How alcohol use disorder is treated, why withdrawal needs medical attention, which medications and therapies have evidence behind them, and how to compare programs.

What alcohol use disorder is

Alcohol use disorder (AUD) is a medical condition in which a person cannot reliably control drinking despite harm to their health, relationships or work. It ranges from mild to severe, and it is treatable at every stage. Needing help does not require hitting a particular low point.

Common signs include drinking more or longer than intended, failed attempts to cut down, strong cravings, needing more alcohol to feel the same effect, and withdrawal symptoms when drinking stops.

Why stopping suddenly can be dangerous

Alcohol withdrawal can be serious. In people who drink heavily, stopping abruptly can cause seizures and delirium tremens, a medical emergency that involves confusion, fever and a racing heart. Withdrawal should be planned with a clinician rather than attempted alone.

If you or someone you love drinks heavily every day, speak to a doctor or a medically supervised detox program before stopping. In an emergency, call 911.

Levels of care

Treatment is matched to the person's needs rather than being one-size-fits-all.

Medically supervised detox, for managing withdrawal safely
Residential (inpatient) treatment, with 24-hour structure and support
Partial hospitalization (PHP), most of the day in treatment while living elsewhere
Intensive outpatient (IOP), several sessions a week around work or family
Standard outpatient care and ongoing therapy, often as step-down after higher levels of care

Medications that can help

Three medications are approved in the U.S. for alcohol use disorder: naltrexone, acamprosate and disulfiram. They work differently — some reduce cravings, some ease the discomfort of early abstinence, and some cause an unpleasant reaction to alcohol — and a prescriber decides which fits a given person. Medication is not a substitute for therapy and is most effective alongside it.

Not every treatment center prescribes these medications. If medication matters to you, ask directly whether the program prescribes it or coordinates with an outside prescriber.

Therapies with evidence behind them

Cognitive behavioral therapy (CBT), which builds skills for handling triggers and cravings
Motivational interviewing, which strengthens a person's own reasons for change
Contingency management and relapse-prevention planning
Twelve-step facilitation and mutual-help groups, which many people use alongside professional treatment
Family therapy, which helps repair relationships and build a supportive home

How to compare programs

Look past the brochure. Good questions to ask any program:

Which accreditations and state licenses does it hold, and can you verify them?
Who provides care day to day, and is a physician or psychiatric prescriber available?
How does it manage withdrawal, and is medical staff on site overnight?
Does it prescribe medication for alcohol use disorder?
Does it treat co-occurring conditions such as depression, anxiety or trauma?
How does it plan for discharge and connect you to care near home?

Paying for treatment

Many private plans and Medicaid cover alcohol treatment, though coverage varies by plan and level of care. Ask the program to verify your benefits in writing and ask your insurer about authorization, covered days and out-of-pocket costs. Federal parity law generally requires coverage for substance use treatment comparable to medical coverage, and you can appeal a denial.

After treatment

Recovery continues after the program ends. A strong plan includes outpatient therapy or IOP close to home, regular peer support, a stable living situation, and — for some people — ongoing medication. You can find outpatient and support options near you with our aftercare finder.

Sources

This guide is informational and not medical advice. If you are in crisis, call or text 988; in an emergency, call 911.

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