Recovery from alcohol abuse does not happen in a matter of days. Alcohol rehab is a multistep process that demands time, effective therapies, and the support of friends and family. But the time and effort that go into recovery from alcoholism will pay off in the form of improved physical health, stronger personal relationships, and a more positive outlook on the future.
Understanding the Disease of Alcoholism
In the past, heavy drinking was considered to be a sign of a weak character and a lack of self-discipline. Today, research in the fields of neurology and addiction science have taught us that alcoholism is a chronic disorder of the brain.
Alcoholism is a complex condition that is not caused by a lack of willpower, but by a combination of contributing factors:
- Family history: Having a family background of alcoholism accounts for up to 60 percent of the risk of developing alcoholism, according to the National Institute on Alcohol Abuse and Alcoholism. People with one or more close relatives who drink heavily are more likely to drink heavily themselves, both because of genetics and because of environmental factors.
- Brain chemistry: Low levels of the neurotransmitters that affect mood and promote contentment, such as dopamine, have been linked with alcohol and drug abuse. The American Journal of Medical Genetics notes that having a deficiency in the brain cells that process dopamine increases the likelihood of addictive behaviors like alcohol abuse.
- Personal trauma: A history of childhood abuse or violent and disturbing experiences in adulthood — such as military combat, sexual assault, or homicide — has been associated with substance abuse. In fact, the U.S. Department of Veterans Affairs states that up to 75 percent of individuals who have survived severe trauma or abuse have problems with alcohol.
- A co-occurring mental illness: Substance abuse is substantially more common in individuals with psychiatric disorders (depression, anxiety, bipolar disorder, schizophrenia, and others) than in the general population. The National Alliance on Mental Illness (NAMI) reports that among people who abuse alcohol, nearly 33 percent have a form of mental illness.
Not everyone who has one of these elements in their background will develop the disease of alcoholism. There are many factors that can protect an individual against having problems with alcohol, such as a strong social support network or successful personal relationships. However, it pays to be aware of the risk factors for alcoholism, so you can minimize the chances of developing the disease.
Alcoholism is an addictive disorder that will continue to get worse without intervention and treatment. The National Institute on Drug Abuse defines addiction as a chronic brain disease with symptoms that include compulsive use of the drug, frequent relapses, and persistence in abusing the substance in spite the harm it causes. Unless the individual enters treatment or participates in recovery activities, the disease is likely to progress to the point of disability and premature death.
Alcohol Abuse Statistics
When does heavy drinking or casual partying turn into a serious disease? Moderate drinking is generally defined as one drink per day for women and two drinks per day for men, according to the Dietary Guidelines for Americans 2010, but many people consume far more than these recommendations. The National Health Interview Survey 2014 found that in 2014, over 31 percent of American men had at least one day of heavy drinking (five or more alcoholic beverages in a 24-hour period) in the past year, while 14.5 percent of American women had at least one heavy drinking day.
Binge drinking is a sign that recreational alcohol use has become dangerous and destructive. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that close to 25 percent of adults age 18 and older had engaged in binge drinking, or the consumption of five or more alcoholic beverages within a matter of hours, in the past 30 days.
Heavy drinking greatly increases the risks of alcohol-related health problems, such as:
- Liver disease
- Certain types of cancer
- Heart disease
- High blood pressure
- Heart attack and stroke
- Accidental injuries and premature death
- Brain damage
Drinking heavily also makes it more likely that an individual will become addicted to alcohol. In spite of the growing publicity about the health risks of alcoholism, this substance remains one of the most widely abused drugs in the United States. According to the National Survey on Drug Use and Health (NSDUH), over 16,600 Americans age 18 and older — approximately 7 percent of this population of adults — abused alcohol or were dependent on alcohol in 2013.
The Centers for Disease Control and Prevention (CDC) offers statistics on alcohol use in the US:
- Alcohol was responsible for around 88,000 deaths per year in 2006-2010.
- Out of those who died, alcohol shortened their life expectancy by an average of 30 years.
- Ten percent of deaths among Americans age 20-64 are related to alcohol abuse.
- Alcohol abuse cost the US nearly $250 billion in 2010.
Unfortunately, statistics indicate that most people who need treatment for alcohol abuse do not receive it. Some of these individuals did not agree that they needed treatment, while others recognized their need for help but were not ready to commit to a program, or did not believe they had the resources to enter a rehab facility.
