Alcohol use disorder (AUD) can be difficult to recognize because the signs are not always apparent. There are people who drink daily, those who binge drink, people who have gaps between their drinking episodes, and some whose lives appear outwardly successful, all while being unable to control their drinking.
Therapy for alcoholism can help a person realize why they developed an addiction to alcohol, develop ways to identify their harmful behaviors, and learn healthy alternative strategies for recovery.
At SOBA, our staff provides a wide variety of support services for alcohol use disorder, co-occurring mental health disorders, relapse prevention, and ongoing recovery.
Key Points
Alcohol use disorder is a chronic disease characterized by a person’s inability to either stop or control their drinking, despite negative consequences.
There are several common signs that a person may be developing an addiction to alcohol including intense cravings, loss of control over consumption, withdrawal symptoms when trying to cut down or quit, secrecy around drinking, and continuing to consume alcohol even though it causes harm to their personal health, employment, or finances.
Individual and group therapy are both effective means of helping a person recover from an addiction to alcohol and can include modalities such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), motivational interviewing, relapse prevention, and other techniques based on individual needs.
In certain cases, prescription medications such as naltrexone, acamprosate, and disulfiram can also be used when clinically indicated.
Alcohol withdrawal can cause serious complications requiring close medical supervision.
What Is Alcohol?
Alcohol is a legal and usually socially acceptable depressant that affects the central nervous system. It can slow down a person’s reaction time, reduce inhibitions, affect judgment, and influence emotions. Due to alcohol being readily available and commonly accepted in social settings, it can be challenging for someone to recognize when regular drinking has progressed into alcohol misuse or dependence.
Alcohol use disorder, or AUD, is the clinical term for the continued or excessive use of alcohol resulting in significant distress or impairment in social, occupational, or other areas of functioning. It can range from mild to severe.
Severe AUD is often referred to as alcoholism or alcohol dependence.[1] It is important to understand that alcohol use disorder is not a moral failing or a lack of willpower, but a treatable condition that can impact the brain, body, relationships, job performance, and overall emotional well-being.
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Alcohol addiction usually develops gradually. Repeated drinking can change the brain systems involved in reward, stress, and self-control. As tolerance increases, a person may need more alcohol to feel the same effect. When they try to stop, withdrawal symptoms or cravings may push them back toward drinking.
Binge drinking can also increase risk. While not everyone who binge drinks develops AUD, repeated heavy drinking can reinforce patterns of craving, impaired control, and reliance on alcohol to cope. For some people, what begins as weekend drinking becomes more frequent, more secretive, or more difficult to stop.
National data show that alcohol dependence statistics remain a major public health concern. NIAAA reports that millions of people in the United States meet criteria for AUD, yet many do not receive treatment.[2] This treatment gap is one reason early support, brief intervention, and evidence-based care matter.
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The characteristics of alcohol use disorder can vary from person to person, but common signs might include:
Drinking more or for longer periods than originally planned.
Trying to reduce the amount you drink, but not being able to
Cravings or strong urges to drink
Spending considerable amounts of time drinking or getting over the effects of drinking
Missing obligations due to drinking or next-day hangovers
Continuing to drink even though there has been a detrimental impact on relationships, employment, education, or physical or mental well-being.
Giving up recreational activities and hobbies due to drinking
Experiencing alcohol withdrawal symptoms when cutting back or trying to stop
Substance use disorders frequently co-occur with many other psychiatric conditions including anxiety, depression, bipolar disorder, and post-traumatic stress disorder (PTSD).[3] Co-occurring disorders complicate substance use treatment, as the client will require attention for their substance use issues and their mental health issues simultaneously. A coordinated care model is necessary to ensure the client receives proper care for both issues.
Therapy for Alcoholism
Treatment for alcohol use disorder helps people gain insight into their motivation for drinking and what triggers the urge to drink, and to develop new ways to react to those triggers. All treatment plans should be personalized since there is no one-size-fits-all treatment plan that works for everyone.
Commonly employed therapies include:
Cognitive behavioral therapy
CBT is used by therapists to enable clients to recognize the thought patterns, feelings, and experiences that result in their drinking. CBT also helps clients acquire strategies for managing stress and cravings, and for preventing relapses.[4]
Dialectical behavior therapy
DBT helps clients acquire skills to regulate their emotions, tolerate distress, be mindful, and improve relationships. These abilities can be particularly helpful for clients who have turned to alcohol to manage emotions or stress.
