Alcohol Use Disorder

Finding The Right Treatment

Treatment of AUD

Psychotherapy and Medication Management are two broad categories of evidence-based treatment for AUD. After evaluation and consultation with a psychiatrist, nurse, practitioner, or physician’s assistant, a specific treatment plan will be discussed. Treatment is not a one size fits all program. Rather, it should be tailored to the specific needs of the client. Treatment recommendations may be in outpatient or inpatient settings and may include participation in a 12 Step Program.

Treatment goals are best accomplished when there is a sense of connection between the client and the treatment provider, in a supportive clinical atmosphere that is free of judgment and stigma.

Psychotherapy and Behavioral Therapy

Psychotherapy, often referred to as “talk therapy,” has a range of treatment options. By teaming up with a licensed therapist, clients can learn coping strategies and communication skills to help them recover from AUD. There are different kinds of professionals who can provide effective therapy:

• Clinical psychologists (PhD)
• Licensed social workers (LSW)
• Licensed professional counselors (LPC)
• Licensed clinical professional counselors (LCPC)
• Licensed Marriage and Family Therapists (LMFT)

Effective types of psychotherapy have been identified in the treatment of AUD and any co-occurring conditions that may be present:

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) has been well researched and is widely used in the treatment of AUD. CBT focuses on how the distorted ways that we think about ourselves and our lives leads to behavioral choices, including problematic drinking. Challenging old assumptions and beliefs can lead to positive growth and behavioral change. CBT also helps people to identify feelings and situations that may “cue” them to pick up a drink.

Motivational Enhancement Therapy

Motivational Enhancement Therapy is a short-term therapy that was developed specifically for those struggling with addictions or who want to make other lifestyle improvements, such as smoking cessation, improving diet, or getting exercise. The therapy helps people to identify the pros and cons of changing their drinking behavior and to build the skills and self confidence to achieve successful recovery.

12-Step Programs

12-step programs are designed to offer a group environment where it feels safe for the person to accept that their problematic drinking has taken control of their life and to give and receive group support to own their life and take back control of their life from the grip of alcoholism. Alcoholics Anonymous, an organization that has existed since 1935, has claimed many successes through these programs. There are AA groups throughout the United States and the world, and meetings are free of charge. Individuals are encouraged to choose a “sponsor,” who offers support and guidance.

Many people who suffer from AUD report that 12-step programs are an effective addition to professional mental health and addictions treatment.

Mindfulness Therapy

Mindfulness Therapy assists people to prevent relapse by focusing on what is going on for them in the current moment. People can avert alcohol use by learning strategies and relaxation methods to help increase their awareness of what is going on for them in the present moment.

Eye Movement Desensitization and Reprocessing

Research suggests that a history of trauma may fuel the drive to abuse alcohol for some people. Eye Movement Desensitization and Reprocessing (EMDR) is a treatment modality designed to help people process trauma and alleviate distressing memories in the form of flashbacks, nightmares and other symptoms of PTSD, which may contribute to self-medicating with alcohol.

Brief Intervention

Brief Intervention is a type of short term-therapy that offers information about the potential risks of a person’s current pattern of alcohol consumption. It is often provided in a primary care physician's office or an emergency room setting where the alcohol abuse has caused the person to seek medical treatment. Frequently, Brief Intervention may be a stepping stone to more comprehensive treatment.

The decision to start therapy

Many people try to cope with their distress on their own, then feel disappointed when they find that this is very difficult to do. Deciding to start therapy can be hard; it takes courage.

For some people, it can take time to warm up to the idea of sharing one’s intimate thoughts or disclosing details of one’s life, especially for those who grew up in a culture where seeking psychological help was frowned upon.

Psychotherapy is increasingly accepted as not only a way to improve mental health symptoms, but also a means for self exploration and personal growth. No problem is too small for a trained therapist: an individual need not worry that others may have it worse. The willingness to reach out for help is increasing: in 2020, one out of every six Americans (men and women) reported seeing a therapist.

Seeing a therapist with whom one feels comfortable, and a sense of connection, and who also participates in their insurance network, is essential. It may take a couple tries to find a therapist who feels like the right fit. If therapy didn't help the first time around, it can be helpful to give another therapist a try because therapeutic styles vary so much from therapist to therapist.

Where to start

Requesting one’s physician to make a referral is often a good place to start. Many health insurance cards have websites or 1-800 numbers to call for a list of in-network providers.

To find a therapist who takes one's insurance, the National Institute of Mental Health offers a comprehensive list of resources.

Psychology Today also lists therapists by type, location and insurance.

Medication management

Medications can play an important role in the treatment of AUD. The Food and Drug Administration has approved three medications for the treatment of AUD: Naltrexone, Acamprosate, and Disulfiram. These medications are not addictive and play an effective role for some people in their recovery.

Naltrexone is taken as a tablet or an injection that lasts around 30 days. Naltrexone works by blocking the receptors in the brain that induce cravings and interfere with the rewarding feelings of drinking.

Acamprosate is a tablet that is prescribed three times a day. Acamprosate works to restore balance to the neurotransmitters or chemical messengers in the brain and reduce the likelihood of relapse.

Disulfram is a tablet that sets up symptoms of profound nausea and skin flushing when alcohol is in the system. This serves as a deterrent to drinking.

Healthcare providers that can prescribe medications

Psychiatrists, psychiatric nurse practitioners, and physician assistants are practitioners who are trained to diagnose and treat mental health conditions by prescribing medications. Sometimes it's hard to find a psychiatric provider because there are so many people who need them. So, individuals often choose to see a different kind of provider who can prescribe. This could be a doctor they already see, like a primary care doctor, family doctor or OB/GYN, or a new primary doctor.