If you or someone you love is struggling with a drinking problem, you may be wondering: Does addiction treatment for alcohol abuse work the same as it does for drugs?
It’s a good question, and while there are certainly different facets to consider, the answer is yes. Why? Because alcohol is a drug, and when drug and alcohol treatment facilities talk about treating “addiction,” they use the term as a catch-all phrase to include any and all mind- and mood-altering chemicals … including alcohol.
So whether you’re looking for alcoholism treatment, or wondering if addiction treatment for alcohol will work, you’re essentially seeking the same thing: a treatment program that will provide you or your loved one with a path to sobriety, free of the bondage of addiction to any and all substances, including booze.
Addiction Treatment for Alcohol: Is It a Drug?
Alcohol has been a part of human history since early man first discovered the intoxicating effects of fermented fruit on the forest floor, and while it’s long been used as everything from currency to a religious aid to a social libation, it’s also been documented as a substance that causes problems for those who overindulge.
In understanding why addiction treatment for alcohol works, it’s important to know that alcohol is, in a conventional sense, a drug. The Merriam-Webster dictionary defines a drug as “something and often an illegal substance that causes addiction, habituation … or a marked change in consciousness.” While not illegal, alcohol certainly qualifies in that it can cause addiction, habituation (“a psychological dependence on a drug after a period of use”) and a change in consciousness.
So how does alcohol affect the brain? There are the immediate effects, according to Northwestern Medicine, in which “alcohol interferes with the brain’s communication pathways, and can affect how your brain processes information.” The stages of alcohol consumption begin with euphoria, when “alcohol increases the release of dopamine, which creates a pleasurable sensation,” and cascades into depression, disorientation and memory loss; excitement, in which both the occipital, temporal, frontal and parietal lobes of the brain are all affected; confusion, at which stage alcohol has impacted the cerebellum and the hippocampus; stupor, during which time your blood alcohol content is in the .25 to .40 range and “all mental, physical and sensory functions are severely impaired”; coma, “a result of compromised respiration and circulation, motor responses and reflexes”; and finally, death due to “a failure of the brain to control all of the body’s vital physical functions.”
While those who suffer from alcoholism — or alcohol use disorder, as its medically and scientifically known — never go through all of those stages every time they drink, repeating these patterns leads to dependence, meaning that individuals feel a physical need to continue to drink in spite of the negative consequences. So while it may be legal, and in many circles socially acceptable, the evidence is clear: Alcohol is a drug, and its use by those who transition from moderate to heavy drinking can lead to alcohol dependence.
The Nuances of Alcohol Addiction
The interchangeability of terminology related to addiction, alcoholism and dependence can be confusing, so let’s break some of them down.
- Excessive drinking: This, according to the Centers for Disease Control, is defined as “binge drinking (four or more drinks on an occasion for women, five or more drinks on an occasion for men); consuming eight or more drinks a week for women or 15 or more drinks a week for men; or any alcohol use by pregnant women or those under the minimum legal drinking age of 21.” It’s important to note, the CDC adds, that while excessive drinking is problematic and may require strategies to reduce or call attention to it, “Nine in 10 adults who drink too much alcohol are not alcoholics or alcohol dependent,” according to one CDC study. However, heavy drinkers aren’t without risk even if they don’t meet the definition of alcoholic, according to the Harvard Health Blog: “Heavy drinking can seriously damage the liver, stomach, heart, brain, and nervous system. It also increases the risk of cancer of the mouth, throat, larynx (voice box), and esophagus. Women who drink heavily are at higher risk of developing breast cancer and osteoporosis. In addition, people who drink heavily may not eat adequately, so they may develop vitamin and mineral deficiencies.”
- While not all heavy drinkers are alcoholics, it’s also important to note that such patterns can lead to dependence, according to a 2008 paper in the journal Alcohol Research and Health: “Continued excessive alcohol consumption can lead to the development of dependence that is associated with a withdrawal syndrome when alcohol consumption is ceased or substantially reduced. This syndrome comprises physical signs as well as psychological symptoms that contribute to distress and psychological discomfort.” This dependence, according to the American Psychological Association, is the technical definition of alcoholism, because those individuals “have lost reliable control of their alcohol use. It doesn't matter what kind of alcohol someone drinks or even how much: Alcohol-dependent people are often unable to stop drinking once they start.”
- So what is alcohol use disorder (AUD)? According to the National Institute on Alcohol Abuse and Alcoholism, “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 eleven questions used to diagnose the severity of an individual’s drinking problem.
For those wondering how addiction treatment for alcohol works, it’s important to understand that while these terms may help explain what’s going on, the bottom line is that (a) alcohol is a drug, (b) like with many other drugs, there are varying stages of dependence and addiction and (c) most important, addiction treatment for alcohol can and does work.
How Does Addiction Treatment for Alcohol Work?
By and large, treatment for both alcoholism and addiction follow the same basic framework. According to the National Institute on Drug Abuse (NIDA), “the goal of treatment is to return people to productive functioning in the family, workplace, and community. According to research that tracks individuals in treatment over extended periods, most people who get into and remain in treatment stop using drugs, decrease their criminal activity, and improve their occupational, social, and psychological functioning.”
Effective treatment often begins, the NIDA adds, with safe, comfortable and medically supervised detoxification, “the process by which the body clears itself of drugs, is designed to manage the acute and potentially dangerous physiological effects of stopping drug use.” However, it should be pointed out, “detoxification alone does not address the psychological, social, and behavioral problems associated with addiction and therefore does not typically produce lasting behavioral changes necessary for recovery.” Effective addiction treatment for alcohol and other drugs is usually the next phase of the recovery process, and may include:
- Short-term residential treatment, which typically lasts 30 days, and provides an array of therapies designed to meet the biopsychosocial needs of those struggling with a drug or alcohol problem. Many facilities rely on a bedrock of 12 Step principles as conceived in fellowships like Alcoholics Anonymous, but truly effective programs have a robust clinical program that includes a number of other therapeutic regimens: Cognitive Behavioral Therapy, Dialectical Behavior Therapy, Cognitive Processing Therapy, Trauma Therapy and so much more.
- Long-term residential treatment, which often combines residential treatment with the added benefit of Intensive Outpatient Programming and residence in a sober living community, the goal of which is to provide "’resocialization’ of the individual and use the program’s entire community — including other residents, staff, and the social context — as active components of treatment,” according to the NIDA. “Addiction is viewed in the context of an individual’s social and psychological deficits, and treatment focuses on developing personal accountability and responsibility as well as socially productive lives.”
- Outpatient treatment, which “costs less than residential or inpatient treatment and often is more suitable for people with jobs or extensive social supports,” according to the NIDA. “It should be noted, however, that low-intensity programs may offer little more than drug education.”
Keep in mind, those are just the bare bones of effective addiction treatment for alcohol. Treatment offerings may vary depending on the scope and size of the respective facilities, but the important thing to remember is this: Addiction treatment for alcohol works the same as it does for other substances. Don’t let the terminology confuse you or lead you to believe that it can’t.