Alcoholism Treatment & Rehab Explained
Residential rehabilitation (rehab) facilities are environments dedicated to healing, in which alcohol users can receive addiction treatment addressing the pressures and dangers posed by dependence, detoxification and withdrawal; the psychological issues both causing and resulting from alcohol abuse and addiction; and other factors including ongoing physical and mental health concerns and the difficulties of adjusting to life after alcohol. Because alcoholism is a multifaceted challenge, all of these issues need to be addressed holistically in order to help the user return to long-term sobriety and build the foundations of the life they want and need.
Dual Diagnosis in Alcohol Addiction Treatment and Rehab
When alcohol addiction occurs alongside another mental health disorder (including another substance use disorder), the condition is known as dual diagnosis. Dual diagnosis is comparatively common in cases of alcohol use disorder, as alcohol abuse and mental health issues are often closely associated. Many people struggling with mental health problems turn to alcohol as a means of self-medication or escape, whilst alcohol abuse and addiction can both cause or contribute to numerous mental disorders.
Dual diagnosis frequently makes addiction treatment more complicated as both disorders need to be treated simultaneously. Some mental health issues make the standard addiction treatment processes impractical, such as a condition that is unreceptive to certain therapy models or if medication normally prescribed for one disorder might interact dangerously with medication for another. Specialist care is typically required in these cases of dual diagnosis.
Warning Signs of Alcohol Abuse and Addiction
Alcohol abuse and alcohol addiction are not synonymous. Alcohol abuse can take various forms and comprises a broad range of drinking behaviours, from binge drinking to full-blown alcohol dependence. Alcohol addiction, meanwhile, is a complex brain disorder characterised by the compulsive desire to drink regardless of the negative consequences of doing so, and it frequently includes a physical dependence to alcohol. This is when the system of an affected individual comes to rely upon the presence of alcohol for normal functioning, with the danger of withdrawal if alcohol is suddenly removed from the system.
While some forms of alcohol abuse can occur during occasional bouts of drinking, it is common for alcohol abuse and alcohol addiction to develop and worsen gradually over time. Recognising the warning signs of a serious problem, and heeding the warning they represent, can help prevent addiction and its risky consequences.
Some noteworthy warning signs of alcohol abuse and addiction include:
- Starting to drink more, and more frequently, than was previously the case
- Prioritising drinking over other activities, or choosing activities specifically because drinking is involved
- Drinking alone
- Lying about how much you drink
- Experiencing frequent hangovers that impair your ability to carry out daily tasks, including work
- Experiencing blackouts due to drinking
- Feeling irritable or otherwise in a bad mood if you have not drunk any alcohol
- Making excuses for why you and/or others should drink
- Growing apart from loved ones and friends as a result of drinking
- Experiencing accident or injury resulting from alcohol consumption
- Finding it difficult to sleep if you haven’t drunk alcohol
- Having others express concern about your drinking habits
- Regularly drinking more than recommended guidelines
- Developing a tolerance for alcohol (needing to drink more and more to feel the desired effect)
- Feeling cravings for alcohol
Short and long-term effects of alcohol
Small quantities of alcohol consumed infrequently are considered relatively harmless (except possibly to pregnant women). However, larger quantities drunk in a manner that constitutes alcohol abuse can have significant effects over both the short and long term, including but not limited to:
- Increased tolerance for alcohol
- Dependence on alcohol
- Prioritising alcohol above personal responsibilities
- Lack of control/inability to stop drinking in excess
- Spending a substantial amount of money on alcohol
- Withdrawal symptoms when alcohol consumption ceases
- Consuming alcohol to cope with psychological or interpersonal problems
- Excessive drinking despite legal, social or interpersonal repercussions
- Use of alcohol that leads to mental or physical damage
- Choosing to continue consuming alcohol, even with associated illnesses or other physical problems
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Detoxification: The First Step of Alcohol Use Disorder Treatment
Someone drinking significant quantities of alcohol regularly over a period of time is likely to develop alcohol dependence. Their brain and body may become accustomed to a certain level of alcohol and require it to function normally. Suddenly stopping alcohol use may cause the brain and body function abnormally and experience unpleasant and dangerous symptoms until they are able to re-stabilise and return to normal.
A person looking for alcohol addiction treatment in this state of dependence will generally need to undergo detoxification or detox. Detox is the cleansing of the user’s system of substances of abuse — in this case, alcohol — in order to overcome physical symptoms of dependence and prepare them for therapy and other aspects of treatment.
