Treatment for 

Alcohol Problems: 

Finding and 

Getting Help 
This guide is written for individuals, 

and their family and friends, who 

are looking for options to address 

alcohol problems. It is intended 

as a resource to understand what 

treatment choices are available 

and what to consider when selecting 

among them. 
Table of Contents 

When Is It Time for Treatment? 2
 

Options for Treatment 4
 

Treatments Led by Health Professionals 6
 

What FDA-Approved Medications Are Available? 8
 

Tips for Selecting Treatment 10
 

An Ongoing Process 12
 

Resources 14
 

1 
When Is It Time for Treatment? 

Alcohol-related problems — which result from drinking too much, 

too fast, or too often — are among the most significant public 

health issues in the United States. 

Many people struggle with controlling their drinking at some time in their lives. Approximately 

17 million adults ages 18 and older have an alcohol use disorder (AUD) and 1 in 10 

children live in a home with a parent who has a drinking problem. 

Does Treatment Work? 

The good news is that no matter how severe the problem may seem, most 

people with an alcohol use disorder can benefit from some form of treatment. 

Research shows that about one-third of people who are treated for alcohol 

problems have no further symptoms 1 year later. Many others substantially 

reduce their drinking and report fewer alcohol-related problems. 

2 
 

 

 

 

 

 

 

 

 

Signs of an Alcohol Problem 

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 the following questions. 

In the past year, have you: 

❏	 Had times when you ended up drinking more, or longer than you intended? 

❏	 More than once wanted to cut down or stop drinking, or tried to, but 

couldn’t? 

❏	 Spent a lot of time drinking? Or being sick or getting over the aftereffects? 

❏	 Experienced craving — a strong need, or urge, to drink? 

❏	 Found that drinking — or being sick from drinking — often interfered 

with taking care of your home or family? Or caused job troubles? 

Or school problems? 

❏	 Continued to drink even though it was causing trouble with your family 

or friends? 

❏	 Given up or cut back on activities that were important or interesting 

to you, or gave you pleasure, in order to drink? 

❏	 More than once gotten into situations while or after drinking that 

increased your chances of getting hurt (such as driving, swimming, 

using machinery, walking in a dangerous area, or having unsafe sex)? 

❏	 Continued to drink even though it was making you feel depressed or 

anxious or adding to another health problem? Or after having had a 

memory blackout? 

❏	 Had to drink much more than you once did to get the effect you want? 

Or found that your usual number of drinks had much less effect than before? 

❏	 Found that when the effects of alcohol were wearing off, you had withdrawal 

symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, 

restlessness, nausea, or sweating? Or sensed things that were not there? 

If you have any of these symptoms, your drinking may already be a cause 

for concern. The more symptoms you have, the more urgent the need for 

change. A health professional can conduct a formal assessment of your symptoms 

to see if an alcohol use disorder is present. For an online assessment of your 

drinking pattern, go to RethinkingDrinking.niaaa.nih.gov. 

3 
 

 

Options for Treatment 

When asked how alcohol problems are treated, people commonly think 

of 12-step programs or 28-day inpatient rehab, but may have difficulty 

naming other options. In fact, there are a variety of treatment methods 

currently available, thanks to significant advances in the field over 

the past 60 years. 

Ultimately, there is no one-size-fits-all solution, and what may work for one person 

may not be a good fit for someone else. Simply understanding the different options 

can be an important first step. 

Types of Treatment 

Behavioral Treatments 

Behavioral treatments are aimed at changing drinking behavior through counseling. 

They are led by health professionals and supported by studies showing they can 

be beneficial. 

Medications 

Three medications are currently approved in the United States to help people 

stop or reduce their drinking and prevent relapse. They are prescribed by a 

primary care physician or other health professional and may be used alone or 

in combination with counseling. 

Mutual-Support Groups 

Alcoholics Anonymous (AA) and other 12-step programs provide peer support 

for people quitting or cutting back on their drinking. Combined with treatment 

led by health professionals, mutual-support groups can offer a valuable added 

layer of support. 

Due to the anonymous nature of mutual-support groups, it is difficult for 


researchers to determine their success rates compared with those led by 


health professionals.
 

