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Alcoholism Treatment

Alcoholism, also known as "alcohol dependence syndrome" exhibits the following characteristics:

  • Craving:  An overpowering desire to drink
  • Loss of control: The lack of the ability to stop drinking once they have begun.
  • Physical dependence: This occurs when the consumption of alcohol is stopped and withdrawal symptoms begin. These can include, but are not limited to: nausea, sweating, shakiness, and anxiety. Relief from these symptoms can only be accomplished by drinking or by taking sedative drug.
  • Tolerance: The need for increasing amounts of alcohol in order to get "high."

No matter what one drinks or how long they’ve been drinking, it is the person’s uncontrollable need for alcohol to avoid experiencing withdrawal symptoms (physical dependence), along with the negative consequences that befall them as a result, that characterize alcoholism.

This is why most alcoholics can't just use their willpower to stop drinking. They are frequently in the grip of a physical dependence on alcohol along with a powerful craving for the substance, a craving that can be as strong if not stronger than the need for essentials like food and water.

If you think you or a loved one may be an alcoholic, the following twenty questions can be a helpful indicator. If three or more can be answered in the affirmative, chances are that person is an alcoholic.

  1. Do you lose time from work due to your drinking?
  2. Is drinking making your home life unhappy?
  3. Do you drink because you are shy with other people?
  4. Is drinking affecting your reputation?
  5. Have you ever felt remorse after drinking?
  6. Have you gotten into financial difficulties as a result of your drinking?
  7. Do you turn to lower companions and an inferior environment when drinking?
  8. Does your drinking make you careless of your family's welfare?
  9. Has your ambition decreased since drinking?
  10. Do you crave a drink at a definite time daily?
  11. Do you want a drink the next morning?
  12. Does drinking cause you to have difficulty in sleeping?
  13. Has your efficiency decreased since drinking?
  14. Is drinking jeopardizing your job or business?
  15. Do you drink to escape from worries or troubles?
  16. Do you drink alone?
  17. Have you ever had a complete loss of memory (blackout) as a result of your drinking?
  18. 18. Has your physician ever treated you for drinking?
  19. Do you drink to build up your self-confidence?
  20. Have you ever been in a hospital or institution on account of drinking?

Although there are occasionally individuals who are able to recover without assistance, the vast majority of alcoholics require help to recover from this disease. Dr. Harry Thiebout, a psychiatrist in the late 1930’s, described alcoholism as a “disease of the body and of the mind.” That is what makes it so difficult to treat and why relapse is such a problem.

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, published by the American Psychiatric Association, defines alcoholism as a disease as well. Genetic research suggests that it is an inherited disease that can be passed down from generation to generation and can affect one member of a family, none or several. It can even skip a generation.

Nevertheless, it’s also the conditions present in one’s environment, such as seeking “lower companionship” (i.e. bar buddies) and easy access to alcohol, that are most influential in the making of an alcoholic. Both genetic and environmental influences can put a person at risk. Therefore, it is prudent for those whose families have been touched by alcoholism in previous generations to be especially vigilant, watch for the signs and symptoms of alcoholism, and take rapid action should a problem arise.

Alcoholism Treatment

There is no known cure for alcoholism at this time, but there are definitely effective methods of treatment. There are numerous treatment programs that use a combination of counseling and medications to help a person stop drinking. Most alcoholics need help to recover from their disease - if they could recover on their own, they would, and treatment for the disease wouldn't exist. With the proper support and treatment, many people are able to stop drinking and rebuild their lives.

Alcoholism treatment works for many people. But just like any chronic disease, there are varying levels of success when it comes to treatment. Some people stop drinking and remain sober. Others have long periods of sobriety with bouts of relapse. And still others cannot stop drinking for any length of time. With treatment, one thing is clear, however: the longer a person abstains from alcohol, the more likely he or she will be able to stay sober.

Many people feel that they should be able to cut down if they think there might be a problem. This is highly unlikely if they have been diagnosed as an alcoholic. Alcoholics who try to cut down almost never succeed because it has become a true compulsion, over which they have no control. Therefore, abstention is the only truly effective course for recovery.

This can be a challenge. An alcoholic can't be forced to get help except under certain circumstances, such as a violent incident that results in court-ordered treatment or medical emergency. But you don't have to wait for someone to "hit rock bottom" to act and get them into a drug rehab. Many alcoholism treatment specialists suggest the following steps to help an alcoholic get treatment:

Stop all "cover ups." Family members often make excuses to others or try to protect the alcoholic from the results of his or her drinking. It is important to stop covering for the alcoholic so that he or she experiences the full consequences of drinking.

