การอดสุรา

ทำไมคุณต้องงดสุรา

การอดสุราให้ผลดีต่อตัวคุณและคนรอบข้างดังนี้

• มีเงินมากขึ้น หากคุณดื่มมากและสามารถอดสุราได้คุณก็จะประหยัดเงินได้มาก
• ไม่มีอาการจากสุรา เช่นเมาค้าง ไม่ปวดศีรษะ ไม่ปวดกระเพาะ
• ทำให้สมาธิดี สมองแจ่มใส
• หลับดีขึ้น ไม่ค่อยอ่อนเพลีย
• ใช้เวลาอย่างคุ้มค่า แทนที่จะเสียเวลาพูดเรื่องไร้สาระ
• ลดอัตราเสี่ยงต่ออุบัติเหตุ
• มีปัญหาขัดแย้งกับครอบครัว เพื่อนน้อยลง
• ลดปัจจัยเสี่ยงต่อความดันโลหิตสูง อ้วน และโรคตับ
• เพศสัมพันธ์ดีขึ้น
• โอกาสที่จะตั้งครรภ์สูงขึ้น
• ถ้าคุณตั้งครรภ์และหยุดสุรา ลูกคุณจะแข็งแรงขึ้น

วิธีการอดสุรา

หากคุณดื่มมากกว่าที่กำหนด คุณควรที่จะลดปริมาณสุราโดยวิธีการดังนี้

ขั้นที่1เมื่อตัดสินใจว่าจะเลิกคุณควรจะตัดสินใจว่าจะเลิกโดยเด็ดขาด หรือลดเท่าที่กำหนด

ขั้นที่2 เลือกวันที่จะอดหรือลดสุรา

ขั้นที่3 วางแผนเลี่ยงสุราโดยการหลีกเลี่ยงปัจจัยที่ทำให้เกิดการดื่มสุรา หากดื่มสุราที่บ้านให้หาเครื่องดื่มอื่นแทนสุรา และห้ามผู้อื่นหยิบสุราให้

ขั้นที่4 วิธีการลดสุรา

• ใช้เครื่องดื่มที่มีส่วนผสมของสุราต่ำ
• ให้ผสมสุราให้เจือจางมากๆ
• ให้ค่อยๆดื่มอย่าดื่มเร็ว
• อย่าดื่มแบบชนแก้วหรือคว่ำแก้ว
• เมื่อคุณดื่มมากไปให้งดสุรา 48 ชั่วโมงเพื่อให้ร่างกายปรับตัว
• ให้รับประทานอาหารก่อนดื่มเพื่อให้ได้รับสารอาหารครบถ้วนและลดการดูดซึมของสุรา
• พยายามจำกัดการดื่มและปฏิบัติตามนั้น
• ให้รางวัลกับตัวเองเมื่อสามารถทำได้

อย่าท้อแม้ว่าครั้งแรกจะไม่ประสบผลสำเร็จ พยายามต่อไปและอาจจะต้องปรึกษาแพทย์

Standing on the Shoulders of Giant Studies on Treatment of Alcohol Use Disorders

A massive study published in 2006 followed more than 1,300 study participants at 11 academic locations over a three-year period to determine what combination of treatment, medication, and counseling was the most effective for treating alcohol abuse disorders.2

The Combining Medications and Behavioral Interventions for Alcohol Dependence (COMBINE) study produced some surprising results when it revealed that one of the newer medications used for the treatment of alcoholism failed to improve treatment outcomes on its own.3

As shown in COMBINE, no single medication or treatment strategy is effective in every case or in every person.

Anti-Alcohol Drugs Revia, Vivitrol and Campral

The study did find that when combined with a structured outpatient medical management intervention consisting of nine brief sessions conducted by a healthcare professional that the alcohol-deterrent medications Revia and Vivitrol (naltrexone) and up to 20 sessions of alcohol counseling were equally effective treatments for alcoholism.2

"These results demonstrate that either naltrexone or specialized alcohol counseling—with structured medical management—is an effective option for treating alcohol dependence," said Mark L. Willenbring, MD, director, division of treatment and recovery research, National Institute of Alcohol Abuse and Alcoholism. "Although medical management is somewhat more intensive than the alcohol dependence interventions offered in most of today's health care settings, it is not unlike other patient care models such as initiating insulin therapy in patients with diabetes mellitus."