Detoxing from alcohol is particularly risky compared to other substances of abuse. Some of the symptoms of alcohol withdrawal can include seizures and/or very high body temperatures that can be fatal without urgent medical attention. It is imperative if you suffer from alcohol dependence that you do not attempt to go through withdrawal without medical assistance.
Fortunately, medications are available to alleviate some of the symptoms of alcohol withdrawal, including some of the most dangerous ones. Going through detox in a treatment facility also offers the security of 24/7 monitoring by experienced medical professionals who can provide these medications. In the most severe cases of alcohol dependence, a period of managed tapering (reducing dosages over time), potentially assisted by medication, may be required before the individual enters regular detox in order to minimise the stress placed on their system.
How long alcohol detox and withdrawal last depends on several factors, including the severity and duration of the addiction and the physiology of the user. Usually, symptoms begin to manifest between eight and 24 hours after the last drink, peaking between one and three days later, and usually persist for a few days after that. Some individuals go on to develop the condition known as post-acute, or protracted, withdrawal syndrome (PAWS), in which some symptoms can last months or even years.
Medication Used for Alcohol Addiction Treatment and Rehab
Although some less severe cases of alcohol addiction can be treated without medication, it is a fundamental aspect of treatment in many more serious cases.
Medicines prescribed during withdrawal to treat the worst symptoms include various benzodiazepines (including chlordiazepoxide, diazepam, oxazepam and lorazepam), which can help ease symptoms such as seizures, insomnia, pain, anxiety and panic, and nausea.
Antidepressants and anxiolytics (anti-anxiety drugs) are used to deal with some of the more problematic and persistent psychological withdrawal symptoms.In very serious cases involving a pronounced risk of death, emergency treatment may include any of a wide range of medications targeting specific aspects of the crisis.
Medications can also be used to reduce alcohol consumption over time. Some approved by the NHS for the treatment of alcohol use disorder include acamprosate (which reduces cravings by targeting the gamma-aminobutyric acid (GABA) receptors in the brain also affected by alcohol); disulfiram (which causes immediate hangover symptoms when alcohol is consumed); and naltrexone and nalmefene (which reduce cravings by blocking opioid receptors in the brain). Other medications may be available at specific treatment facilities.
Pros and cons of using medication in alcohol addiction treatment and rehab
Where possible and appropriate, doctors try to avoid prescribing medication in addiction treatment, but frequently some symptoms are simply too distressing or dangerous for a pharmaceutical approach not be taken. Indeed, in the case of alcohol withdrawal, some medicines can be life-saving.
- Medication can make detox and withdrawal significantly safer and less distressing.
- Some medications can help reduce alcohol consumption over time.
- Some medications can address co-occurring mental health disorders in cases of dual diagnosis, making addiction treatment less challenging.
- Taking medicine can reassure the client, making them feel “properly treated.”
- Some pharmaceutical treatment can be very long term, keeping users in treatment at significant cost.
- Some medications can interact dangerously with alcohol or other substances of abuse.
- Some medications, especially benzodiazepines, can themselves be habit-forming.
- Some users abuse certain medications and/or give or sell them to others.
Inpatient Alcohol Addiction Treatment Programme
Many rehabs offer alcohol addiction treatment on either an inpatient or outpatient basis. Inpatient treatment provides clients with a holistic treatment programme including detox and withdrawal, therapy and other elements such as bespoke fitness and dietary plans, all supported by expert on-site medical care. Inpatient treatment in a residential facility typically lasts between one and three months. Residential rehabs provide a calming, secure, confidential and pleasant environment in which a client can focus fully on their treatment and recovery without the distractions and temptations of outside life.
Outpatient Alcohol Addiction Treatment Programme
Some people feel they cannot take time away from family and professional obligations for an inpatient stay in rehab. For these individuals, outpatient treatment may be preferable. Treatment can comprise regular visits for therapy, administration of medication, check-ups and more, while other contact may be managed over the phone and/or online. Some aspects of the treatment programme, including those related to diet and fitness, may be addressed independently. However, outpatient treatment can be challenging as it does not remove the client from their daily environment of substance abuse and the temptations to drink.
