Alcohol use disorder (AUD) is a medical condition that doctors diagnose when a patient’s drinking causes distress or harm. The condition can range from mild to severe and is diagnosed when a patient answers “yes” to two or more of the following question. Had times when you ended up drinking more, or longer than you intended. More than once wanted to cut down or stop drinking, or tried to, but couldn’t. Spent a lot of time drinking? Or being sick or getting over the aftereffects. Experienced craving — a strong need, or urge, to drink. The goal of treatment for alcoholism is quitting, though some people may be able to effectively cut down. Among alcoholics with otherwise good health, social support, and motivation, the likelihood of recovery is good. After treatment, about one-third of patients show no relapse or symptoms at 1 year. Many more report fewer alcohol-related social and health problems by cutting down alcohol intake. Poor social support, lack of motivation, and psychiatric disorders are all risk factors for relapsing. For some high-risk patients, success is measured by longer periods of abstinence, reduced use of alcohol, better health, and improved social functioning.
Detoxification (detox): Abruptly decreasing or discontinuing alcohol can lead to withdrawal symptoms, usually within 6-12 hours. Typical symptoms include tremors, agitation, and insomnia. Alcohol withdrawal can be dangerous, so if symptoms are severe, you may need medical treatment. Rehabilitation: This involves counseling and medications to give the recovering alcoholic the skills needed for maintaining sobriety. This step in treatment can be done inpatient or outpatient. Depending on your support system and environment, both can be effective. Maintenance of sobriety: This step's success requires an alcoholic to be self-disciplined. The key to maintenance is support, which often includes regular Alcoholics Anonymous (AA) meetings and getting a sponsor. Because detoxification does not stop the craving for alcohol, recovery is often difficult to maintain. For a person in an early stage of alcoholism, discontinuing alcohol use may result in some withdrawal symptoms, including anxiety and poor sleep. Withdrawal from long-term dependence may bring the uncontrollable shaking, spasms, panic, and hallucinations of DTs. If not treated professionally, people with DTs have a mortality rate of more than 10%, so detoxification from late-stage alcoholism should be attempted under the care of an experienced doctor and may require a brief inpatient stay at a hospital or treatment center. Detox may involve one or more medications. The mainstay of treatment is benzodiazepines, anti-anxiety drugs used to treat withdrawal symptoms such as anxiety and poor sleep and to prevent seizures and delirium. These are the most frequently used medications during the detox phase, at which time they are usually tapered and then discontinued. They must be used with care, since they may be addictive.
