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Alcohol Use Disorder
by Nicole Mason, DMSc, PA-C, Psychiatry CAQ
June 2, 2024
How To Treat Alcohol Use Disorder
Alcohol use disorder (AUD) is when someone struggles to control their alcohol use, impacting their daily life. Doctors diagnose a chronic drinking problem based on specific criteria, which can range from mild to severe. Chronic alcohol use can be a serious problem with potentially devastating consequences. People with this disorder can get help and improve their condition through different types of intervention.
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​Alcohol use disorder (AUD) is a complex condition with various contributing factors, including genetic, environmental, and psychological elements. If alcohol problems run in your family, you have a higher chance of developing the condition. This is because of a combination of genetic and environmental factors. This means that genetic factors can be influenced by specific environmental factors, increasing the risk.
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Cultural norms regarding alcohol use can influence drinking habits. Peer pressure, family beliefs about alcohol, and community norms influence how much alcohol people drink. Counseling, therapy, and sometimes medication can address this health problem.
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Several factors can increase a person's chance of developing alcoholism. Having easy access to alcohol, especially in adolescence, can increase the chances of alcohol misuse. People with mental health issues like depression, anxiety, bipolar disorder, or trauma may use alcohol to cope. This can be a way for them to try to manage their symptoms and feelings. However, using alcohol as a coping mechanism can lead to further problems.
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If you are having mental health problems, it's best to get help from a professional rather than using alcohol. Some personality traits, like being impulsive, seeking sensation, or taking risks, may increase the chances of misusing alcohol.
Drinking alcohol at a young age, especially as a teenager, raises the risk of developing alcohol use disorder. Stress, financial problems, and life challenges can lead to using alcohol as a way to cope. Experiencing hard times or a rough childhood can increase the chances of someone misusing alcohol or developing AUD. Multiple factors can cause the development of AUD.
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People may have different combinations of risk factors. Not everyone with risk factors will develop drinking problems or need help. Having a strong support system and access to mental health resources can help reduce the risk. Early intervention, education, and addressing contributing factors are crucial components of preventing and treating alcohol use disorder.
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Alcohol addiction can lead to serious problems like health issues, intoxication, overdose, and higher chances of getting sick. It can also lead to strained relationships, financial problems, and legal issues.
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How To Stop Drinking Too Much: Alcohol Use Disorder Treatment Options
Treatment for alcohol use disorder often involves a combination of medication-assisted treatment (MAT), counseling, and support groups. Doctors may use medications like naltrexone, topiramate, and gabapentin to help manage withdrawal symptoms and cravings.
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To avoid alcohol problems, it is important to understand the risks of drinking too much. If drinking starts becoming a problem, seeking help early is crucial. Additionally, it is important to address the underlying reasons why someone may misuse alcohol. Efforts to reduce the stigma associated with seeking help for addiction are also crucial.
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Medications We Use
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Medical Providers use several medications to treat alcohol use disorder (AUD) and help individuals reduce or quit drinking. These medications often target different aspects of the addiction process, including reducing cravings, blocking the rewarding effects of alcohol, and managing withdrawal symptoms. Here are some medications commonly prescribed for the treatment of AUD and their mechanisms of action:
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Naltrexone: Naltrexone is an opioid receptor antagonist, meaning it blocks the effects of opioids. It is believed that it helps reduce the desire for alcohol and the pleasure from drinking by stopping the release of endorphins.
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Acamprosate: Acamprosate is believed to stabilize the balance between excitatory and inhibitory neurotransmitters in the brain, particularly affecting the glutamate system. It may help reduce withdrawal symptoms and cravings in individuals who have stopped drinking.
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Disulfiram: Disulfiram works by inhibiting the enzyme aldehyde dehydrogenase, which is involved in the metabolism of alcohol. When someone taking disulfiram consumes alcohol, it leads to an accumulation of acetaldehyde, causing unpleasant symptoms such as nausea, vomiting, and flushing. This aversive reaction is intended to deter individuals from drinking.
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Topiramate: Topiramate is an anticonvulsant that modulates neurotransmitter activity in the brain. It is thought to reduce alcohol cravings and promote abstinence by affecting various neurotransmitter systems, including GABA and glutamate.
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Baclofen: Baclofen is a muscle relaxant that may also have effects on the GABAergic system in the brain. Some studies suggest that baclofen may help reduce cravings and promote abstinence in individuals with AUD.
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Clonidine: Clonidine is not specifically designed to treat AUD, but it has been used off-label for this purpose. Clonidine is an alpha-2 adrenergic agonist, and it works by stimulating certain receptors (alpha-2 receptors) in the brain. It primarily acts on the central nervous system to reduce sympathetic nervous system activity. This can lead to a decrease in the release of norepinephrine, a neurotransmitter associated with stress and arousal.
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Gabapentin: Gabapentin is an anticonvulsant that modulates the activity of certain neurotransmitters in the brain, particularly gamma-aminobutyric acid (GABA). It is believed to increase the synthesis and release of GABA, an inhibitory neurotransmitter. GABA has calming effects on the brain and can help reduce excitability. Gabapentin is sometimes used off-label to treat alcohol cravings and withdrawal symptoms. By enhancing GABAergic activity, gabapentin may have a calming effect on the central nervous system, reducing the hyperactivity and excitability associated with alcohol withdrawal. This, in turn, may help reduce cravings and improve abstinence.