4 
 

 

 

 

 

Starting With a Primary Care Doctor 

For anyone thinking about treatment, talking to a primary care physician is an 

important first step — he or she can be a good source for treatment referrals 

and medications. A primary care physician can also: 

• Evaluate whether a patient’s drinking pattern is risky 

• Help craft a treatment plan 

• Evaluate overall health 

• Assess if medications for alcohol may be appropriate 

Types of Professionals Involved in Care 

Many health professionals can play a role in treatment. Below is a list of 

providers and the type of care they may offer. 

 Provider Degrees Treatment 

 Type & Credentials Type 

Primary Care M.D., D.O. (Doctor of Medications, Brief 

Provider Osteopathic Medicine), Behavioral Treatment, 

 additionally you may see Referral to Specialist 

 a Nurse Practitioner or 

 Physician’s Assistant 

Psychiatrist M.D., D.O. Medications, 

Behavioral Treatment 

Psychologist Ph.D., Psy.D., M.A. Behavioral Treatment 

Social Worker	 M.S.W. (Master of Social Behavioral Treatment 

Work), L.C.S.W. (Licensed 

Clinical Social Worker) 

Alcohol Varies—most States require Behavioral Treatment 

Counselor some form of certification 

Individuals are advised to talk to their doctors about the best form of primary 

treatment. 

5 
 

 

 

 

 

Treatments Led by Health Professionals 

Professionally led treatments include:
 

Medications 

Some are surprised to learn that there 

are medications on the market 

approved to treat alcohol dependence. 

The newer types of these medications 

work by offsetting changes in the 

brain caused by alcoholism. 

All approved medications are nonaddictive and can be used alone or 

in combination with other forms of 

treatment. Learn more about these 

approved treatments on p. 8. 

Behavioral Treatments 

Also known as alcohol counseling, behavioral treatments involve working with a health 

professional to identify and help change the behaviors that lead to heavy drinking. 

Behavioral treatments share certain features, which can include: 

•	 Developing the skills needed to stop 

or reduce drinking 

•	 Helping to build a strong social 

support system 

•	 Working to set reachable goals 

•	 Coping with or avoiding the 

triggers that might cause relapse 

6 
 

 

 

 

Types of Behavioral Treatments 

• Cognitive–Behavioral Therapy can take place one-on-one with a therapist 

or in small groups. This form of therapy is focused on identifying the feelings 

and situations (called “cues”) that lead to heavy drinking and managing 

stress that can lead to relapse. The goal is to change the thought processes 

that lead to excessive drinking and to develop the skills necessary to cope 

with everyday situations that might trigger problem drinking. 

• Motivational Enhancement Therapy is conducted over a short period 

of time to build and strengthen motivation to change drinking behavior. 

The therapy focuses on identifying the pros and cons of seeking treatment, 

forming a plan for making changes in one’s drinking, building confidence, 

and developing the skills needed to stick to the plan. 

• Marital and Family Counseling incorporates spouses and other family 

members in the treatment process and can play an important role in 

repairing and improving family relationships. Studies show that strong 

family support through family therapy increases the chances of maintaining 

abstinence (stopping drinking), compared with patients undergoing 

individual counseling. 

• Brief Interventions are short, one-on-one or small-group counseling 

sessions that are time limited. The counselor provides information 

about the individual’s drinking pattern and potential risks. After receiving 

personalized feedback, the counselor will work with the client to set goals 

and provide ideas for helping to make a change. 

Ultimately, choosing to get treatment may be more important than the approach 

used, as long as the approach avoids heavy confrontation and incorporates empathy, 

motivational support, and a focus on changing drinking behavior. 

7 
 

 

 

What FDA-Approved Medications Are Available?
 

Certain medications have been shown to effectively help people 

stop or reduce their drinking and avoid relapse. 

Current Medications 

The U.S. Food and Drug Administration (FDA) has approved three medications 

for treating alcohol dependence, and others are being tested to determine if they 

are effective. 

•	 Naltrexone can help people reduce 

heavy drinking. 

•	 Acamprosate makes it easier to 

maintain abstinence. 

•	 Disulfiram blocks the breakdown 

(metabolism) of alcohol by the body, 

causing unpleasant symptoms such 

as nausea and flushing of the skin. 

Those unpleasant effects can help 

some people avoid drinking while 

taking disulfiram. 

It is important to remember that not all people will respond to medications, 

but for a subset of individuals, they can be an important tool in overcoming 

alcohol dependence. 