The study found that combining another alcohol-deterrent drug Campral (acamprosate) with the medical management program did not improve outcomes. Campral did not perform better than the placebo or dummy pill. This finding stumped researchers since previous studies performed in Europe using Campral had yielded positive treatment outcomes.

COMBINE Study Highlights

After 16 weeks, the COMBINE study showed overall positive outcomes for study participants.3

• All groups studied substantially reduced drinking during treatment. The overall percentage of days absent tripled, from 25 to 73 percent, and alcohol consumption per week decreased from 66 to 13 drinks, a decrease of 80 percent.
• Patients who received medical management plus either Revia or Vivitrol (naltrexone) or specialized counseling showed similarly improved outcomes of alcohol abstinence (80 percent) compared with patients who received medical management and placebo pills (75 percent).
• Patients who received Revia or Vivitrol reported less craving for alcohol.
• Adding either Revia or Vivitrol or specialized alcohol counseling to medical management almost doubled the chance to do well.

Combined Behavioral Intervention for Alcoholism Treatment

Combined behavioral intervention (CBI)— which includes counseling, integrated cognitive-behavioral therapy, motivational enhancement, and techniques to enhance mutual help group participation—has shown beneficial outcomes in studies.4 

The Use of Medication in Treating Alcohol Use Disorders

According to research, medications seem to be a positive part of the most effective combination for treatment for alcohol use disorders. And, it is underused as a method for treating alcoholism.5

"The most robust finding in the study is that those receiving any medication did much better than those who received no pills at all," says Professor Barbara Mason, Scripps Research Institute, and an author of the study. "This should be a wake-up call. With less than one percent of those seeking help for alcohol dependence receiving a prescription, medication is underutilized. Medication for alcoholism can offer patients an advantage for their recovery, especially in a real-world setting."

The Sinclair Method

In 2001, David Sinclair, Ph.D., a researcher in Finland claimed an 80 percent cure rate for alcohol dependence when anti-alcohol drugs Revia or Vivitrol are prescribed according to his Sinclair Method. Dr. Sinclair's research has been published in the peer-reviewed journals Alcohol and Alcoholism and the Journal of Clinical Psychopharmacology.6 The Sinclair Method is the standard treatment protocol for alcohol dependence in Finland, the method is also used in the U.K., but the method has yet to catch on in the United States. 

With the Sinclair Method, people only take Revia or Vivitrol before drinking and never otherwise.7 Revia and Vivitrol are not like other anti-alcohol drugs that cause intense sickness and hangover sensations when taken with alcohol. The change in behavior only appears over time. With the Sinclair Method, Revia or Vivitrol is taken one hour before drinking alcohol. At the end of four to six months of treatment with the Sinclair Method, 80 percent of people who had been overusing alcohol were either drinking moderately or abstaining entirely.7

The way this process works is when people normally drink alcohol, endorphins are released into the brain, and this reinforces the behavior of drinking alcohol. Revia and Vivitrol block the feel-good endorphins. Much like when Pavlov's dogs were presented with food when a bell was rung, these dogs became conditioned to salivate at the sound of the bell alone. However, when these dogs continued to be presented with the ringing bell and no food, the salivating stopped.

It is believed that the main reason the Sinclair Method has not caught on in the U.S. is two-fold. In the U.S., 12-step programs based on abstinence seem to dominate treatment plans prescribed by doctors, and doctors do not like that the Sinclair Method encourages people with alcohol dependency problems to continue drinking.4

Overcoming Alcohol Addiction

Are you ready to quit drinking or cut down to healthier levels? These tips can help you get started on the road to recovery.

How do I stop drinking?

Overcoming an addiction to alcohol can be a long and bumpy road. At times, it may even feel impossible. But it’s not. If you’re ready to stop drinking and willing to get the support you need, you can recover from alcoholism and alcohol abuse—no matter how heavy your drinking or how powerless you feel. And you don’t have to wait until you hit rock bottom; you can make a change at any time. Whether you want to quit drinking altogether or cut down to healthier levels, these guidelines can help you get started on the road to recovery today.

