Diagnosis

You're likely to start by seeing your primary care doctor. If your doctor suspects you have a problem with alcohol, he or she may refer you to a mental health provider.

To assess your problem with alcohol, your health care provider will likely:

  • Ask you several questions related to your drinking habits. The health care provider may ask for permission to speak with family members or friends. However, confidentiality laws prevent your health care provider from giving out any information about you without your consent.
  • Perform a physical exam. Your health care provider may do a physical exam and ask questions about your health. There are many physical signs that indicate complications of alcohol use.
  • Lab tests and imaging tests. While there are no specific tests to diagnose alcohol use disorder, certain patterns of lab test abnormalities may strongly suggest it. And you may need tests to identify health problems that may be linked to your alcohol use. Damage to your organs may be seen on tests.
  • Complete a psychological evaluation. This evaluation includes questions about your symptoms, thoughts, feelings and behavior patterns. You may need to fill out a questionnaire to help answer these questions.
  • Use the DSM-5 criteria. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association, is often used by mental health providers to diagnose mental health conditions and by insurance companies to reimburse for treatment.

Treatment

Treatment for alcohol use disorder can vary, depending on your needs. Treatment may involve a brief intervention, individual or group counseling, an outpatient program, or a residential inpatient stay. Working to stop the use of alcohol to improve quality of life is the main treatment goal.

Treatment for alcohol use disorder may include:

  • Detox and withdrawal. Treatment may begin with a program of detoxification or detox — withdrawal that's medically managed — which generally takes two to seven days. You may need to take sedating medications to prevent withdrawal symptoms. Detox is usually done at an inpatient treatment center or a hospital.
  • Learning skills and establishing a treatment plan. This usually involves alcohol treatment specialists. It may include goal setting, behavior change techniques, use of self-help manuals, counseling and follow-up care at a treatment center.
  • Psychological counseling. Counseling and therapy for groups and individuals help you better understand your problem with alcohol and support recovery from the psychological aspects of alcohol use. You may benefit from couples or family therapy — family support can be an important part of the recovery process.
  • Oral medications. A drug called disulfiram (Antabuse) may help to prevent you from drinking, although it won't cure alcohol use disorder or remove the compulsion to drink. If you drink alcohol, the drug produces a physical reaction that may include flushing, nausea, vomiting and headaches. Naltrexone (Revia), a drug that blocks the good feelings alcohol causes, may prevent heavy drinking and reduce the urge to drink. Acamprosate (Campral) may help you combat alcohol cravings once you stop drinking. Unlike disulfiram, naltrexone and acamprosate don't make you feel sick after taking a drink.
  • Injected medication. Vivitrol, a version of the drug naltrexone, is injected once a month by a health care professional. Although similar medication can be taken in pill form, the injectable version of the drug may be easier for people recovering from alcohol use disorder to use consistently.
  • Continuing support. Aftercare programs and support groups help people recovering from alcohol use disorder to stop drinking, manage relapses and cope with necessary lifestyle changes. This may include medical or psychological care or attending a support group.
  • Treatment for psychological problems. Alcohol use disorder commonly occurs along with other mental health disorders. If you have depression, anxiety or another mental health condition, you may need talk therapy (psychotherapy), medications or other treatment.
  • Medical treatment for health conditions. Many alcohol-related health problems improve significantly once you stop drinking. But some health conditions may warrant continued treatment and follow-up.
  • Spiritual practice. People who are involved with some type of regular spiritual practice may find it easier to maintain recovery from alcohol use disorder or other addictions. For many people, gaining greater insight into their spiritual side is a key element in recovery.

Residential treatment programs

For a serious alcohol problem, you may need a stay at a residential treatment facility. Most residential treatment programs include individual and group therapy, support groups, educational lectures, family involvement and activity therapy.

Residential treatment programs typically include licensed alcohol and drug counselors, social workers, nurses, doctors and others with expertise and experience in treating alcohol use disorder.

