If you or someone you know is in crisis right now: call or text 988 (Suicide & Crisis Lifeline). For a possible overdose or any medical emergency, call 911. For help finding treatment, the SAMHSA National Helpline is free and open 24/7 at 1-800-662-4357.
The short answer
Alcohol use disorder (AUD) is treatable. Options include medically supervised withdrawal when needed, counseling and behavioral therapy, FDA-approved medications, peer support and structured programs at different levels of care. Many people never hear that medication is an option, so ask about it. Heavy drinkers should not stop suddenly without medical advice, because alcohol withdrawal can be dangerous.
Step 1: get assessed, and check withdrawal risk
A clinician asks about how much and how long you drink, past withdrawal, health and mental health. This decides whether you need medical withdrawal management and what level of care fits. (See [How to Know If You Need Rehab: A Self-Assessment Checklist] and [Can You Detox at Home? Dangers of Alcohol and Benzodiazepine Withdrawal].)
Step 2: withdrawal management, if needed
Medical teams monitor you and may use medication to reduce symptoms and the risk of seizures. It can happen in a hospital, a detox unit or, for low-risk cases, outpatient with close supervision. It is the first step, not the whole treatment. (See [What Is the Difference Between Detox and Rehab?].)
Step 3: treatment that addresses the disorder
Behavioral therapies
- Cognitive behavioral therapy (CBT) builds skills to handle triggers and cravings.
- Motivational enhancement therapy strengthens your own reasons to change.
- 12-step facilitation connects you to peer support.
- Couples and family therapy can improve support at home.
(See [Evidence-Based Therapies in Addiction Treatment: CBT, DBT and Contingency Management].)
Medications
| Medication | What it does | Things to know |
|---|---|---|
| Naltrexone | Reduces cravings and the rewarding effect of drinking | Comes as a daily pill or monthly injection. It is not addictive. It blocks opioid medicines, so tell every doctor you take it. |
| Acamprosate | Helps the brain adjust after you stop drinking and eases lingering discomfort | Usually started after you have stopped drinking. Kidney function matters. |
| Disulfiram | Causes an unpleasant reaction if you drink | Works best with strong support or supervision. Safety checks are important. |
| Other medications | Some, such as topiramate or gabapentin, are sometimes used off-label | Only under a doctor’s guidance |
Your doctor will check your health, including your liver, to choose a safe option. Medication works best with counseling. (See [Medication-Assisted Treatment (MAT): How It Works and Who It’s For].)
Mutual-help groups
Groups such as AA and SMART Recovery are free and add daily support. (See [AA vs SMART Recovery vs Other Mutual-Help Groups: Which Fits You?].)
Levels of care
| Level | When it may fit |
|---|---|
| Outpatient | Milder disorder, stable home, low withdrawal risk |
| IOP or PHP | Need more structure while living at home |
| Residential | Severe disorder, unsafe home, past relapses |
| Hospital-based | Severe withdrawal or serious medical conditions |
(See [Inpatient vs Outpatient Rehab: Which Level of Care Is Right for You?] and [PHP vs IOP: Partial Hospitalization and Intensive Outpatient Compared].)
Goals: stopping or cutting back
Many programs aim for abstinence. For some people with milder problems, reduced drinking is a first goal. A clinician helps you choose a safe goal, which is not a good idea if you have liver disease, are pregnant or take interacting medications.
Finding help
NIAAA offers an online Alcohol Treatment Navigator, and you can search FindTreatment.gov or call the SAMHSA helpline. (See [How to Use FindTreatment.gov and the SAMHSA National Helpline].)
Staying well afterward
Plan for aftercare, which may include therapy, medication, peer support and changes to routines. (See [What Is Aftercare? How to Build a Relapse-Prevention Plan] and [Relapse Is Not Failure: What to Do After a Slip].)
If you are a family member
You cannot make someone stop, but you can encourage an assessment and learn skills. (See [How to Help a Spouse With Alcohol Use Disorder: What Works and What Doesn’t].)
Frequently asked questions
What is the best treatment for alcohol use disorder?
It depends on the person. Therapy plus medication, when appropriate, and ongoing support work for many.
Are there medications for alcohol use disorder?
Yes. Naltrexone, acamprosate and disulfiram are FDA-approved.
Do I need detox?
Not always, but heavy drinkers often need medical supervision to stop safely.
Can I drink moderately after treatment?
Some people with milder problems can reduce drinking, but for many, abstinence is safer. Talk to your clinician.
Sources
- National Institute on Alcohol Abuse and Alcoholism (NIAAA). Treatment for Alcohol Problems and Alcohol Treatment Navigator. niaaa.nih.gov
- SAMHSA. Medications for Substance Use Disorders. samhsa.gov
- American Society of Addiction Medicine. The ASAM Criteria. asam.org
This article is for general information only and is not medical advice. Talk to a qualified health professional before changing how you drink or starting any medication.