The Medical Treatment of Alcoholism

by Mark L. Willenbring, M.D.

FIVE THINGS TO KNOW

1. Almost one in 10 people in the United States experience alcohol dependence at some time during their lives.
Alcoholism occurs in both sexes, all ethnic and racial groups, and in people from all walks of life. It develops when someone drinks too much too often. Drinking more than three drinks a day if you are a woman or four drinks if you are a man increases health risks, including risk for alcohol dependence. If you are concerned about whether you are drinking too much, discuss it with your doctor.
2. Alcoholism usually starts in the late teens or early twenties, yet most people don't seek help until 15- 20 years later.
Earlier treatment is more successful and results in far less destruction to individuals and their families. Seek help if you keep going over your limit, can't quit or cut down on your own, continue drinking in spite of emotional, physical or social problems caused by drinking, or if your friends or family express concern. You don't have to wait for a crisis.
3. Only about one in 10 people with alcoholism ever receives professional treatment.
Recent research suggests that newer medications are effective treatments for alcohol dependence when combined with brief counseling by a health professional. This means that many more people can receive treatment from their family, or primary care, doctor. Specialized alcohol counseling also works well, and all approaches (12-step, cognitive and motivational) are about equally effective. Some people will need more intensive programs.
4. Whatever treatment you receive, the most important thing is to stick with it. The longer you stay in treatment, the more likely you are to succeed.
If you have a relapse, recognize that this is a chronic disease, and try to get back on track as quickly as possible. If you are taking medication for alcohol dependence, be sure to take it as prescribed. Do not discontinue it even if you don't notice feeling any different. The medicine is working if you are not drinking, or if you are drinking much less.
5. Twelve-step and other support programs really do work! Recovering people who attend groups on a regular basis do better than those who do not.
If you are taking medication for alcohol dependence, don't worry about whether it is a "crutch." Medication can improve recovery rates by 20-40% in the first three months after stopping. Also, it's fine to take medication and to attend support groups or alcohol counseling.