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What Alcohol Use Disorder Means
Alcohol use disorder means a person has a problem with alcohol dependence or misuse. The word "disorder" doesn't mean someone can't function normally; it just means they have a diagnosable medical condition. And people who have an AUD are often able to change their behavior and return to normal functioning.
People with alcohol use disorder may have family histories of AUD, be more prone to impulsive behavior, and be at higher risk for having anxiety or depression.
The most common symptoms of alcohol use disorder include:
- Craving
- Loss of control over drinking
- Using alcohol in situations where it is unsafe (such as driving under the influence)
- Continuing to drink despite negative consequences
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Counseling and Behavioral Approaches
Counseling approaches for alcohol problems include:
Individual counseling: A counselor helps an individual identify his or her drinking patterns and the situations in which he or she drinks. The individual develops an understanding of how alcohol affects him or her, as well as the negative consequences of drinking. He or she also identifies ways to resist pressure to drink, cope with stress, and manage cravings.
Group counseling: A counselor may lead a group discussion about drinking patterns, family problems, interpersonal conflicts, work-related issues, and other relevant topics.
Motivational enhancement therapy: Involves identifying the pros and cons of changing behavior; this approach is especially useful for individuals who are not yet motivated to change their drinking habits.
Family counseling: A counselor works with an individual's family members to address alcohol use problems. The goal of family counseling may be to improve communication between family members, to increase understanding of alcohol problems, or to facilitate changes in the family environment that encourage abstinence from alcohol.
Motivational enhancement and cognitive-behavioral work well when combined. The motivational interview helps the counselor understand how ready the client is to make changes.
Cognitive-behavioral therapy, or CBT, may be used in conjunction with motivational enhancement to help the client understand what triggers the need to drink, recognize problems associated with alcohol abuse, and develop skills for coping without using alcohol. This approach is short-term and goal-oriented and teaches clients the skills they need to deal with problem drinking by changing their thinking patterns.
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Medicines
However, you must tell your doctor if you're taking any other medications, because they can interact with each other. If you are pregnant or breastfeeding, talk to your doctor before starting on any medication.
Medicines approved for alcohol use disorder include:
- Acamprosate helps people maintain abstinence from alcohol.
- Disulfiram causes unpleasant effects if a person drinks alcohol while using the medicine. Side effects may include feeling sick to one's stomach; sweating; flushing; headache; thirst; chest pain or tightness; difficulty breathing; palpitations; weakness; blurred vision; confusion; irritability; and trouble sleeping.
- Naltrexone helps to prevent relapse by reducing the urge to drink alcohol. It can be prescribed alone, in combination with counseling, or as a long-acting injection.
Medicines can be useful in treating alcohol use disorder. Other medications may also be helpful in treating co-occurring mental health disorders, such as depression or anxiety.
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Care Levels Across Ohio
County boards plan a continuum that may include one or more of these levels. The range of choices may include:
- Outpatient treatment for less severe alcohol problems.
- Inpatient services that may provide detoxification and withdrawal management, as well as medical attention.
- Residential care where intensive treatment helps stabilize someone with very serious problems and complications.
Residential care may be a good choice for people who:
Have severe alcohol problems, including withdrawal complications or co-occurring health issues.
May lack social support to maintain sobriety in an outpatient setting.
Outpatient, residential, and inpatient options differ across communities throughout Ohio. The continuum of care includes different types of outpatient care, intensive outpatient treatment programs (IOP), partial hospitalization, residential treatment, and medically supervised detoxification as well as services for those at risk of becoming addicted to alcohol.
Many communities may not have a full set of options, so ask about options that are right for your situation when you need treatment.
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Mutual-Help and Peer Groups
Mutual-help groups add peer support alongside medical treatment and other therapies. These programs meet regularly and allow people with alcohol use disorder to share their experiences, gain strength, and offer each other compassion.
The most common mutual help group is Alcoholics Anonymous (AA). AA provides a step-by-step approach that includes a sponsor who offers guidance during recovery. People can also find support groups for family members of alcohol-dependent people.
