Your success in treatment for alcohol abuse and dependence is strongly linked to admitting that you have a problem and your desire to stop drinking. Supportive treatments, such as counseling, won't be successful if you continue to drink.

Treatment also depends on whether you are physically dependent on alcohol. Most people with alcohol problems need to completely stop drinking. Treatment first focuses on relieving symptoms of withdrawal, and then the focus shifts to staying sober.

You might need medicines that help reduce withdrawal symptoms during the process of detoxification.

Counseling, support groups, education, and sometimes medicines can help you stay sober during recovery. It can be very discouraging to start drinking again (relapse). Although you might feel guilty about relapsing-and you should do everything you can to avoid it-a relapse is no reason to quit treatment. Staying sober is a lifelong process.

The family members of someone who has an alcohol problem are affected too. They can benefit from education, family therapy, and participation in Al-Anon or other self-help support groups. Sometimes family members with good intentions will enable you to continue drinking by making excuses for your drinking or covering up problems that your alcohol use is causing. Counseling can help them recognize destructive, enabling behaviors and might help strengthen relationships.

Initial treatment

Initial treatment for alcohol abuse and dependence includes:

• Screening with a test such as the Alcohol Use Disorders Identification Test (AUDIT).
• Assessing your life and the impact alcohol has had on it.
• Stopping drinking.
• Treating withdrawal symptoms if you are alcohol-dependent. This is best done under medical supervision.
• Staying sober throughout your recovery.

How to stop drinking alcohol

Although some people can stop drinking on their own, others need medical help to manage the physical process of withdrawal. If you think you have an addiction to alcohol, talk to your doctor about whether you need to withdraw from alcohol under medical supervision.

Your doctor might be able to give you medicine that will help you safely withdraw from alcohol. Other medicines might be prescribed later to help you stay sober. Withdrawal from alcohol is safer, less painful, and quicker when you get a doctor's help.

If you have severe withdrawal symptoms (such as uncontrolled shaking, seizures, or hallucinations), you might be admitted to a treatment center or hospital for detoxification.

Medicines to reduce withdrawal symptoms include:

• Antianxiety medicines (such as diazepam), which treat withdrawal symptoms such as delirium tremens (DTs).
• Seizure medicines, which are used to reduce or stop severe withdrawal symptoms during detoxification.

Medicines to help you stay sober during recovery include:⁵

• Disulfiram (Antabuse), which slows the pleasurable effects that alcohol produces and makes you nauseated when you drink.
• Naltrexone (ReVia, Vivitrol), which interferes with the pleasure you get from drinking. Vivitrol is a once-a-month shot (injection) that is approved by the U.S. Food and Drug Administration (FDA) to treat alcohol abuse and dependence.
• Acamprosate (Campral), which can reduce your craving for alcohol. This medicine was recently approved to treat alcohol abuse and dependence.
• Topiramate (Topamax), which is a medicine used to treat seizures. One recent study shows that it might also help treat alcohol problems.⁶ Experts are still studying how this medicine, and medicines like it, might help with recovery from alcohol abuse and addiction.