Motivational interviewing
Motivational Interviewing, or MI, empowers clients to explore their ambivalence about change. Rather than using guilt or force to influence change, MI fosters open dialogue about clients' goals, values, and motivations.
Family therapy
Enables family members to establish stronger communication, build healthier boundaries, and better understand alcohol use disorders.
Other therapy options treatment plans may include are contingency management, support groups, and collaboration with psychiatrists, social workers, or other professionals in addiction medicine.
Medication Options for Alcohol Use Disorder
A range of medication options are available in addition to counseling and behavioral interventions to aid in treating people diagnosed with AUD.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has identified FDA- approved medications to treat alcohol dependence, which include naltrexone, acamprosate, and disulfiram.[5] Although these medications do not provide a “cure” for alcohol dependence, they can provide several benefits when used with ongoing professional counseling and medical monitoring, including reducing the desire to drink, providing additional support in maintaining sobriety, and discouraging alcohol consumption during periods of time that would otherwise lead to heavy drinking.
All medication decisions must be made under the supervision of a qualified health care provider. People experiencing AUD may also require treatment for co-occurring mental health issues such as depression, anxiety, or sleep disorders, as well as traumatic stress-related symptoms. That is why it is necessary to develop a comprehensive treatment plan to determine if medication, therapy, or a combination of both would best meet their needs.
Detoxification and Withdrawal Safety
Alcohol withdrawal can be very dangerous, and there are many physical and emotional side effects, including anxiety, excessive sweating, shaking or tremors, insomnia, nausea, irritability, headaches, rapid heartbeat, and strong cravings, with extreme cases having the potential for hallucinations, seizures, dizziness or confusion, and delirium tremens.[6]
Delirium tremens is considered one of the most severe forms of alcohol withdrawal and can be a life-threatening condition. Typical characteristics of delirium tremens include sudden onset of confusion, high fever, visual hallucinations, agitation, and tremors or convulsions.[7] Heavy drinkers with a prolonged history of alcohol dependence or those who have experienced previous complications related to alcohol withdrawal are not advised to stop consuming alcohol without receiving proper medical attention. SOBA offers professional alcohol detox to individuals when appropriate.
Frequently Asked Questions About Therapy for Alcoholism
01
Am I an alcoholic if I only binge drink?
Not necessarily, but binge drinking can still be very harmful. If you feel you can’t control your drinking, if you regularly drink more than you intended, or if you face negative consequences from alcohol use, it might be time to speak with a professional.
02
What does alcohol addiction feel like?
Feeling addicted to alcohol might mean wanting to stop but not being able to, drinking to manage emotions, concealing alcohol use, feeling anxious without alcohol, or continuing to drink despite negative work, relationship, financial, or legal consequences.
03
How does alcohol addiction work?
Alcohol affects systems in the brain that deal with reward, stress, and making decisions. With repeated drinking over time, tolerance increases, cravings grow, and withdrawal symptoms also increase, making it harder to stop without support.
04
What therapy is best for alcoholism?
There is no one best therapy for everyone. Treatment approaches like cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), motivational interviewing, family therapy, group therapy, support with medication, and peer support can all be useful depending on individual needs.
05
Can alcohol withdrawal symptoms be dangerous?
Yes, sometimes alcohol withdrawal can cause seizures, hallucinations, or delirium tremens. People who drink heavily or who have had withdrawal symptoms before should get medical guidance before stopping drinking.
06
Are medications used for alcohol use disorder?
Yes. Doctors might prescribe naltrexone, acamprosate, and disulfiram. Medication tends to work best when used along with counseling and recovery support.
If you are unsure if your drinking has become problematic, you don’t have to figure it out alone.
SOBA New Jersey is here to support you. We help our clients understand alcohol use disorder, determine the right level of care for their needs, and start therapy in a supportive environment.
Whether you are worried about binging, withdrawal symptoms, relapse, or co-occurring mental health concerns for yourself or a loved one, our team can help you take the next step.
Reach out today. Our admissions team is ready to help you take the first step.
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