Health A-Z

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Harvard Medical School

Alcohol Dependence (Alcoholism)

Treatment

Only a minority of people can regain control of their drinking. More often, once a person has lost control of his or her drinking, it is difficult to go back to drinking moderate amounts. Therefore, the goal of treatment of alcohol dependence is usually to stop drinking alcohol completely.

The first step in this process is recognizing the problem. The well-known phenomenon of denial, which is a common part of the illness, often turns the illness into a chronic one. Unfortunately, the longer the illness persists, the harder it is to treat.

A doctor or substance abuse expert may be able to help the person look at the consequences of drinking. If an individual is beginning to think about alcohol as a problem, educational groups may provide support for weighing the pros and cons of drinking.

It is never easy for family members and friends to confront the problem. A professional may have to help loved ones — kindly, but firmly — talk to the drinker about the painful impact drinking has on them.

The next step is to stop drinking and get treatment to prevent dangerous withdrawal symptoms, a process called detoxification (or simply "detox"). Depending on your symptoms, this can be done as an outpatient, or as an inpatient in a hospital or drug treatment facility. During the withdrawal process, your doctor probably will prescribe a class of antianxiety drugs called benzodiazepines for a few days to lessen withdrawal symptoms.

After weaning from alcohol, you may be offered a medication to help reduce cravings. Two medications that fit in this category are naltrexone (ReVia) and acamprosate (Campral). As an alternative, sometimes the drug disulfiram (Antabuse) may be prescribed. This drug does not reduce craving, but it creates an incentive not to drink, because drinking alcohol while taking disulfiram causes nausea and vomiting.

After detoxification, most alcoholics need some form of long-term support or counseling to remain sober. Recovery programs focus on teaching a person with alcoholism about the disease, and helping him or her to learn new coping strategies to deal with the stresses of everyday life without turning to alcohol. Psychotherapy may help a person deal with the underlying stresses and influences that trigger drinking. Many patients benefit from self-help groups such as Alcoholics Anonymous (AA), Rational Recovery or SMART (Self Management and Recovery Training).

It is very important to treat any other problems, such as depression or anxiety, that may contribute to the risk of drinking.

If your doctor suspects that you have any alcohol-related damage to your liver, stomach or other organs, you may need additional tests and treatments for these problems. Your doctor also will suggest a healthy diet with vitamin supplements, especially B vitamins.