Most people with alcohol problems do not decide to make a big change out of the blue or transform their drinking habits overnight. Recovery is usually a more gradual process. In the early stages of change, denial is a huge obstacle. Even after admitting you have a drinking problem, you may make excuses and drag your feet. It’s important to acknowledge your ambivalence about stopping drinking. If you’re not sure if you’re ready to change or you’re struggling with the decision, it can help to think about the costs and benefits of each choice.

Evaluating the costs and benefits of drinking

Make a table like the one below, weighing the costs and benefits of drinking to the costs and benefits of quitting.

Set goals and prepare for change

Once you’ve made the decision to change, the next step is establishing clear drinking goals. The more specific, realistic, and clear your goals, the better.

Example #1: My drinking goal

• I will stop drinking alcohol.
• My quit date is __________.

Example #2: My drinking goal

• I will stop drinking on weekdays, starting as of __________.
• I will limit my Saturday and Sunday drinking to no more than three drinks per day or five drinks per weekend.
• After three months, I will cut back my weekend drinking even more to a maximum of two drinks per day and three drinks per weekend.

Do you want to stop drinking altogether or just cut back? If your goal is to reduce your drinking, decide which days you will drink alcohol and how many drinks you will allow yourself per day. Try to commit to at least two days each week when you won’t drink at all.

When do you want to stop drinking or start drinking less? Tomorrow? In a week? Next month? Within six months? If you’re trying to stop drinking, set a specific quit date.

How to accomplish your goals

After you’ve set your goals to either stop or cut back your drinking, write down some ideas on how you can help yourself accomplish these goals. For example:

Get rid of temptations. Remove all alcohol, barware, and other alcohol-related paraphernalia from your home and office.

Announce your goal. Let friends, family members, and co-workers know that you’re trying to stop or cut back on drinking. If they drink, ask them to support your recovery by not doing so in front of you.

Be upfront about your new limits. Make it clear that drinking will not be allowed in your home and that you may not be able to attend events where alcohol is being served.

Avoid bad influences. Distance yourself from people who don’t support your efforts to stop drinking or respect the limits you’ve set. This may mean giving up certain friends and social connections.

Learn from the past. Reflect on previous attempts to stop or reduce your drinking. What worked? What didn’t? What can you do differently this time to avoid pitfalls?

Cutting back vs. quitting alcohol altogether

Whether or not you can successfully cut back on your drinking depends on the severity of your drinking problem. If you’re an alcoholic—which, by definition, means you aren’t able to control your drinking—it’s best to try to stop drinking entirely. But if you’re not ready to take that step, or if you don’t have an alcohol abuse problem but want to cut back for personal or health reasons, the following tips can help:

Set your drinking goal. Choose a limit for how much you’ll drink, but make sure your limit is not more than one drink a day if you’re a woman, two drinks a day if you’re a man—and try to have some days each week when you won’t drink alcohol at all. Write your drinking goal down and keep it where you will frequently see it, such as on your phone or taped to your refrigerator.

Keep a record of your drinking to help you reach your goal. For 3 to 4 weeks, write down every time you have a drink and how much you drink. Reviewing the results, you may be surprised at your weekly drinking habits.

Cut down drinking at home. Try to limit or remove alcohol from your home. It’s much easier to avoid drinking if you don’t keep temptations around.

Drink slower. When you drink, sip slowly and take a break of 30 minutes or one hour between drinks. Or drink soda, water, or juice between alcoholic drinks. Drinking on an empty stomach is never a good idea, so make sure you eat food when you drink.

Schedule one or two alcohol-free days each week. Then, try to stop drinking for one week. Make a note about how you feel physically and mentally on these days—recognizing the benefits may help you to cut down for good.

Alcohol addiction treatment options

Some people are able to stop drinking on their own or with the help of a 12-step program or other support group (see the Get more help section below for links). Others need medical supervision in order to withdraw from alcohol safely and comfortably. Which option is best for you depends on how much you’ve been drinking, how long you’ve had a problem, the stability of your living situation, and other health issues you may have.

The first step is often to consult your primary care doctor or GP. Your doctor can evaluate your drinking patterns, diagnose any co-occurring disorders, assess your overall health, and offer treatment referrals. They may even be able to prescribe medication to help you quit.

