Treatment for Alcohol Use Disorder

Your health care provider can help you figure out if you are drinking at unhealthy levels and would benefit from treatment. The type of treatment that will be best for you depends on a number of things. Consider the following:

• How challenging it has been for you to control your drinking
• If you have been able to reduce the amount of drinking on your own
• If you might benefit from medicine to reduce alcohol craving and alcohol use
• If you might benefit from the help of a counselor
• If you might benefit from more assistance to reduce your drinking
• If you feel sick when you try to cut down on your drinking
• If you have support from family or friends to reduce your drinking or quit altogether

Some people who are drinking at unhealthy levels, but not dependent on alcohol, have decided to cut back their drinking on their own. Many have found an online app from the VA National Center for PTSD called VetChange to be helpful. It is available for free from the iTunes store and Google Play.

Treatment options

There are multiple apps based on 12-step recovery principles. There is also an app called Overcoming Addictions for those who want to stop alcohol or drug use. It’s based on the Smart Recovery Program that is an abstinence-focused cognitive behavioral program. SMART Recovery is an alternative to Alcoholics Anonymous (AA), which is also widely available.

The VA provides a wide range of effective treatments. These include:

• Group therapy
• Individual therapy
• Inpatient or residential treatment
• Medicines to reduce craving or reduce alcohol use

Treatment programs usually include counseling, such as:

• Individual and group therapy. This is where you talk about your recovery with a counselor or with other people who are trying to quit or reduce the harm caused by their drinking. You can get support from others who have struggled with alcohol.
• Cognitive behavioral therapy (CBT). This is where you learn to change thoughts and actions that make you more likely to use alcohol. A counselor teaches you ways to deal with cravings and not go back to alcohol or drinking at harmful levels.
• Motivational interviewing (MI). This is where you address mixed feelings about making changes in your drinking habits and getting treatment. A counselor helps you find your personal motivation to change.
• Motivational enhancement therapy (MET). This uses motivational interviewing (with assessment and feedback) to help you find motivation to quit or cut down to safer levels of use. It usually lasts for 2 to 4 sessions.
• Brief intervention therapy. This therapy provides feedback, advice, and goal-setting in very short counseling sessions.
• 12-step facilitation therapy. This therapy helps you to get involved and benefit more from participation in Alcoholics Anonymous and other 12-step programs.
• Couples and family therapy. This can help you become and stay sober and keep good relationships within your family.

If you have questions about how to make healthy lifestyle changes, talk with your health care team.

Helping someone you care about

If someone you care about has an alcohol problem, you may be able to help them limit their drinking by talking to them. Here are some tips to help.

• Discuss the impact that the drinking has on you.
• Talk with the person in private, when they are not drinking alcohol and when you are both calm.
• Call for an appointment right away if the person agrees to get help.

The VA health care team will not judge them. Instead, they will listen to the person's concerns and treatment preferences. They will discuss a variety of different options available to help the person reduce or stop alcohol use and live a healthier, more fulfilling life.

You may privately check your alcohol use with the Alcohol Use Disorders Screening Test (AUDIT) by going to MyHealtheVet. You can also take a confidential, on-line assessment through NIAAA. If these assessments suggest you may be drinking at troubling levels, moderating your drinking reduces your risk for these problems.

Alcohol problems may be diagnosed during a routine health care provider visit. They can also be diagnosed when you see a health care provider for another problem. If a partner or friend is concerned that you may have an alcohol problem, they may encourage you to see your health care provider. Your health care provider will:

• Ask questions about your symptoms and past health, and may do a physical exam, including blood tests to see how your liver is functioning.
• Do a mental health assessment to find out whether you may have a problem that is often seen with alcohol use. This might be depression, anxiety, or posttraumatic stress disorder (PTSD). Although it is not unusual for people to try to ease mental health distress with alcohol, healthier choices are available to manage symptoms and distress.
• Ask questions or schedule medical tests to find any health problems commonly linked to alcohol, such as gastritis, pancreatitis, or liver disease.

For more information

• VetChange
• Alcoholics Anonymous Online Intergroup
• SMART Recovery online
• Alcohol Use Disorders Screening Test (AUDIT)
• Confidential, on-line assessment through NIAAA