Alcohol abuse treatment enforces the common goal of abstinence. Alcoholics that are in good health, have a good social support system, and are motivated have a very good chance at recovering. About half will remain sober at the end of a one year treatment and most of those will stay sober forever. Those with poor social support, poor motivation, or psychiatric disorders tend to relapse within a few years of treatment. For these people, success is measured by longer periods of abstinence, reduced use of alcohol, better health, and improved social functioning.
There can not be any form of treatment program put in place until the alcoholic is willing to admit that they have a problem and agrees to remain clean and sober. They must also understand that alcoholism is curable and must be motivated to change. Treatment has two stages: discontinuing alcohol use -- sometimes called detoxification or detox and recovery. Detoxification will stop the alcoholic from experiencing the very unpleasant illness that accompanies alcohol withdrawal but it will not stop or reduce the cravings for alcohol. Recovery is often very difficult to maintain.
If the alcoholism is still young discontinuing alcohol use may result in some withdrawal symptoms, including anxiety and insomnia. Withdrawal from long-term dependence may bring the uncontrollable shaking, spasms, panic, and hallucinations of delirium tremens (DT). If not treated professionally, people with DT have a sizeable mortality rate so detoxification from late-stage alcoholism should be attempted under the care of an experienced provider and may require an inpatient stay at a hospital or treatment center.
Treatment will likely involve one or more medications. Benzodiazepines are anti anxiety drugs used to treat withdrawal symptoms such as anxiety and insomnia 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. Disulfiram may be used once the detox phase is complete and the person is abstinent. It interferes with alcohol metabolism so that drinking a small amount will cause nausea, vomiting, confusion, and breathing difficulty.
Antidepressants may be used to control any underlying or resulting anxiety or depression, but because those symptoms may disappear with abstinence, the medications are usually not started until after detox is complete and there has been some abstinence. Camporal is the latest drug used to control cravings and it seems to be working quite well.
Because an alcoholic remains susceptible to becoming dependent again, the key to recovery is total abstinence. Recovery typically takes a broad-based approach, which may include education programs, group therapy, family involvement, and participation in self-help groups. Alcoholics Anonymous (AA) is the most well known of the self-help groups, but other approaches have also proved successful. Alcoholics are often deficient in vitamins A, B complex, and C; folic acid; carnitine; magnesium, selenium, and zinc; as well as essential fatty acids and antioxidants. Restoring such nutrients by providing thiamine (vitamin B-1) and a multivitamin can aid recovery and are an important part of all detox programs.