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Detecting the Signs of Alcohol Abuse
Over time, alcohol eventually takes a toll on the individual’s physical, mental, and financial wellbeing. But because drinking is such a common social practice, it can be easy to overlook some of the early red flags of the disease, such as:
- A preoccupation with drinking and alcohol-related activities
- A loss of the ability to set limits on how much or how often one drinks
- The need to drink more alcohol to get the same effects
- Dramatic changes in mood or personality when drinking
- A decline in performance at work or school
- Neglect of relationships or activities that don’t involve drinking
- Frequent attempts to stop drinking without success
- Feelings of guilt or remorse about one’s alcohol use
- Repeated attempts to quit drinking or to cut back without success
Many people who drink destructively will eventually attempt to stop on their own. They may try to limit the number of drinks they consume, save their drinking for weekends, or drink only in the company of others. However, in most cases, people who abuse alcohol need the help and support of others to achieve long-term recovery, including friends, family, and compassionate addiction treatment progressions.
Approaching Someone Who Needs Help
Convincing a loved one that help is needed can be one of the most challenging barriers to treatment. Denial is common among people struggling with alcohol abuse. The need to drink alcohol in order to function physically and mentally can become so overwhelming that the individual will do anything to avoid losing the connection with that substance.
When talking with a person who has a drinking problem, the most effective approach is usually to be as objective and nonjudgmental as possible. Accusations, criticism, and emotional outbursts will often alienate the individual instead of bringing the person closer to treatment. Use the following tips to make your conversation compassionate yet productive:
- Plan what you want to say. Write down your thoughts beforehand, so you’ll feel calm and collected when you speak. Some people find it helpful to compose a letter to the individual, which can actually be presented at the meeting.
- Choose a time when you feel you can control your emotions. If you are overly tired, stressed, or upset, the conversation is more likely to turn into an argument.
- Schedule the talk for a time when your loved one is sober. Your friend or family member should be lucid enough to understand what you’re saying. This ensures that your loved one will be in a better frame of mind to consider recovery.
- Seek support from others. Talking to someone about alcoholism may be easier if you have the support of others who care about the individual. A formal meeting, also known as an intervention, may make it easier to expedite the process of getting your loved one into treatment.
- Have a treatment plan in place. If your desired outcome is to get your loved one into treatment, it’s important to have a plan in place to make this happen. Take some time to research facilities that are appropriate for your loved one’s needs.
- Make your loved one accountable. Your loved one should understand that if he or she continues to refuse help, there will be consequences involved. These consequences might include losing certain privileges at home or even ending a key relationship. Writing out these consequences in the form of a contract will make the terms very clear.
Above all, remember that alcoholism is a disease that should be treated with as much compassion and understanding as any other serious medical condition. It can be extremely frustrating, even frightening, to watch a loved one engage in alcohol abuse. But an effective alcohol treatment program can help prevent the devastating effects of alcoholism and get your loved one back on the path to a healthy, rewarding life.
Finding a Treatment Program
A little research into alcohol treatment options will confirm that there are many different ways to treat this disease and that there are probably dozens of rehab centers within an easy distance of your own community. The types of treatment programs that you will find when you start your search actually represent levels of care:
- Medical detox: In this phase of treatment, clients are kept medically stable while the alcohol leaves the system. Medical detox may take place at a hospital, dedicated detox facility, rehab center, or outpatient clinic, depending on the severity of the client’s alcohol abuse and overall medical condition.
- Inpatient alcohol rehab: Clients in an inpatient program benefit from the structure of 24-hour monitoring while they are kept safe and stable in a comfortable environment. At this stage of treatment, the work of rehab begins with therapy, support groups, family counseling, 12-Step meetings, and other services.
- Residential treatment: Residential rehab programs offer longer stays for clients who need 24-hour care. Daily schedules consist of individual and group therapy, trauma therapy, behavioral modification, and other structured activities that promote sobriety.
- Partial hospitalization programs (PHPs): In a PHP, clients receive intensive recovery services, including individual therapy, group therapy, and other rehabilitative activities, at the treatment facility while living at a sober living home or a private residence. A PHP offers a way to help the client make the transition from rehab to life in the community in a safe, supportive environment.
- Intensive outpatient programs (IOPs): The IOP represents a step down from the partial hospitalization program, with even more flexibility than the PHP provides. Clients still participate in recovery activities up to seven days a week, but they may live at home, work, and take care of family at the same time.
- Aftercare planning: In the aftercare stage of treatment, clients hone their new coping skills and practice healthy behaviors. Each client should finish rehab with a set of resources for building a sober life and a support system for sustaining sobriety.
