Alcoholism - Treatment for Alcoholism

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The new approach to outpatient treatment uses “medical management” -- a disease management approach that is used for chronic illnesses such as diabetes. With medical management, patients receive regular 20-minute sessions with a health care provider. The provider monitors the patient’s medical condition, medication, and alcohol consumption.

An important 2006 study in the Journal of the Medical American Association (JAMA ) found that medical management can successfully treat alcoholism when it is combined with either:

• Drug treatment with naltrexone (ReVia, Vivitrol), or
• Behavioral counseling with a therapy technique called combined behavioral intervention (CBI)

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The study did not find any benefit for another drug, acamprosate (Campral), either used alone or in combination with naltrexone.

Inpatient Treatment Options. A typical inpatient regimen may include the following stages:

• A physical and psychiatric work-up for any physical or mental disorders
• Detoxification -- this phase involves initiating abstinence, managing withdrawal symptoms and complications, and ensuring that the patient remains in treatment
• On going treatment with medications in some cases
• Psychotherapy, usually cognitive-behavioral therapy
• An introduction to Alcoholics Anonymous

Outpatient Treatment Options. People with mild to moderate withdrawal symptoms are usually treated as outpatients. Treatments are similar to those in inpatient situations and include:

• Psychotherapy or counseling
• Medications that target brain chemicals involved in addiction
• Social support groups such as Alcoholics Anonymous
• Cognitive therapies
• Quitting smoking (smoking interferes with the brain’s recovery from alcoholism)

After-Care and Work Therapy. After-care employs services that help alcoholics maintain sobriety. For example, in some cities, sober-living houses provide residences for people who are trying to stay sober. They do not offer formal treatment services, but the people living there offer each other support and maintain an abstinent environment. A 2002 study reported that work therapy improved the outcome for homeless veterans who were being treated for substance abuse.