Tips for finding the best addiction treatment

There’s no magic bullet or single treatment that works for everyone. Everyone’s needs are different, so it’s important that you find a program that feels right to you. Any alcohol addiction treatment program should be customized to your unique problems and situation.

Treatment doesn’t have to be limited to doctors and psychologists. Many clergy members, social workers, and counselors also offer addiction treatment services.

Treatment should address more than just your alcohol abuse. Addiction affects your whole life, including your relationships, career, health, and psychological well-being. Treatment success depends on examining the way alcohol abuse has impacted you and developing a new way of living.

Commitment and follow-through are key. Recovering from alcohol addiction or heavy drinking is not a quick and easy process. In general, the longer and more intense the alcohol use, the longer and more intense the treatment you’ll need. But regardless of the treatment program’s length in weeks or months, long-term follow-up care is crucial to your recovery.

Get treatment for other medical or mental health issues. People often abuse alcohol to ease the symptoms of an undiagnosed mental health problem, such as depression or anxiety. As you seek help for alcohol addiction, it’s also important to get treatment for any other psychological issues you’re experiencing. Your best chance of recovery is by getting combined mental health and addiction treatment from the same treatment provider or team.

Withdrawing from alcohol safely

When you drink heavily and frequently, your body becomes physically dependent on alcohol and goes through withdrawal if you suddenly stop drinking. The symptoms of alcohol withdrawal range from mild to severe, and include:

• Headache
• Shaking
• Sweating
• Nausea or vomiting
• Anxiety and restlessness
• Stomach cramps and diarrhea
• Trouble sleeping or concentrating
• Elevated heart rate and blood pressure

Alcohol withdrawal symptoms usually start within hours after you stop drinking, peak in a day or two, and improve within five days. But in some alcoholics, withdrawal is not just unpleasant—it can be life threatening.

If you’re a long-term, heavy drinker, you may need medically supervised detoxification. Detox can be done on an outpatient basis or in a hospital or alcohol treatment facility, where you may be prescribed medication to prevent medical complications and relieve withdrawal symptoms. Talk to your doctor or an addiction specialist to learn more.

Get support

Whether you choose to tackle your alcohol addiction by going to rehab, getting therapy, or taking a self-directed treatment approach, support is essential. Don’t try to go it alone. Recovering from alcohol addiction or abuse is much easier when you have people you can lean on for encouragement, comfort, and guidance.

Support can come from family members, friends, counselors, other recovering alcoholics, your healthcare providers, and people from your faith community.

Lean on close friends and family – Having the support of friends and family members is an invaluable asset in recovery. If you’re reluctant to turn to your loved ones because you’ve let them down before, consider going to couples counseling or family therapy.

Build a sober social network – If your previous social life revolved around alcohol, you may need to make some new connections. It’s important to have sober friends who will support your recovery. Try taking a class, joining a church or a civic group, volunteering, or attending events in your community.

Make meetings a priority – Join a recovery support group, such as Alcoholics Anonymous (AA), and attend meetings regularly. Spending time with people who understand exactly what you’re going through can be very healing. You can also benefit from the shared experiences of the group members and learn what others have done to stay sober.

Find new meaning in life

While getting sober is an important first step, it is only the beginning of your recovery from alcohol addiction or heavy drinking. Rehab or professional treatment can get you started on the road to recovery, but to stay alcohol-free for the long term, you’ll need to build a new, meaningful life where drinking no longer has a place.

Five steps to a sober lifestyle

1. Take care of yourself. To prevent mood swings and combat cravings, concentrate on eating right and getting plenty of sleep. Exercise is also key: it releases endorphins, relieves stress, and promotes emotional well-being.
2. Build your support network. Surround yourself with positive influences and people who make you feel good about yourself. The more you’re invested in other people and your community, the more you have to lose—which will help you stay motivated and on the recovery track.
3. Develop new activities and interests. Find new hobbies, volunteer activities, or work that gives you a sense of meaning and purpose. When you’re doing things you find fulfilling, you’ll feel better about yourself and drinking will hold less appeal.
4. Continue treatment. Your chances of staying sober improve if you are participating in a support group like Alcoholics Anonymous, have a sponsor, or are involved in therapy or an outpatient treatment program.
5. Deal with stress in a healthy way. Alcohol abuse is often a misguided attempt to manage stress. Find healthier ways to keep your stress level in check, such as exercising, meditating, or practicing breathing exercises or other relaxation techniques.

