Treatment for Alcoholism: What is it?

Editor Dan Schimmel, LCSW, CAP
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If you are 100% sure that you have a drinking problem, but you’re not 100% sure whether or not you should go to rehab, or you’re unsure as to where to even start if you do go, then you’re reading the right article. Now, that being said, if you feel you are in any kind of danger due to your drinking, stop reading this article and seek help immediately. Here we’ll answer some of the top questions people have about rehab for alcoholism.

Everyone knows rehab exists. Does everyone know what rehab truly is? Rehab is a shortened version of the word rehabilitation, the noun form of rehabilitate, which literally means “to help somebody to return to good health or a normal life by providing training or therapy,” according to the Encarta dictionary. For this reason mainly, we prefer the term treatment, and we like to call rehabs treatment centers. Joining a program at a treatment center does not entail a white-walled, locked-in-your-room type of experience.

Look back at the last three words of the definition above: ‘training or therapy’. That’s what entering into a program at a treatment facility will consist of. First and foremost, quitting alcohol with alcoholism is extremely dangerous when attempted without the proper help. Many notable figures throughout history have died attempting to quit drinking without treatment, most recently Amy Winehouse. Secondly, treatment nowadays is designed to be as comfortable as possible. It feels more like a home than a facility.

What follows is a Q&A style section where we answer some of the most common questions asked about treatment for alcoholism. If your question was not answered, please contact us today and we’ll be happy to answer any questions you have.

What are the different types of treatment programs?

Basically, there are five types of treatment not for just alcoholism, but for all substance addictions:

  1. Detoxification Only – Almost always the first step in treatment programs of all types, medical detoxification, (commonly called detox), involves ridding the body of alcohol completely in a safe and effective manner. It is deadly, as noted, to quit alcohol without help. It’s during detox that any withdrawal symptoms will occur. Detoxing in a treatment program offers as much relief as possible from such symptoms, which could include tremors, vomiting, or hallucinations, among many others.
  2. Inpatient Treatment – You may have heard the term ‘residential treatment’. Inpatient treatment is the same thing. It entails that you live at the facility itself for however long your stay is. All accommodations are taken care of, and you would live there as if it were an extended stay at a hotel. However, at this hotel, there is absolutely no drug use or alcohol drinking, and the food is much healthier for sure. Also, there are usually plenty of healthy activities available, all to promote a better lifestyle.
  3. Outpatient Treatment – In the case of outpatient treatment, you would not live at the facility, but would instead attend for the time blocks your program entails. All of the actual treatments and medical staff and equipment and therapies are fully available. Clients live home, still work all of their hours at their jobs, and life outside of the facility carries on as usual. Sessions are almost always scheduled around the needs of clients.
  4. Intensive Outpatient Treatment – This type of treatment allows for the client to live at home but still receive close to the level of care as someone in inpatient treatment. Intensive outpatient treatment is not opted for as much as any of the other types, since only a particular lifestyle combined with a particular level of addiction would bring the need for it about.
  5. Partial Hospitalization – This type of treatment is only recommended for those who have completed an entire inpatient treatment and require assistance regaining a normal life. One can expect evidence-based methods of care and 24/7 access to a full medical staff, similarly to inpatient, except partial hospitalization offers the option of either on-site of off-site living. Programs typically offer a level of care comparable to an inpatient program, but on less than a 24-hour basis.

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None of this is to say that any type of treatment is insufficient, or less than the other. There are simply options because there are different levels of addiction to alcohol. A college-aged binge drinker who only began one year ago may very well be an alcoholic, but likely not on the same level as someone who drinks a bottle of liquor a day and has for years.

Which type of treatment should I choose?

Ultimately, this is a decision that should be made between you and whoever you consider to be in your support group. This could be a couple of close friends, or family members, or simply someone you trust. We recommend also talking with your primary doctor before choosing which treatment type to enter into. That being said, here’s an idea of which type suits which addict.