Private Alcohol Addiction Rehabs and Confidentiality
One of the major concerns facing any client going into treatment is confidentiality. The stigma associated with addiction, especially including alcoholism, is so great that keeping their treatment a secret is a priority for many. As a result, guaranteeing confidentiality is also a priority for treatment facilities, and numerous safeguards are put in place to ensure that client details are kept safe and privacy and secrecy are maintained throughout the treatment process. If you are considering entering rehab and have any concerns regarding confidentiality, contact an addiction specialist and enquire about standard confidentiality protocols and procedures in residential rehab.
Alcohol Addiction Treatment Near Home vs. Different City or County
Where to go to get alcohol addiction treatment is not necessarily a straightforward question. Some people prefer to attend facilities close to home for reassurance of being close to loved ones and a familiar environment, and it is likely to make visits by family and friends significantly easier. On the other hand, many people specifically target facilities far away from their homes to put both physical and psychological distance between themselves and the environment in which they have succumbed to addiction.
Meanwhile, there are many factors involved in choosing the correct treatment facility, and geography may not be the most important one for any given client. If a specific approach to treatment is only provided at a certain facility, it may be more important to prioritise that approach than to take into consideration how close to or far from home that facility might be.
When Is the Right Time for Rehab to Begin?
Every journey through addiction and recovery is different, and what works for one individual may not work for another. It is important to recognise that there are comparatively few universal truths in the field of addiction and addiction treatment.
If you are able to catch your slide into alcohol abuse and addiction early enough, you may be able to resolve your situation without needing to go to rehab. However, serious problems can develop quite quickly, and it is always better to err on the side of caution. If you believe you have a problem with alcohol, the sooner you can take steps to remedy it, the easier it will be to tackle that problem.
The first step is to contact your GP and/or an addiction specialist to discuss your situation and get advice on treatment options. If it is decided that you should attend rehab, the right time to do so will be as soon as is practical. You may have some urgent priorities that need to be attended to before you can take the time out for rehab, and you might need a period of pharmaceutical treatment to manage your addiction before you are able to go into rehab without the worries about those priorities impeding your treatment.
On the other hand, your situation may be so serious that you need to de-prioritise everything else and get urgent help, in which case being admitted to rehab immediately may be the only option.
Alcohol Addiction Rehabilitation: How Long Does It Take?
Recovery from alcohol addiction is a long-term or even lifelong process requiring constant diligence and dedication, and you are not cured the moment you leave a rehab facility. Many people describe themselves as alcoholics, even though they may not have touched alcohol in years or even decades, as a constant reminder of how easy it would be to slip back into addiction.
However, in the short term, addiction treatment programmes of the kind provided in rehab usually last between one and three months, though shorter, more intensive programmes may be provided. At the other extreme, some clients may choose to stay in rehab for several more months before they feel adequately prepared for life outside the facility.
Some pharmaceutical treatment plans, especially those aimed at tapering down dosages, can last several months, either independently or prior to a stay in rehab. In addition, many clients in recovery choose to attend support group meetings (such as those provided by Alcoholics Anonymous) for months or even years after treatment.
What Are the Stages of Alcohol Treatment and Rehab?
Alcohol treatment can typically be divided into three stages, the first two of which are primarily addressed in residential rehab.
Having gone through detox, a client can focus on the more profound psychological challenges that have led to and resulted from their addiction. Rehabilitation sees the user adjusting to existing without alcohol abuse and coming to terms with their situation in order to be able to change problem behaviours and build a better future.
Cleansing a person’s system of alcohol and other substances of abuse is vital before any deeper treatment can be provided. The detox phase, which may include withdrawal symptoms and require medication, deals with the immediate physical pressures of dependence.
In many ways the hardest phase of treatment, maintenance involves staying abstinent whilst reintegrating into daily life. The recovering user will need to implement the coping strategies and psychological defence mechanisms against relapse they’ve been taught in therapy and work hard daily to keep their life moving in a more positive direction. They may benefit from counselling and support group attendance, possibly for long after their last drink.
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Questions to Ask Yourself when Choosing an Alcohol Addiction Treatment and Rehab Centre
If you are considering entering alcohol addiction treatment, you may not know much about the subject or about which facilities might be most appropriate for you. When assessing potential facilities, ask yourself the following questions:
- What type of services does the facility offer?
- How far do you have to travel to get to the treatment facility?
- Are friends and family allowed to visit?
- Do you require special accommodation for a disability?
- What programmes are required as part of your treatment?