Plan for triggers and cravings

Cravings for alcohol can be intense, particularly in the first six months after you quit drinking. Good alcohol treatment prepares you for these challenges, helping you develop new coping skills to deal with stressful situations, alcohol cravings, and social pressure to drink.

Avoiding drinking triggers

Avoid the things that trigger your urge to drink. If certain people, places, or activities trigger a craving for alcohol, try to avoid them. This may mean making major changes to your social life, such as finding new things to do with your old drinking buddies—or even giving up those friends and finding new ones.

Practice saying “no” to alcohol in social situations. No matter how much you try to avoid alcohol, there will probably be times where you’re offered a drink. Prepare ahead for how you’ll respond, with a firm, yet polite, “no thanks.”

Managing alcohol cravings

When you’re struggling with alcohol cravings, try these strategies:

Talk to someone you trust: your sponsor, a supportive family member or friend, or someone from your faith community.

Distract yourself until the urge passes. Go for a walk, listen to music, do some housecleaning, run an errand, or tackle a quick task.

Remind yourself of your reasons for not drinking. When you’re craving alcohol, there’s a tendency to remember the positive effects of drinking and forget the negatives. Remind yourself of the adverse long-term effects of heavy drinking and how it won’t really make you feel better, even in the short term.

Accept the urge and ride it out, instead of trying to fight it. This is known as “urge surfing.” Think of your craving as an ocean wave that will soon crest, break, and dissipate. When you ride out the craving, without trying to battle, judge, or ignore it, you’ll see that it passes more quickly than you’d think.

Handling setbacks in your recovery

Alcohol recovery is a process—one that often involves setbacks. Don’t give up if you relapse or slip. A drinking relapse doesn’t mean you’re a failure or that you’ll never be able to reach your goal. Each drinking relapse is an opportunity to learn and recommit to sobriety, so you’ll be less likely to relapse in the future.

What to do if you slip:

• Get rid of the alcohol and get away from the setting where you lapsed
• Remind yourself that one drink or a brief lapse doesn’t have to turn into a full-blown relapse
• Don’t let feelings of guilt or shame keep you from getting back on track
• Call your sponsor, counselor, or a supportive friend right away for help

How to help someone stop drinking

Alcohol abuse and addiction doesn’t just affect the person drinking—it affects their families and loved ones, too. Watching a family member struggle with a drinking problem can be as heartbreakingly painful as it is frustrating. But while you can’t do the hard work of overcoming addiction for your loved one, your love and support can play a crucial part in their long-term recovery.

Talk to the person about their drinking. Express your concerns in a caring way and encourage your friend or family member to get help. Try to remain neutral and don’t argue, lecture, accuse, or threaten.

Learn all you can about addiction. Research the kinds of treatment that are available and discuss these options with your friend or family member.

Take action. Consider staging a family meeting or an intervention, but don’t put yourself in a dangerous situation. Offer your support along each step of the recovery journey.

Don’t make excuses for your loved one’s behavior. The person with the drinking problem needs to take responsibility for their actions. Don’t lie or cover things up to protect someone from the consequences of their drinking.

Don’t blame yourself. You aren’t to blame for your loved one’s drinking problem and you can’t make them change.

For more, read Helping Someone with a Drinking Problem.

Authors: Melinda Smith, M.A., Lawrence Robinson, and Jeanne Segal, Ph.D.

When Is It Time for Treatment?

Alcohol-related problems — which result from drinking too much, too fast, or too often — are among the most significant public health issues in the United States.

Many people struggle with controlling their drinking at some time in their lives. Approximately 17 million adults ages 18 and older have an alcohol use disorder (AUD) and 1 in 10 children live in a home with a parent who has a drinking problem.

Does Treatment Work?

The good news is that no matter how severe the problem may seem, most people with an alcohol use disorder can benefit from some form of treatment.

Research shows that about one-third of people who are treated for alcohol problems have no further symptoms 1 year later. Many others substantially reduce their drinking and report fewer alcohol-related problems.

Signs of an Alcohol Problem

Alcohol use disorder (AUD) is a medical condition that doctors diagnose when a patient’s drinking causes distress or harm. The condition can range from mild to severe and is diagnosed when a patient answers “yes” to two or more of the following questions.

