‘I'm An Alcohol Addiction Specialist—This Is the One Type of Treatment I See Work the Most Often’
Excessive alcohol use has been on the rise over the past few years, and much of it was exacerbated by the pandemic. But while there are several effective treatments for alcohol addiction, many people never seek them out and don’t get the help they need.
Nearly 30 million Americans ages 12 and up had alcohol use disorder in 2022, according to the National Institute on Alcohol Abuse and Alcoholism. Alcohol-related deaths jumped during the pandemic, rising 25.5% between 2019 and 2020 alone, after increasing just 2.2% a year over the previous 20 years, according to a study published in JAMA.
There are several reasons why, says Dr. Thomas Kash, Ph.D., director of the Bowles Center for Alcohol Studies at the University of North Carolina. People were stuck at home, and “it was an immensely stressful time for a lot of people,” he says. “A lot of people increase their alcohol consumption in response to stress.”
Women are especially affected by alcohol use complications, and many are drinking more. A recent study published in JAMA Health Forum found that during the first 18 months of the pandemic, women ages 40 to 64 were more likely to experience severe complications from alcohol like withdrawal, liver disease and alcohol-related cardiovascular disease.
Despite the increase in alcohol use and abuse and the complications from it, fewer than 10% of people with alcohol use disorder seek treatment, according to NIAAA. Here’s what you should know about the available and effective treatments.
What Exactly Is Alcohol Use Disorder?
Alcohol use disorder (AUD) is a medical condition where a person can’t stop drinking, even though it negatively affects their health, relationships and daily life, according to NIAAA. People also often refer to the condition as alcohol abuse, alcohol dependence, alcohol addiction and alcoholism.
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Binge drinking (consuming five or more drinks for men and four for women in about two hours) and heavy drinking—five or more drinks a day for men (or 15 or more per week) and four or more a day for women (eight or more a week)—can lead to AUD.
AUD can be mild, moderate or severe. Your risk for the condition is increased by a family history of AUD, trauma or mental health conditions and starting drinking before age 15.
Drinking too much alcohol can harm your health in a number of ways. It can affect your brain, damage your heart, lead to liver and pancreas disease and increase your risk for cancer, according to NIAAA.
Signs You Might Need Treatment for Alcohol Use
Recognizing the signs of excessive alcohol use is crucial for early intervention and treatment, says Dr. Joseph Volpicelli, MD. Ph.D., executive director of the Institute of Addiction Medicine.
The main sign is a lack of control over drinking, he says. Drinking creates the desire to drink more, and the cycle continues, increasing the likelihood that someone will struggle to cut back on alcohol or drink more than intended.
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“This is an important warning sign that one should seek help for excessive alcohol use,” Dr. Volpicelli says.
Experiencing negative health and psychosocial consequences from drinking—but still drinking—should also signal that you might need help, he adds. This might include becoming obsessed with drinking, strained relationships, declining work performance or engaging in risky behaviors.
Another sign is “physiological adaptation,” where you need to drink more alcohol to feel its effects, Dr. Volpicelli says.
“At this point, the desire to drink becomes a physical need to drink to avoid or reduce alcohol withdrawal,” which might include tremors, rapid heart rate, nausea, and anxiety, he explains.
If you’re worried that you (or someone you care about) has AUD, complete the Alcohol Use Disorder Identification Test (AUDIT) online, says Dr. David Streem, MD, Cleveland Clinic Lutheran Hospital's chief of psychiatry and medical director of the Alcohol and Drug Recovery Center. “This is a validated questionnaire that can give you feedback on your drinking habits.”
The Most Effective Alcohol Addiction Treatment
Treatment for AUD is typically individualized based on someone’s needs and preferences and how severe their condition is, Dr. Volpicelli says. It also depends on whether someone will likely experience withdrawal, their potential for relapse, medical conditions and their recovery environment, Dr. Streem says.
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The most effective treatment for AUD for most people involves a combination of group therapy or a support group, such as Alcoholics Anonymous, for one to three months and medication, Dr. Streem says.
“The reason why this combination is most helpful is that the problem is addressed from several different angles—biological, psychological and social/environmental,” he explains.
There are three FDA-approved medications to treat AUD: disulfiram, acamprosate and naltrexone, Dr. Volpicelli says. Each works a little differently but helps people stop or reduce drinking and prevent them from returning to drinking.
Talk therapy, cognitive behavioral therapy and motivational enhancement therapy may also help some people by encouraging them to recognize thought patterns that contribute to drinking, minimize stress and improve motivation, Dr. Volpicelli says.
Some people with more severe AUD may need in-patient addiction treatment, he adds.
“There's no one-size-fits-all for treatment,” Kash says. “What might work for one person, might not work for another person.”
For help finding the right AUD treatment for you, NIAAA has an online Alcohol Treatment Navigator to help. You can also call the Substance Abuse and Mental Health Services Administration hotline: 1-800-662-HELP.
Making Lifestyle Changes Can Enhance Treatment
Sometimes, lifestyle adjustments are recommended along with medication and therapy, Dr. Streem says.
“Humans being social creatures, if you spend time around others who drink alcohol or use drugs, you’re likely to do the same,” he explains. So it’s usually recommended to avoid environments and situations that involve drinking while you’re in recovery.
Stopping drinking can leave a void for some people, and Dr. Volpicelli says finding healthy alternatives, such as hobbies or physical activity, can help some people avoid returning to drinking.
Also, adhering to a healthy diet, getting regular physical activity, managing stress, building a support network, finding new interests and hobbies, setting goals and celebrating milestones can help with AUD recovery, he adds.
“Implementing these lifestyle changes alongside formal treatment can significantly improve the chances of long-term recovery and enhance overall quality of life,” Dr. Volpicelli says.
Next, read about how alcohol and other habits can harm your liver.
Sources:
Thomas Kash, Ph.D., director of the Bowles Center for Alcohol Studies at the University of North Carolina
Joseph Volpicelli, MD, Ph.D., executive director of the Institute of Addiction Medicine
David Streem, MD, Cleveland Clinic Lutheran Hospital's chief of psychiatry and medical director of the Alcohol and Drug Recovery Center
Alcohol Use Disorder (AUD) in the United States: Age Groups and Demographic Characteristics, National Institute on Alcohol Abuse and Alcoholism
High-Acuity Alcohol-Related Complications During the COVID-19 Pandemic, JAMA Health Forum
Drinking Levels Defined, NIAAA
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