer pressure or having grown up in an alcoholic home, or psychological traits like impulsivity or low self-esteem.
Counseling and Behavioral Approaches
Counseling for alcohol problems often teaches patients how to cope with their drinking urges through skills training that helps them resist the temptation to use. Patients may learn to identify and avoid people, places, things, or thoughts that trigger a desire to drink; they also are encouraged to learn to recognize and handle negative emotions without turning to alcohol.
Counseling also encourages patients to make lifestyle changes, such as developing new habits and interests, avoiding people who use drugs and alcohol, and joining mutual support groups. Other behavioral approaches teach patients how to become aware of their thoughts, feelings, and behaviors so that they can develop more effective ways of coping with problems without using drugs or alcohol.
Patients may be taught skills such as stress management, assertiveness training, problem solving, communication, relaxation techniques, decision making, conflict resolution, and other personal skills. These approaches also help patients identify and change the thoughts that trigger or reinforce their drug use or drinking. For example, a patient in an outpatient program might work with a counselor to develop strategies for coping with cravings and avoiding high-risk situations.
Behavioral therapy helps patients identify the feelings and situations that lead to alcohol use. It teaches them skills to cope with stress and change their thoughts about drinking. It can be done individually or in groups.
Motivational enhancement therapy builds a short plan to change your drinking behavior. It includes just two or three sessions with a counselor.
The first session helps you find the pros and cons of getting help for alcohol problems.
The second session focuses on building up your confidence and teaching skills that can help you stick to your plan.
A third session may be held if needed, depending on what you decide in the first two.
Cognitive-behavioral therapy (CBT) helps you identify how thoughts, feelings, and actions affect drinking behavior. It teaches you new ways of thinking and coping with problems that lead to heavy drinking.
Medicines
Oral naltrexone is a once-daily tablet. Acamprosate must be taken three times daily.
Disulfiram causes unpleasant effects if even small amounts of alcohol are consumed.
Disulfiram should only be used with patients who are motivated to stop drinking and have been able to abstain from drinking for at least 12 hours before starting the medication.
Oral naltrexone is taken once daily, while the injectable form is administered every 4 weeks by a health professional. Naltrexone decreases the craving for alcohol in people who have stopped drinking.
Acamprosate is started after drinking has already stopped.
If a person drinks alcohol while taking disulfiram, he will experience nausea, vomiting, headache, and other unpleasant reactions.
Naltrexone is used primarily to block cravings for alcohol in those individuals who have stopped drinking. Naltrexone may be especially useful as a treatment for individuals with co-occurring opioid dependence and alcohol abuse or dependence, since it blocks opioids.
Care Levels Across Georgia
Across Georgia, ASAM care levels run from outpatient services to intensive inpatient programs with detoxification services.
Care levels for alcohol problems in Georgia include outpatient counseling, residential programs, detoxification, inpatient rehabilitation, partial hospitalization or day programs, and other types of treatment. The level of care needed will depend upon the nature and severity of symptoms and underlying causes.
Alcohol use disorders are often treated with outpatient counseling or therapy. This treatment involves regular office visits for individual or group counseling. Outpatient alcohol addiction treatment programs offer psychotherapy, behavioral therapy, and medication support. An individualized program can be tailored for each client depending on the type of AUD problem, comorbid conditions, and other issues.
Intensive Outpatient (IOP) or Partial Hospitalization Programs (PHP) are both types of intensive care for substance use disorders which include counseling, education, support groups and other therapies. Both IOP and PHP programs offer patients greater flexibility in treatment scheduling than residential facilities.
Residential programs typically offer 24-hour care in a safe and comfortable environment. The level of intensity varies widely among these types of residential treatment settings, from high-intensity hospital-based units to low-intensity group settings.
Community Service Boards across Georgia connect people with alcohol use disorders (AUD) to community services and support.
The Georgia Crisis and Access Line is a statewide crisis telephone line available 24/7 to support people in emotional distress, family members, significant others, or providers. The GCAL helps link callers with local crisis services, such as Mobile Crisis Teams (MCTs) and urgent appointment services.
Someone in Georgia looking for alcohol care may start with their primary care doctor who can do an initial screening and possibly prescribe some treatment. This can be followed by one or more levels of more intense treatment.
Mutual-Help and Peer Groups
Peer meetings such as Alcoholics Anonymous sit alongside more formal counseling or psychotherapy. There are many different groups, each offering its own take on recovery, some using the 12-step approach and others not. You may want to attend a few sessions before deciding whether you would like to make it your primary source of support.
Some mutual-help groups use the traditional 12-step model (such as Alcoholics Anonymous), while others do not. Some follow a nonreligious format; others have a specific religious foundation. There are also some that use techniques derived from research and practice. Examples include Rational Recovery Systems, SMART Recovery, LifeRing Secular Recovery, Women for Sobriety, and Self-Management and Recovery Training (SMART).
Alcoholics Anonymous and other mutual-support groups provide opportunities for people with alcohol problems to share their experiences fighting alcoholism and help each other stay sober. For some people, mutual-help organizations represent their first positive exposure to the recovery community. For others, they provide a valuable connection to sober peers who can understand what it's like to struggle with the disease of addiction.
Alcohol Use With Mental Health Conditions
When alcohol use sits beside another mental health problem, it's called co-occurring disorders, dual diagnosis, or simply "a dual disorder." Treatment for a dual disorder involves treating both the mental illness and alcohol addiction at the same time. That way, each one doesn't affect the other. Treating them together also means that you'll have better odds of long-term recovery.
Treating both alcohol use and a mental health problem requires a coordinated effort of your doctor and mental health care professionals. You may need special treatment because of the unique nature of your condition. Some people get better with therapy, while others do much better with medications. In any case, it is important to have a plan that works for you.
In some cases, your alcohol problem may be the result of self-medication. Self-medicating means using alcohol or drugs to relieve anxiety or depression. Unfortunately, this often leads to addiction because these substances only provide temporary relief. If this is true for you, then addressing both issues will increase your chance of success.
Signs of Quality Treatment
Remaining in treatment for an adequate period matters because clients need time to work through the various stages of recovery. While some people are able to change their attitudes, beliefs and behaviors within a short amount of time, others have to stay in treatment longer than they may have initially anticipated.
The length of stay in treatment depends on many factors, including:
- How long a person has been addicted to alcohol or drugs
- The presence of other disorders and their severity
- A person's motivation to change
- Support system
Some people may be able to reduce their use within a matter of weeks. Others may need several months.
Most individuals benefit from 3 months or more of continuous treatment.
Quality alcohol treatment programs tend to offer the following services in addition to the basics.
The program should also provide counseling for the family members themselves, which is often overlooked.
A variety of addiction treatment services including individual, group, and family therapy; 12-step or non-12-step support groups; educational classes to help clients learn to cope with stress and live a sober lifestyle; relapse prevention training; and aftercare planning.
Continuing care and aftercare services, which often include alumni programs or groups, community referrals, and additional treatment as needed. The facility should also encourage clients to be active in self-help groups such as Alcoholics Anonymous or other 12-step groups that meet regularly in the area.
Behavioral Therapy - Cognitive-behavioral therapy and motivational enhancement therapies are behavioral therapies that help people modify their attitudes and behaviors related to drug abuse. These approaches frequently include both individual and group counseling.
Medications - There are medications available to treat some kinds of addiction. Most medication-assisted treatment programs combine behavioral therapy with medications.
Care Levels - Depending on the severity of your alcohol problem, you may need a lower or higher level of care.