In the past year, have you:

• Had times when you ended up drinking more, or longer than you intended?

• More than once wanted to cut down or stop drinking, or tried to, but couldn’t?

• Spent a lot of time drinking? Or being sick or getting over the aftereffects?

• Experienced craving — a strong need, or urge, to drink?

• Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?

• Continued to drink even though it was causing trouble with your family or friends?

• Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?

• More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?

• Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?

• Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?

• Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?

If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more urgent the need for change. A health professional can conduct a formal assessment of your symptoms to see if an alcohol use disorder is present. For an online assessment of your drinking pattern, go to RethinkingDrinking.niaaa.nih.gov.

Options for Treatment

When asked how alcohol problems are treated, people commonly think of 12-step programs or 28-day inpatient rehab, but may have difficulty naming other options. In fact, there are a variety of treatment methods currently available, thanks to significant advances in the field over the past 60 years.

Ultimately, there is no one-size-fits-all solution, and what may work for one person may not be a good fit for someone else. Simply understanding the different options can be an important first step.

Types of Treatment

Behavioral Treatments

Behavioral treatments are aimed at changing drinking behavior through counseling. They are led by health professionals and supported by studies showing they can be beneficial.

Medications

Three medications are currently approved in the United States to help people stop or reduce their drinking and prevent relapse. They are prescribed by a primary care physician or other health professional and may be used alone or in combination with counseling.

Mutual-Support Groups

Alcoholics Anonymous (AA) and other 12-step programs provide peer support for people quitting or cutting back on their drinking. Combined with treatment led by health professionals, mutual-support groups can offer a valuable added layer of support.

Due to the anonymous nature of mutual-support groups, it is difficult for researchers to determine their success rates compared with those led by health professionals.

Starting With a Primary Care Doctor

For anyone thinking about treatment, talking to a primary care physician is an important first step — he or she can be a good source for treatment referrals and medications. A primary care physician can also:

• Evaluate whether a patient’s drinking pattern is risky

• Help craft a treatment plan

• Evaluate overall health

• Assess if medications for alcohol may be appropriate

Types of Professionals Involved in Care

Many health professionals can play a role in treatment. Below is a list of providers and the type of care they may offer.
Provider Type	Degrees & Credentials	Treatment Type
Primary Care Provider	M.D., D.O. (Doctor of Osteopathic Medicine), additionally you may see a Nurse Practitioner or Physician’s Assistant	Medications, Brief Behavioral Treatment, Referral to Specialist
Psychiatrist	M.D., D.O.	Medications, Behavioral Treatment
Psychologist	Ph.D., Psy.D., M.A.	Behavioral Treatment
Social Worker	M.S.W. (Master of Social Work), L.C.S.W. (Licensed Clinical Social Worker)	Behavioral Treatment
Alcohol Counselor	Varies—most States require some form of certification	Behavioral Treatment
Individuals are advised to talk to their doctors about the best form of primary treatment.

Treatments Led by Health Professionals

Professionally led treatments include:

Medications

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Some are surprised to learn that there are medications on the market approved to treat alcohol dependence. The newer types of these medications work by offsetting changes in the brain caused by alcoholism.

All approved medications are non-addictive and can be used alone or in combination with other forms of treatment. Learn more about these approved treatments.

Behavioral Treatments

Also known as alcohol counseling, behavioral treatments involve working with a health professional to identify and help change the behaviors that lead to heavy drinking. Behavioral treatments share certain features, which can include:

• Developing the skills needed to stop or reduce drinking

• Helping to build a strong social support system

• Working to set reachable goals

• Coping with or avoiding the triggers that might cause relapse

Types of Behavioral Treatments

• Cognitive–Behavioral Therapy can take place one-on-one with a therapist or in small groups. This form of therapy is focused on identifying the feelings and situations (called “cues”) that lead to heavy drinking and managing stress that can lead to relapse. The goal is to change the thought processes that lead to alcohol misuse and to develop the skills necessary to cope with everyday situations that might trigger problem drinking.

• Motivational Enhancement Therapy is conducted over a short period of time to build and strengthen motivation to change drinking behavior. The therapy focuses on identifying the pros and cons of seeking treatment, forming a plan for making changes in one’s drinking, building confidence, and developing the skills needed to stick to the plan.