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Benzodiazepines: They exert their effects by enhancing the activity of gamma-aminobutyric acid (GABA), which is the major inhibitory neurotransmitter in the brain. GABA reduces neuronal excitability and has a calming effect on the central nervous system. Benzodiazepines bind to a specific site on the GABA-A receptor, potentiating the effects of GABA. They are primarily employed to manage the symptoms of alcohol withdrawal from heavy drinking, which can be severe and potentially life-threatening. However, the use of benzodiazepines in AUD treatment is generally short-term and carefully monitored due to the risk of dependence and other adverse effects.
MAT programs commonly use these medications, which combine medication with counseling and therapies to treat alcohol addiction. Which medication you decide to use depends on a person's medical history, the severity of addiction, and the treatment plan. Research has shown that MAT is effective in reducing alcohol use, preventing relapse, and supporting long-term recovery.
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Therapy
Counseling therapy can help you feel better by teaching you how to cope with your thoughts and feelings. These therapies consist of:
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Cognitive behavioral therapy. This therapy can help you deal with depression by teaching skills for managing thoughts, behaviors, and organization.
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Family therapy. Therapy can help people with depression deal with the stress of living with loved ones who don't understand depression.
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Music therapy. This therapy utilizes music to help relax an individual to enhance their mood. Music therapy activates cognitive, motor, and speech centers in the brain to help improve overall functioning.
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Talk therapy. This type of therapy employs a variety of techniques to help a person better deal with thoughts and behaviors.
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Interpersonal therapy. IPT is a type of therapy that focus on personal relationships and how you feel.
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Integrative therapy. This therapy combines different types to create a personalized treatment.
Alcohol Use Disorder Treatment Facilities
Providers can offer treatment for alcohol use disorder at different levels, such as outpatient or inpatient/residential care. The appropriate level of care for someone with AUD varies based on the severity of their condition. It also depends on whether they have other medical or mental health concerns. Additionally, their response to previous treatment is a factor to consider.
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Outpatient Treatment:
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Outpatient Counseling: Individuals attend counseling sessions while living at home. This level of care is suitable for those with mild to moderate AUD who can manage their daily responsibilities. This is the level of treatment facility at Pine Ridge Mental Healthcare.
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Intensive Outpatient Programs (IOP): offer more frequent and structured counseling sessions than traditional outpatient programs. They provide a higher level of support without requiring a residential stay.
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Partial Hospitalization Program (PHP):
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Individuals receive treatment during the day and return home in the evenings. PHPs offer a more intensive level of care than outpatient programs, often involving daily therapeutic activities.
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Residential/Inpatient Treatment:
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Residential Rehabilitation Centers: Individuals live at a facility for a specified period, receiving 24-hour care and a structured treatment program. This is appropriate for individuals with moderate to severe AUD.
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Inpatient Detoxification: For those in acute alcohol withdrawal, inpatient detoxification provides medical supervision to manage withdrawal symptoms safely.
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Medication-Assisted Treatment (MAT) Programs:
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MAT programs combine medications with counseling and support, which you can receive at Pine Ridge Mental Healthcare. Medications such as naltrexone, acamprosate, or disulfiram may be prescribed to help reduce cravings and support recovery.
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Aftercare and Continuing Care:
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After completing a primary treatment program, individuals often participate in aftercare or continuing care programs. These may include outpatient counseling, support groups, and relapse prevention strategies to maintain recovery, which you can also find at Pine Ridge Mental Healthcare.
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Therapeutic Communities:
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Therapeutic communities are long-term residential programs that focus on holistic recovery. Individuals live in a supportive community and participate in various therapeutic activities.
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What kind of treatment someone needs is decided after an assessment by a healthcare professional. This assessment takes into account issues such as amounts of alcohol used, binge drinking, urge to drink, medical conditions, and psychiatric conditions. It also looks at someone's support system and their desires for change. Treatment plans are made to meet the specific needs of each person.
Alcohol Use Disorder Resources
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National Institute on Alcohol Abuse and Alcoholism (NIAAA):
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NIAAA is a part of the National Institutes of Health (NIH). It provides valuable information, research, and resources related to alcohol use and its effects.
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Website: NIAAA
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Alcoholics Anonymous (AA):
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AA is a worldwide program for people to share their experiences and give hope to each. From this, they can support each other in sobriety.
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Website: Alcoholics Anonymous
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SMART Recovery:
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SMART Recovery is a science-based program. It is a self-help program for any type of addictive behavior, including alcohol addiction
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Website: SMART Recovery
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Moderation Management:
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Moderation Management offers support to people who want to make positive changes in their alcohol drinking. This program is for those wanting moderation in drinking or abstinence.
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Website: Moderation Management
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Substance Abuse and Mental Health Services Administration (SAMHSA):
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SAMHSA provides a national helpline offering free, confidential assistance for individuals and families facing substance use disorders, including AUD.
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Helpline: 1-800-662-HELP (4357)
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Website: SAMHSA
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National Council on Alcoholism and Drug Dependence (NCADD):
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NCADD offers information, resources, and support for individuals and families affected by alcoholism and drug dependence.
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Website: NCADD
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Women for Sobriety:
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Women for Sobriety is an organization that provides support for women recovering from alcohol and drug addiction.
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Website: Women for Sobriety
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Rethinking Drinking (NIAAA):
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This online resource from NIAAA provides help for individuals looking to see what their drinking patterns are. From this, they can make better decisions about their alcoholism drinking problems.
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Website: Rethinking Drinking
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Let’s Work Together
Get in touch so we can start working together to get help for alcohol problems.