Types of Alcohol Abuse Treatment
There are many options available to treat alcohol abuse. These include Inpatient Treatment programs, Outpatient Treatment programs and 12-Step Treatment programs.
Inpatient treatment, which includes residential treatment and rehabilitation programs, is provided in centers where you live for the duration of treatment. Many residential treatment programs offer 24-hour supervised medical care while attending individual and group counseling and receiving medication.
Inpatient treatment may take approximately 30 days, 60 days or 90 days. Your treatment may take place in facilities with amenities that are relatively standard or are more extensive in terms of recreational or treatment options (luxury or rehab or residential care).
To avoid experiencing severe withdrawal, inpatient treatment is often recommended. You are at risk if you:
- Are 60 years old or older.
- Have co-existing medical or psychiatric conditions.
- Use or abuse other drugs such as sedatives.
- Have a history of other withdrawal episodes and complications (e.g., seizure).
- Have abused alcohol for an extended period of time.
- Have not responded to other types of treatment.
Luxury & Executive Treatment Centers
Luxury treatment centers tend to have amenities you might find on vacation or at a five-star hotel, such as massage treatments, chef-prepared meals and beautiful surroundings. Executive treatment centers are set up to allow you to continue to work and meet with clients and you receive treatment.
In contrast to inpatient, where you live at the facility while receiving treatment, you visit an outpatient treatment center regularly to receive treatment.
There are many outpatient options for people with alcohol abuse problems. These include:1
- Group counseling or psychotherapy.
- 12-step programs.
- Individual psychotherapy and variations on this, such as Cognitive Behavioral Therapy (CBT), Contingency Management (CM) and Motivational Enhancement therapy (MET).
- Cognitive Behavior Therapy works to solve current problems and change unhelpful thinking and behavior.
- Contingency Management Therapy is similar, but puts more emphasis on rewarding "positive" (e.g., abstinent) behaviors and punishing the opposite.
- Motivational Enhancement Therapy involves an emphasis on motivations to pursue recovery and abstinence, and it is based on motivational interviewing.
These treatments are often therapist-led and may be enhanced by peer support in group settings. Conversely, 12-step programs emphasize peer support.
12-Step Recovery Support Group
The most common 12-step support group for alcoholism is Alcoholics Anonymous. It is a peer support-based system that helps you through acceptance of, restitution for and (ideally) resolution of your problems related to alcohol abuse. It may be based on religion and spiritualism, though their inclusion may depend on the person in question.
The Alcoholics Anonymous 12-step model often involves introducing you into a group and the nomination of a "sponsor" from that group to you. This sponsor works one-on-one with you to help you through the steps or stages of the model. Note that Alcoholics Anonymous stresses complete abstinence from alcohol use.
Which Type of Recovery Center Should I Consider?
The type of treatment you choose depends on a number of factors. These may include:
- Addiction or abuse severity.
- Employment/family responsibilities.
- History of prior treatment.
- Insurance providers and the treatment types they will cover.
Outpatient may be a good option if you're unable to take time away from work or other responsibilities. But inpatient, though more expensive, may be a good choice if you've been through outpatient treatment before and relapsed, or if you've been drinking heavily for a long time.
Another service to look for in a treatment facility is dual diagnosis. Recovery centers that specialize in dual diagnosis will assess and treat other issues and conditions that co-occur with alcoholism. These may include:
- Cardiovascular conditions.
- Liver damage.
- Mental health issues (e.g., depressive symptoms and suicidal thoughts2).
In addition, alcohol abuse may be accompanied by other forms of substance abuse.1 People who abuse other drugs in addition to alcohol may also have developed viral conditions such as hepatitis C.1
How Long Does Treatment Take?
You may wantÂ a program that allows you to extend your stay if necessary. This gives you flexibility in case you get to the end of a 30-day inpatient program, for example, and decide that
The goal of aftercare is to keep you focused on recovery and increase the probability of abstinence.
How Much Does Alcohol Rehab Cost?
Money shouldn't deter you from getting help for your alcohol addiction.
Call 1-888-966-8334 to find out what payment options are available and if your insurance will cover your treatment.
Rehab or residential treatment may be more expensive. But it may be worth it if you need or want to avoid abuse cues (e.g., the temptation to drink or visual cues such as advertising material) until treatment is complete. Some of these centers may offer services such as payment plans to manage the cost. Don't be afraid to ask!
Many insurance companies offer phone or online services for questions about treatment services. For those without insurance, facilities with public funding may be an option. These may be found on the Substance Abuse and Mental Health Administration's (SAMHSA) Treatment Services Locator or the Recovery.org homepage.
What's the Withdrawal Process Like?