Time your intervention. The best time to talk to the drinker is shortly after an alcohol-related problem has occurred--like a serious family argument or an accident. Choose a time when he or she is sober, both of you are fairly calm, and you have a chance to talk in private.

Recovery starts with admitting there is a problem with alcohol. There are many reputable and highly professional treatment programs available, but one doesn’t necessarily have to seek professional help or check into a program in order to get better – especially if finances is a factor.

Peer support groups can be an invaluable source of guidance, assistance, and encouragement. Alcoholics Anonymous (AA) is the most well-known and widely available self-help group for alcoholics in treatment and recovery. AA uses fellowship and a set of guided principles—the 12 steps—to help members achieve and maintain sobriety.

A key part of a 12-step program is choosing a sponsor, a recovering alcoholic who has time and experience remaining sober. A good sponsor helps you understand and work the steps to alcohol recovery and provides support when you are feeling the urge to drink.

Other addiction support groups such as SMART Recovery and Secular Organizations for Sobriety (SOS) have different philosophies about alcohol treatment and recovery, yet offer the same benefits of group support.

These are a few of the most popular alcohol support groups:

  • Alcoholics Anonymous
  • Secular Organizations for Sobriety
  • SMART Recovery
  • Women for Sobriety

Some people can stop drinking on their own without a doctor’s help, while 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, and other health issues you may have. If, for example, someone has been drinking heavily and frequently for an extended period of time, they will have become physically dependent on alcohol. When they suddenly stop drinking, the body goes through withdrawal. Some of the “milder” symptoms of alcohol withdrawal are:

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

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 can be life threatening. Some of the most severe symptoms are:

  • severe vomiting
  • confusion and disorientation
  • fever
  • hallucinations
  • extreme agitation
  • seizures or convulsions

Call 911 or go to the emergency room if you experience any of these! They may be a sign of a particularly ruthless form of alcohol withdrawal called delirium tremens, or DTs. This rare, emergency condition causes dangerous changes in the way your brain regulates your circulation and breathing, so it’s important to get to the hospital right away.

If you are 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. As part of the alcohol detoxification process, you may be prescribed medication to prevent medical complications and relieve withdrawal symptoms.

There are three oral medications--disulfiram (Antabuse), naltrexone (Depade, ReVia), and acamprosate (Campral) currently approved to treat alcohol dependence. In addition, an injectable, long-acting form of naltrexone (Vivitrol) is available. These medications have been shown to help people with dependence reduce their drinking, avoid relapse to heavy drinking, and achieve and maintain abstinence. Naltrexone acts in the brain to reduce craving for alcohol after someone has stopped drinking. Acamprosate is thought to work by reducing symptoms that follow lengthy abstinence, such as anxiety and insomnia. Disulfiram discourages drinking by making the person taking it feel sick after drinking alcohol.

Other types of drugs are available to help manage symptoms of withdrawal (such as shakiness, nausea, and sweating) if they occur after someone with alcohol dependence stops drinking.

Although medications are available to help treat alcoholism, there is no "magic bullet." In other words, no single medication is available that works in every case and/or in every person. Developing new and more effective medications to treat alcoholism remains a high priority for researchers.

Once again, most reputable alcoholism treatment programs also include meetings of Alcoholics Anonymous (AA), which describes itself as a “worldwide fellowship of men and women who help each other to stay sober.” While AA is generally recognized as an effective mutual help program for recovering alcoholics, not everyone responds to AA's style and message, and other recovery approaches are available. Even those who are helped by AA usually find that AA works best in combination with other elements of treatment, including counseling and medical care.

To reiterate, alcoholism is, at this time, an incurable but highly treatable disease. That means that even if an alcoholic has been sober for a long while and has regained health, he or she remains susceptible to relapse and must continue to avoid all alcoholic beverages. “Cutting down” on drinking doesn't work; cutting out alcohol is necessary for a successful recovery.

However, even individuals who are determined to stay sober may suffer one or several “slips,” or relapses, before achieving long-term sobriety. Relapses are very common and do not mean that a person has failed or cannot eventually recover from alcoholism. Keep in mind, too, that every day that a recovering alcoholic has stayed sober prior to a relapse is extremely valuable time, both to the individual and to his or her family. If a relapse occurs, it is very important to try to stop drinking once again and to get whatever additional support is needed to abstain from drinking.

For more information on alcohol abuse and alcoholism, contact the following organizations:

For Families:

Al-Anon Family Group Headquarters
1600 Corporate Landing Parkway
Virginia Beach, VA 23454-5617
800-356-9996
www.al-anon.alateen.org

For Alcoholics:

Alcoholics Anonymous (AA) World Services
475 Riverside Drive, 11th Floor
New York, NY 10115
212-870-3400
www.alcoholics-anonymous.org

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