- Will the centre help you transition to an addiction support group?
- What is the cost for services? What payment methods does the centre accept?
- How long will you be required to stay at the centre if you opt for inpatient treatment?
- Does the facility fit with your beliefs?
Always contact an addiction specialist prior to enrolling in any rehab to discuss any other questions you may have.
Alcohol Addiction Treatment & Health Insurance
Some private alcohol addiction treatment programmes can be expensive, but not all health insurance policies cover private addiction treatment and others may cover treatment only in certain facilities. If you are considering private rehab and have private health insurance, contact your insurer to find out exactly what your policy does and does not cover in this regard and if there are any clauses that might make your claim invalid.
If you are uncertain about exactly what is acceptable according to your insurance policy, you may wish to speak with an addiction specialist to discuss your situation.
Alcohol Treatment and Rehab Facts and Stats
- Each year, more than 3 million people around the world die as a result of the harmful use of alcohol, representing over 5% of all human deaths.
- Around 13.5% of all deaths of people aged 20 to 39 are the result of alcohol abuse.
- In England alone, government estimates for the number of alcohol-dependent people range from 482,000 to 745,000.
- Over 75,000 people in England were in treatment for alcohol use disorders in 2018.
- The median age of people in alcohol treatment in England in 2017/18 was 46; 12% of those in treatment were aged 60 or over.
Alcohol Addiction Treatment and Rehab Success Rate
It is impossible to say exactly how many alcohol users achieve and sustain complete abstinence, as not all individuals going into treatment report success or failure later on. However, UK government research showed that as of 2012, the best-performing treatment facilities in the country were achieving a success rate of between 60% and 80% for clients who were maintaining sobriety five years later. At the other end of the spectrum, the worst performers were achieving success rates of only 20% or below.
It is important to recognise that a huge number of factors affect treatment and recovery, and even the best facilities cannot control the circumstances in which recovering users may find themselves later in life. However, it is clear that there is a significant difference in outcomes between the best- and worst-performing treatment facilities. If you are considering going into rehab for alcohol addiction, it is advisable that you speak with an addiction specialist about the performance of any facility or facilities that you are interested in.
Explore Treatment Options Now
Addiction treatment can be a daunting subject, as there is so much information available and so many choices to make. However, while it is vital to make the correct choices for yourself and your situation, it is also important not to get lost in a labyrinth of data and end up not acting and allowing your addiction to worsen. Contact an addiction specialist who can discuss the treatment options that might be appropriate for and available to you and who can give you information on any treatment programmes or facilities in which you are particularly interested.
Achieving sobriety is one thing; maintaining it is another. Once you have gone through treatment, your recovery process is not complete the moment you leave the facility. You need to tend to your recovery day by day using all the tools you have learned during treatment and doing everything possible to avoid temptation.
Continuing care: what comes after?
Quality rehabs are well aware that recovery is an ongoing process and will provide aftercare programmes (typically for up to a year) when you leave rehab. These may involve regular appointments on-site, phone and/or email consultations and general check-ups to see how you are progressing, as well as scheduling elements like counselling sessions and support group attendance outside rehab.
Relapse prevention is a critical aspect of recovery; although one or even occasional relapses should not be seen as failure or automatically imply a return to addiction, giving in to relapse does pose serious risks. During treatment you will be taught various relapse prevention tools and strategies, and it is vital that you stick to those at all times in order to avoid undoing weeks and months of hard work.
Alcoholics Anonymous and other support groups
Around the country, various support groups — of which Alcoholics Anonymous is the most famous — work to provide advice and companionship to recovering alcoholics. Attending support groups can be a powerful element of recovery and is often an aspect of aftercare programmes provided by rehab. Attendance is typically free, with the only criterion for participation being a commitment to abstinence. Contact an addiction specialist to find out about support group meetings in your area.
Get Help Today
Alcoholism is a dangerous and potentially life-threatening condition, and the sooner you can take steps to overcome it, the more likely that you will achieve recovery. If you are struggling with an alcohol addiction, reach out to your GP and/or an addiction specialist today to discuss your condition and find out about treatment options.
Take control of your life — get started on the road to recovery
If you are struggling with alcoholism, it is understandable that you may feel powerless in the face of alcohol and may see no way out from your addiction. However, with professional help, you can break the chains that are binding you. Pick up the phone to your GP and/or an addiction specialist and begin the process of taking back control of your life.
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