It is strongly recommended that anyone who plans to stop drinking meet with a medical professional on the risk of developing severe withdrawal and the potential need for supervised detox. Medical supervision during alcohol withdrawal is crucial, in case of severe side effects such as convulsions. In addition, remember that detox is not treatment, but is rather the first stage of alcohol recovery.
Alcohol Withdrawal Symptoms
- Agitation and/or feelings of anxiety.
- Changes in blood pressure and heart rate.
The severity of symptoms often depends on the rate and length of time you've been abusing alcohol.3 In severe cases, delirium (known as delirium tremens) and seizures may occur.3
The detoxification process, during which any remaining alcohol is safely allowed to leave your body, often involves medications to manage withdrawal symptoms. These medications may include:3-6
- Anxiolytics (medications that treat anxiety) such as benzodiazepines.
- Alpha-adrenergic agonists such as dexmedetomidine (to treat cardiovascular changes).
- Naltrexone, an indirect opioid-receptor antagonist (to help with cravings).
Do I Need to Take Medication?
Many inpatient facilities use medication to treat alcoholism. The medications may be combined with psychosocial therapy with the goal of enhancing abstinence and recovery. However, some other forms of treatment, particularly peer support-based therapies such as 12-step programs, may not encourage or permit the use of medications.
Again, any use of medication depends on the needs and preferences of the person.
Disulfiram is considered safe for people without severe liver problems, psychiatric disorders or cardiovascular disease.13 However, it is associated with side effects including increased anxiety, headaches and fatigue.13
Are There Alcohol Rehabs for Teens?
A recent national survey reported that approximately 79% of U.S. teens had used alcohol, and 15% had reached abusive levels of drinking.9 Treatment options for adolescents may include family-based interventions, as family influences are often a factor associated with teen alcohol abuse.10
Peer support-based programs such as Alcoholic Anonymous are also available for adolescents.11
Does Alcohol Abuse Treatment Work?
Any form of treatment is better than no treatment, and there is little evidence to suggest that one type of treatment is better than another.1 However, this may be related to the low numbers and quality of comparative studies.1
A review of studies on 12-step programs indicates that their effects on abstinence are largely positive, but that it is difficult to draw concrete scientific conclusions due to the structure of these programs and that of much of the research conducted on them.12
 Klimas J, Tobin H, Field CA, et al. Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users. Cochrane Database Syst Rev.2014;12:CD009269.
 Campos LM, Yoshimi NT, Simao MO, Torresan RC, Torres AR. Obsessive-compulsive symptoms among alcoholics in outpatient treatment: Prevalence, severity and correlates. Psychiatry Res.2015.
 Muncie HL, Jr., Yasinian Y, Oge L. Outpatient management of alcohol withdrawal syndrome. Am Fam Physician.2013;88(9):589-595.
 Hammond CJ, Niciu MJ, Drew S, Arias AJ. Anticonvulsants for the treatment of alcohol withdrawal syndrome and alcohol use disorders. CNS Drugs.2015;29(4):293-311.
 Wong A, Smithburger PL, Kane-Gill SL. Review of adjunctive dexmedetomidine in the management of severe acute alcohol withdrawal syndrome. Am J Drug Alcohol Abuse.2015:1-10.
 Bart G. Maintenance Medication for Opiate Addiction: The Foundation of Recovery. Journal of addictive diseases.2012;31(3):207-225.
 Plosker GL. Acamprosate: A Review of Its Use in Alcohol Dependence. Drugs.2015;75(11):1255-1268.
 Suh JJ, Pettinati HM, Kampman KM, O'Brien CP. The status of disulfiram: a half of a century later. J Clin Psychopharmacol.2006;26(3):290-302.
 Swendsen J, Burstein M, Case B, et al. Use and abuse of alcohol and illicit drugs in US adolescents: results of the National Comorbidity Survey-Adolescent Supplement. Arch Gen Psychiatry.2012;69(4):390-398.
 Rowe CL, Liddle HA. Family-based treatment development for adolescent alcohol abuse. Int J Adolesc Med Health.2006;18(1):43-51.
 Sussman S. A review of Alcoholics Anonymous/ Narcotics Anonymous programs for teens. Eval Health Prof.2010;33(1):26-55.
 Donovan DM, Ingalsbe MH, Benbow J, Daley DC. 12-Step Interventions and Mutual Support Programs for Substance Use Disorders: An Overview. Social work in public health.2013;28(0):313-332.
 Malcolm R, Olive MF, Lechner W. The safety of disulfiram for the treatment of alcohol and cocaine dependence in randomized clinical trials: guidance for clinical practice. Expert Opin Drug Saf.2008;7(4):459-472.
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