• Marital and Family Counseling incorporates spouses and other family members in the treatment process and can play an important role in repairing and improving family relationships. Studies show that strong family support through family therapy increases the chances of maintaining abstinence (stopping drinking), compared with patients undergoing individual counseling.

• Brief Interventions are short, one-on-one or small-group counseling sessions that are time limited. The counselor provides information about the individual’s drinking pattern and potential risks. After receiving personalized feedback, the counselor will work with the client to set goals and provide ideas for helping to make a change.

Ultimately, choosing to get treatment may be more important than the approach used, as long as the approach avoids heavy confrontation and incorporates empathy, motivational support, and a focus on changing drinking behavior.

What FDA-Approved Medications Are Available?

Certain medications have been shown to effectively help people stop or reduce their drinking and avoid relapse.

Current Medications

The U.S. Food and Drug Administration (FDA) has approved three medications for treating alcohol dependence, and others are being tested to determine if they are effective.

• Naltrexone can help people reduce heavy drinking.

• Acamprosate makes it easier to maintain abstinence.

• Disulfiram blocks the breakdown (metabolism) of alcohol by the body, causing unpleasant symptoms such as nausea and flushing of the skin. Those unpleasant effects can help some people avoid drinking while taking disulfiram.

It is important to remember that not all people will respond to medications, but for a subset of individuals, they can be an important tool in overcoming alcohol dependence.

Scientists are working to develop a larger menu of pharmaceutical treatments that could be tailored to individual needs. As more medications become available, people may be able to try multiple medications to find which they respond to best.

“Isn’t taking medications just trading one addiction for another?”

This is not an uncommon concern, but the short answer is “no.” All medications approved for treating alcohol dependence are non-addictive. These medicines are designed to help manage a chronic disease, just as someone might take drugs to keep their asthma or diabetes in check.

Looking Ahead: The Future of Treatment

Progress continues to be made as researchers seek out new and better treatments for alcohol problems. By studying the underlying causes of alcoholism in the brain and body, NIAAA is working to identify key cellular or molecular structures — called “targets” — that could lead to the development of new medications.

Personalized Medicine

Ideally, health professionals would be able to identify which alcoholism treatment is most effective for each person. NIAAA and other organizations are conducting research to identify genes and other factors that can predict how well someone will respond to a particular treatment. These advances could optimize how treatment decisions are made in the future.

Current NIAAA Research — Leading to Future Breakthroughs

Certain medications already approved for other uses have shown promise for treating alcohol dependence and problem drinking:

• The anti-smoking drug varenicline (marketed under the name Chantix) significantly reduced alcohol consumption and craving among people with alcoholism.

• Gabapentin, a medication used to treat pain conditions and epilepsy, was shown to increase abstinence and reduce heavy drinking. Those taking the medication also reported fewer alcohol cravings and improved mood and sleep.

• The anti-epileptic medication topiramate was shown to help people curb problem drinking, particularly among those with a certain genetic makeup that appears to be linked to the treatment’s effectiveness.

Tips for Selecting Treatment

Professionals in the alcohol treatment field offer advice on what to consider when choosing a treatment program.

Overall, gather as much information as you can about the program or provider before making a decision on treatment. If you know someone who has first-hand knowledge of the program, it may help to ask about his or her personal experience.

Here are some questions you can ask that may help guide your choice:

• What kind of treatment does the program or provider offer? 
  It is important to gauge if the facility provides all the currently available methods or relies on one approach. You may want to learn if the program or provider offers medication and if mental health issues are addressed together with addiction treatment.

• Is treatment tailored to the individual? 
  Matching the right therapy to the individual is important to its success. No single treatment will benefit everyone. It may also be helpful to determine whether treatment will be adapted to meet changing needs as they arise.

• What is expected of the patient? 
  You will want to understand what will be asked of you in order to decide what treatment best suits your needs.

• Is treatment success measured? 
  By assessing whether and how the program or provider measures success, you may be able to better compare your options.

• How does the program or provider handle relapse? 
  Relapse is common and you will want to know how it is addressed. For more information on relapse, see Relapse Is Part of the Process.