Together, these programs form a spectrum of services that support a long-term sobriety. Many people who seek treatment will go through several of these programs as they advance through recovery. Detox is the foundation of recovery, cleansing the body of alcohol and preparing the mind for rehab. Inpatient treatment or residential rehab often follow the detox phase, providing a structured environment where the client can focus on recovery without the distractions or stressors of daily life.
Once clients feel stronger and more confident in sobriety, they may transition to a more flexible outpatient program that offers independence and autonomy. Outpatient rehab programs offer many of the same services and therapies as inpatient treatment centers, but they give clients the opportunity to live in the community, hold down a job, and take care of family obligations at the same time.
Questions to Ask a Treatment Center
Making that first phone call to a treatment center may feel intimidating. This list of questions will help you structure your conversation with an admissions counselor and find a program that meets your loved one’s needs.
- What are your credentials and accreditations?
- What therapies and services do you provide?
- Who are the professionals who make up your team?
- What credentials do your staff members have?
- What accommodations and amenities does your facility provide?
- Do you offer support and counseling for family members?
- Do you provide aftercare services?
- What kind of payment do you accept?
- Do you offer transportation to your facility?
- How soon can my loved one get into treatment?
- How long does a treatment program last?
During treatment, clients should have access to a staff of compassionate, credentialed professionals from the fields of medicine, addiction treatment, mental health, social services, nutrition, trauma therapy, and more. A comprehensive staff includes doctors, nurses, health technicians, nutritionists or dietitians, and fitness professionals. All of these experts contribute to sustainable, long-term recovery.
The Intake Process
The intake phase is a critical step in the early stages of alcohol treatment. A thorough intake assessment and evaluation will ensure that clients receive treatment that addresses their unique needs. During this phase, an incoming client receives a complete evaluation that covers the following:
- Medical history
- History of substance abuse
- Psychological evaluation
- History of personal trauma or abuse
- Sources of social support
- Needs of family and loved ones
- Financial needs
The initial assessment includes an evaluation of the severity and duration of the client’s alcohol use, history of rehab admissions, and the presence of co-occurring medical conditions or psychiatric disorders that need to be addressed. This information helps the treatment team identify the right level of care for the client and create a personalized care plan for recovery.
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Finances shouldn’t be an obstacle when you are seeking help for your loved one, but in reality, paying for recovery services is a key concern for almost everyone who seeks help. Alcohol treatment services are available to anyone who is committed to getting recovery, regardless of their ability to pay. For individuals with limited financial resources, publicly funded detox and rehab programs can provide intensive treatment, while outpatient services or 12-Step programs are available for those who do not need 24-hour care.
Medical insurance and personal financial resources can be used to cover treatment at private facilities. Most major health insurance plans cover substance abuse treatment. An admissions counselor at the facility will be able to review your resources and determine which services your insurance will cover.
Progressing through Treatment
Once the intake process is complete, alcohol treatment begins with medical detox. Detox can be completed on an inpatient or an outpatient basis, depending on how much supervision the client needs. Clients with a potential for severe withdrawal symptoms, or those who have a higher risk of relapse, will need to go through detox at an inpatient facility or hospital where they can be monitored around the clock by clinical staff. Clients who are medically stable and highly motivated to go through rehab may complete the detox process on an outpatient basis, with scheduled visits to a clinic or rehab facility. Those suffering from addictions to alcohol, opiates, or benzodiazepines always require medical detox to ensure their safety and wellbeing throughout the withdrawal process.
It’s not uncommon for the public to mistake alcohol detox for alcohol rehab, but detox and rehab actually represent two distinct stages in recovery. In medical detox, clients recover from the acute physical effects of alcohol abuse. During the detox phase, clients are prepared to enter a rehab program, where they will receive therapeutic services the promote recovery.
In the aftercare phase, clients who have completed the stages of rehab may continue to attend meetings, see therapists, or participate in social events with other individuals who have been through rehab. The goal of aftercare is to help recovering clients re-enter the community and support them in the use of new coping strategies.
Individualized treatment for alcoholism is not a one-size-fits-all process. The goals and steps of a treatment plan should reflect the client’s substance use history, medical condition, and the existence of any co-occurring psychiatric conditions. In addition, an alcohol treatment plan should provide support and education for the loved ones of its clients, so they can pursue their own recovery and create a healthy living environment that supports sobriety.