SMART stands for Self-Management and Recovery Training. SMART offers meetings where attendees can discuss the issues they are having with their addiction. They also offer online support.
Mutual help groups offer support and education to people trying to reduce or stop their use of drugs or alcohol. They are peer-led, and people attend meetings at a local office or center or online.
People who have been successful in recovery can talk to someone who is having a hard time staying sober, and others can share their experiences and problems. The groups also teach skills that help people stay away from alcohol and drugs.
The main types of mutual-help groups include:
- Twelve step programs (AA, NA, CA)
- SMART Recovery
- Women for Sobriety
Peer support is listed among recovery supports that individuals can access at their own discretion. This means that people do not need to be in a treatment program or other type of structured recovery program to attend peer-support groups.
People in all phases of addiction recovery may find peer groups beneficial, but they are particularly useful for people who have completed treatment and want to stay in recovery.
Peer-support organizations are also available for family members and friends of people with substance use disorders. These groups can help families learn how to be more supportive, set healthy boundaries, and develop healthier relationships. Examples include Al-Anon and Nar-Anon.
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Alcohol Use With Mental Health Conditions
Alcohol use often appears together with mental health conditions in people who have an active addiction to alcohol. Some people may drink excessively as a way to self-medicate. While drinking can give temporary relief, it's not effective long term.
Mental health conditions that often co-occur with AUD include:
- Depressive disorders. Depression is a common problem in people with alcohol addiction.
- Trauma- and stress-related disorders. This includes disorders related to traumatic events, such as war or sexual assault.
- Other substance use disorders. If you have a problem with alcohol, you are more likely to abuse other substances like tobacco, marijuana, or prescription drugs.
If you have AUD along with another mental health condition, it is called co-occurring disorder. Co-occurring conditions often require treatment from both a doctor and a therapist.
A full assessment covers mental health as well as other issues, including whether a person is suffering from depression, anxiety, posttraumatic stress disorder (PTSD), bipolar disorder, and so forth. Treatment for AUD should include addressing any co-occurring mental health conditions.
Treatment for AUD can help people change their drinking behavior or stop drinking alcohol completely, depending on the needs of the individual. It includes counseling, medication, support from family and friends, recovery housing, community services, and following up with health care providers and counselors. A person's treatment plan should be developed individually, with the input of the patient as well as that of his or her family members.
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Signs of Quality Treatment
Signs of quality alcohol treatment include:
A focus on the individual's needs.
A range of evidence-based therapies are offered.
Individualized treatment plans based on the person's unique needs and circumstances.
Staff that is trained in providing treatment for AUD.
Family involvement, including education and counseling.
Aftercare and support for ongoing recovery.
The program uses a variety of approaches to provide care to people with a wide range of needs.
Treatment programs are able to quickly enroll new patients into care.
Ask whether a program offers medication and/or behavioral treatments. Behavioral therapies are very important for treating alcohol use disorder. For example, cognitive-behavioral therapy helps people learn how to avoid things that trigger their drinking and how to cope with those triggers when they inevitably encounter them. Motivational enhancement therapy helps people recognize the extent of their drinking problems and involves the patient in planning for change.
A good treatment plan will also take into account other mental health problems, if any, as well as medical and social issues, such as employment status, family situation, and housing.
The treatment provider should explain the complete range of available services, including all counseling and medical options. It is also important that you find out whether the program provides treatment tailored to an individual's age group or gender.
Some programs may offer more than one approach, while others may use only one recognized method. Many treatment centers have special features as well, like group meetings, residential settings, or outpatient services. Ask what methods of care are available at each place you're considering and how they fit with your needs and circumstances.
Ask about the credentials of the staff members who will deliver treatment. The staff should be experienced in working with drug and alcohol problems. They should also have knowledge of other medical or mental health issues that may need to be addressed during treatment.
Some programs may offer more than one type of care, such as a residential program that also includes outpatient care after the person leaves. This kind of care allows for easy transitions between different levels of care.