  1. Detoxification Only – Let’s not beat around the bush. Detox as a standalone method is the cheapest of all addiction treatment types. Cost effectiveness is perhaps the main reason to choose detox only. However, beware of not completing a full program if you feel at all that you couldn’t beat your addiction yourself. Detox only is mainly for those who know beyond all doubts that they will recover once their body is rid of alcohol and other toxins.
  2. Inpatient Treatment – Are you the type of drinker who would go through hours of therapy only to return home and get drunk? Is the overwhelming temptation of alcohol too much to bear when not safely within a treatment facility? Live there for a while, then. Inpatient treatment is designed specifically for addicts or alcoholics who require a long-term separation from the availability of drugs/alcohol on top of professional treatment. Also, if you succeed more in group settings than solo, inpatient treatment is likely for you.
  3. Outpatient Treatment – Do you feel like you definitely need help, but that you also are fully capable of living your everyday life, such as working, sleeping at home, etc.? Consider outpatient treatment to be appointment-based treatment. You will find a schedule that works, and you will attend the facility however many days a week are deemed fit. Treatment is equally as effective for outpatient clients as for any others – it’s just that you don’t live at the facility. Please only opt for outpatient treatment if you are sure that you can handle everyday life and not drink/use drugs as you head down the path toward full recovery.
  4. Intensive Outpatient Treatment – Do you absolutely have to live at home and/or continue working every day, but you also need the level of help that an inpatient client would receive? Intensive outpatient treatment is for you, then, but as previously noted, this is the rarest form of substance addiction therapy. Usually if an addiction is so bad that intensive treatment is required, full-on inpatient treatment is recommended.
  5. Partial Hospitalization – Have you already completed a treatment program, or at the very least a detox program? Now you need help transitioning back to real, sober, everyday life? Partial hospitalization, while it sounds scary, means only that your treatment will be carried out in a hospital setting. While all addiction is serious, partial hospitalization is more often reserved for severe cases, and only post-treatment. Rarely, if ever, does someone enter into partial hospitalization as the first treatment type.

I know what type of treatment I want… now where do I actually get it?

The Substance Abuse and Mental Health Services Administration, otherwise known as SAMHSA, is the American government’s leading organization on such matters. SAMHSA offers what they call a ‘behavioral health treatment services locator,’ which is available for free use by clicking here. You can search by address, city, or zip code. If you do not have access to the internet, you can call 1-800-662-4357 or for TTY, call 1-800-487-4889.

Of course there is always Google, a phone book, or asking around as well. Just make sure you do ample research before heading off to a facility. The vast majority of facilities do really good work, but as in all industries, there are some bad apples simply after your dollar. In fact, there is a criminal activity on the rise called patient brokering, which involves a recruiter of sorts who seeks out addicts with insurance. If successful, the broker will send the addict to the facility which originated the scam, and the addict will be billed mercilessly for unnecessary things. Everyone involved profits, except for the addict – the one everyone was supposed to help in the first place. It’s awful. Beware of it.

Do all treatment facilities use drugs in curing an addiction?

Not all, but most treatment facilities will use medicine somewhere along the process of attempting to cure your addiction, regardless of what it’s to. With alcoholism, there are three main drugs used to combat the disease: acamprosate, disulfiram, and naltrexone. Each has its own unique mechanism to assist in stopping alcoholism and preventing relapse.

Acamprosate

A normal brain functions differently from an alcoholic brain, which functions with impairment. As the drinking gets worse, so does the impairment. The chemical signaling that happens inside the brain becomes disrupted, causing levels of certain neurotransmitters to go from healthy to abnormal. The drug called acamprosate stabilizes the otherwise haywire chemical signaling in the brain. Therefore, it reduces both the craving for alcohol and the symptoms of alcohol withdrawal.

Disulfiram

Ok follow this closely. When someone drinks alcohol, an enzyme in liver, let’s call it Enzyme 1, breaks down the alcohol into something called acetaldehyde. Then, there is another enzyme, which shall be called Enzyme 2, which breaks the acetaldehyde down into acetic acid – something harmless. However, acetaldehyde is not so harmless. When there is a buildup of acetaldehyde, the effects of a hangover are felt. Disulfiram prevents that particular enzyme in the liver from working, causing acetaldehyde to build up rather quickly.

Summed up, a person on disulfiram would feel a very bad hangover within 10 minutes of even having one mouthful of beer. This very basic and very blunt formula works to prevent drinking, but does not prevent the craving to drink.

Naltrexone

This drug is used to combat both alcoholism and opioid addiction. It primarily prevents the craving for alcohol, as it does for opioids. Naltrexone has been proven to reduce both the amount and frequency of drinking.

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Which medication gets prescribed to you depends on many things, especially including your own habits. For the most part, though, acamprosate is used most frequently among these three drugs since it can reduce both craving and symptoms.

Isn’t addiction treatment really expensive?

Again, we want to be honest, and so the answer is yes. However, health insurance is all but guaranteed to drastically reduce the cost of your treatment. In fact, many states now require health insurance companies to fully cover addiction treatment. With the drug overdose crisis at our hands, everyone recognizes that everyone needs to pull together in order to beat it.

The actual cost of treatment varies greatly from facility to facility and from insurance company to insurance company. In fact, the monthly cost continuum is from about $2,000 to $20,000! Just do the research and make sure you don’t go over your budget. Expensiveness does not mean excellence and inexpensiveness does not mean poor quality. Frankly, it becomes the amenities you’re paying for.

In the end, the choice is yours. Just make sure you choose a well-established and trustworthy facility. Not sure where to start, check out our Top 10 Best Drug and Alcohol Treatment Centers in the USA here!


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