Lifestyle and home remedies

You'll need to focus on changing your habits and making different lifestyle choices.

  • Consider your social situation. Make it clear to your friends and family that you're not drinking alcohol. Develop a support system of friends and family who can support your recovery. You may need to distance yourself from friends and social situations that impair your recovery.
  • Develop healthy habits. For example, good sleep, regular physical activity, managing stress more effectively and eating well all can make it easier for you to recover from alcohol use disorder.
  • Do things that don't involve alcohol. You may find that many of your activities involve drinking. Replace them with hobbies or activities that are not centered around alcohol.

Alternative medicine

Avoid replacing conventional medical treatment or psychotherapy with alternative medicine. But if used in addition to your treatment plan when recovering from alcohol use disorder, these techniques may be helpful:

  • Yoga. Yoga's series of postures and controlled breathing exercises may help you relax and manage stress.
  • Meditation. During meditation, you focus your attention and eliminate the stream of jumbled thoughts that may be crowding your mind and causing stress.
  • Acupuncture. With acupuncture, hair-thin needles are inserted under the skin. Acupuncture may help reduce anxiety and depression.

Coping and support

Many people with alcohol problems and their family members find that participating in support groups is an essential part of coping with the disease, preventing or dealing with relapses, and staying sober. Your doctor or counselor can suggest a support group. These groups are also often listed on the Web and sometimes in the phone book.

Here are a few examples:

  • Alcoholics Anonymous. Alcoholics Anonymous (AA) is a self-help group of people recovering from alcoholism that offers a sober peer group built around 12 steps as an effective model for achieving total abstinence.
  • Women for Sobriety. Women for Sobriety is a nonprofit organization offering a self-help group program for women who want to overcome alcoholism and other addictions. It focuses on developing coping skills related to emotional and spiritual growth, self-esteem and a healthy lifestyle.
  • Al-Anon and Alateen. Al-Anon is designed for people who are affected by someone else's alcoholism. Alateen groups are available for teenage children of those with alcoholism. In sharing their stories, family members gain a greater understanding of how the disease affects the entire family.

Preparing for your appointment

Here's some information to help you get ready for your appointment, and what to expect from your doctor.

Consider your drinking habits, taking an honest look at how often and how much you drink. Be prepared to discuss any problems that alcohol may be causing. You may want to take a family member or friend along, if possible.

Before your appointment, make a list of:

  • Any symptoms you've had, including any that may seem unrelated to your drinking
  • Key personal information, including any major stresses or recent life changes
  • All medications, vitamins or other supplements that you're taking, and their doses
  • Questions to ask your doctor

Some questions to ask include:

  • Do you think I drink too much or show signs of problem drinking?
  • Do you think I need to cut back or quit drinking?
  • Do you think alcohol could be causing or worsening my other health problems?
  • What's the best course of action?
  • What are the alternatives to the approach that you're suggesting?
  • Do I need any medical tests for underlying physical problems?
  • Are there any brochures or other printed material that I can have? What websites do you recommend?
  • Would it be helpful for me to meet with a professional experienced in alcohol treatment?

Don't hesitate to ask any other questions.

What to expect from your doctor

Be ready to answer questions from your doctor, which may include:

  • How often and how much do you drink?
  • Do you have any family members with alcohol problems?
  • Do you sometimes drink more than you intend to drink?
  • Have relatives, friends or co-workers ever suggested you need to cut back or quit drinking?
  • Do you feel like you need to drink more than you previously did to get the same effect?
  • Have you tried to stop drinking? If so, was it difficult and did you have any withdrawal symptoms?
  • Have you had problems at school, at work or in your relationships that may be related to alcohol use?
  • Have there been times that you behaved in a dangerous, harmful or violent way when you were drinking?
  • Do you have any physical health problems, such as liver disease or diabetes?
  • Do you have any mental health issues, such as depression or anxiety?
  • Do you use recreational drugs?

Alcohol use disorder care at Mayo Clinic

July 25, 2015
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