When seeking professional help, it is important you feel respected and understood and that you have a feeling of trust that this person, group, or organization can help you. Remember, though, that relationships with doctors, therapists, and other health professionals can take time to develop.

Please note: NIAAA recently launched the NIAAA Alcohol Treatment Navigator. This online tool helps you find the right treatment for you — and near you. It guides you through a step-by-step process to finding a highly qualified professional treatment provider. Learn more at https://alcoholtreatment.niaaa.nih.gov.

Additional Considerations

Treatment Setting — Inpatient or Outpatient?

In addition to choosing the type of treatment that’s best for you, you’ll also have to decide if that treatment is inpatient (you would stay at a facility) or outpatient (you stay in your home during treatment). Inpatient facilities tend to be more intensive and costly. Your health care provider can help you evaluate the pros and cons of each.

Cost may be a factor when selecting a treatment approach. Evaluate the coverage in your health insurance plan to determine how much of the costs your insurance will cover and how much you will have to pay. Ask different programs if they offer sliding scale fees — some programs may offer lower prices or payment plans for individuals without health insurance.

An Ongoing Process

Overcoming an alcohol use disorder is an ongoing process, one which can include setbacks.

The Importance of Persistence

Because an alcohol use disorder can be a chronic relapsing disease, persistence is key. It is rare that someone would go to treatment once and then never drink again. More often, people must repeatedly try to quit or cut back, experience recurrences, learn from them, and then keep trying. For many, continued followup with a treatment provider is critical to overcoming problem drinking.

Relapse Is Part of the Process

Relapse is common among people who overcome alcohol problems. People with drinking problems are most likely to relapse during periods of stress or when exposed to people or places associated with past drinking.

Just as some people with diabetes or asthma may have flare-ups of their disease, a relapse to drinking can be seen as a temporary set-back to full recovery and not a complete failure. Seeking professional help can prevent relapse — behavioral therapies can help people develop skills to avoid and overcome triggers, such as stress, that might lead to drinking. Most people benefit from regular checkups with a treatment provider. Medications also can deter drinking during times when individuals may be at greater risk of relapse (e.g., divorce, death of a family member).

Mental Health Issues and Alcohol Use Disorder

Depression and anxiety often go hand in hand with heavy drinking. Studies show that people who are alcohol dependent are two to three times as likely to suffer from major depression or anxiety over their lifetime. When addressing drinking problems, it’s important to also seek treatment for any accompanying medical and mental health issues.

Advice For Friends and Family Members

Caring for a person who has problems with alcohol can be very stressful. It is important that as you try to help your loved one, you find a way to take care of yourself as well. It may help to seek support from others, including friends, family, community, and support groups. If you are developing your own symptoms of depression or anxiety, think about seeking professional help for yourself. Remember that your loved one is ultimately responsible for managing his or her illness.

However, your participation can make a big difference. Based on clinical experience, many health providers believe that support from friends and family members is important in overcoming alcohol problems. But friends and family may feel unsure about how best to provide the support needed. The groups for family and friends listed below under Resources may be a good starting point.

Remember that changing deep habits is hard, takes time, and requires repeated efforts. We usually experience failures along the way, learn from them, and then keep going. Alcohol use disorders are no different. Try to be patient with your loved one. Overcoming this disorder is not easy or quick.

Pay attention to your loved one when he or she is doing better or simply making an effort. Too often we are so angry or discouraged that we take it for granted when things are going better. A word of appreciation or acknowledgement of a success can go a long way.

Resources

Please note: NIAAA recently launched the NIAAA Alcohol Treatment Navigator. This online tool helps you find the right treatment for you — and near you. It guides you through a step-by-step process to finding a highly qualified professional treatment provider. Learn more at https://alcoholtreatment.niaaa.nih.gov.

Professional help

Your doctor. Primary care and mental health practitioners can provide effective alcoholism treatment by combining new medications with brief counseling visits. To aid clinicians, NIAAA has developed two guides: Helping Patients Who Drink Too Much, and for younger patients, Alcohol Screening and Brief Interventions for Youth: A Practitioner’s Guide. Both are available at www.niaaa.nih.gov/publications/clinical-guides-and-manuals

Specialists in alcohol use disorders. For specialty addiction treatment options, contact your doctor, health insurance plan, local health department, or employee assistance program. Other resources include:

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