Scientists are working to develop a larger menu of pharmaceutical treatments 

that could be tailored to individual needs. As more medications become available, 

people may be able to try multiple medications to find which they respond to best. 

“Isn’t taking medications just trading one addiction 

for another?” 

This is not an uncommon concern, but the short answer is “no.” All medications 

approved for treating alcohol dependence are non-addictive. These medicines 

are designed to help manage a chronic disease, just as someone might take 

drugs to keep their asthma or diabetes in check. 

8 
 

 

 

 

 

Looking Ahead: The Future of Treatment 

Progress continues to be made as researchers seek out new and better treatments for 

alcohol problems. By studying the underlying causes of alcoholism in the brain and 

body, NIAAA is working to identify key cellular or molecular structures — called “targets” — 

that could lead to the development of new medications. 

Personalized Medicine 

Ideally, health professionals would be able to identify which alcoholism treatment is 

most effective for each person. NIAAA and other organizations are conducting research 

to identify genes and other factors that can predict how well someone will respond to 

a particular treatment. These advances could optimize how treatment decisions are 

made in the future. 

Current NIAAA Research — Leading to Future Breakthroughs 

Certain medications already approved for other uses have shown promise for 

treating alcohol dependence and problem drinking: 

•	 The anti-smoking drug varenicline (marketed under the name Chantix) 

significantly reduced alcohol consumption and craving among people 

with alcoholism. 

•	 Gabapentin, a medication used to treat pain conditions and epilepsy, was 

shown to increase abstinence and reduce heavy drinking. Those taking the 

medication also reported fewer alcohol cravings and improved mood and sleep. 

•	 The anti-epileptic medication topiramate was shown to help people curb 

problem drinking, particularly among those with a certain genetic makeup 

that appears to be linked to the treatment’s effectiveness. 

9 
 

 

 

 

 

 

 

 

Tips for Selecting Treatment 

Professionals in the alcohol treatment field offer advice on what to 

consider when choosing a treatment program. 

Overall, gather as much information as you can about the program or provider before 

making a decision on treatment. If you know someone who has first-hand knowledge 

of the program, it may help to ask about his or her personal experience. 

Here are some questions you can ask that may help guide your choice: 

❏ What kind of treatment does the program or provider offer? 

It is important to gauge if the facility provides all the currently available 

methods or relies on one approach. You may want to learn if the program 

or provider offers medication and if mental health issues are addressed 

together with addiction treatment. 

❏ Is treatment tailored to the individual? 

Matching the right therapy to the individual is important to its success. No 

single treatment will benefit everyone. It may also be helpful to determine 

whether treatment will be adapted to meet changing needs as they arise. 

❏ What is expected of the patient? 

You will want to understand what will be asked of you in order to decide 

what treatment best suits your needs. 

❏ Is treatment success measured? 

By assessing whether and how the program or provider measures success, 

you may be able to better compare your options. 

❏ How does the program or provider handle relapse? 

Relapse is common and you will want to know how it is addressed. For more 

information on relapse, see p. 12. 

When seeking professional help, it is important you feel respected and understood 

and that you have a feeling of trust that this person, group, or organization can help 

you. Remember, though, that relationships with doctors, therapists, and other health 

professionals can take time to develop. 

10 
 

Additional Considerations 

Treatment Setting — Inpatient or Outpatient? 

In addition to choosing the type of treatment that’s best for you, you’ll also have to 

decide if that treatment is inpatient (you would stay at a facility) or outpatient (you stay 

in your home during treatment). Inpatient facilities tend to be more intensive and costly. 

Your health care provider can help you evaluate the pros and cons of each. 

Cost may be a factor 

when selecting a treatment 

approach. Evaluate the 

coverage in your health 

insurance plan to determine 

how much of the costs your 

insurance will cover and how 

much you will have to pay. 

Ask different programs if 

they offer sliding scale fees 

— some programs may offer 

lower prices or payment 

plans for individuals without 

health insurance. 

11 
 

An Ongoing Process 

Overcoming an alcohol use disorder is an ongoing process, one 

which can include setbacks. 

The Importance of Persistence 

Because an alcohol use disorder can be a chronic relapsing disease, persistence is key. 

It is rare that someone would go to treatment once and then never drink again. More 

often, people must repeatedly try to quit or cut back, experience recurrences, learn 

from them, and then keep trying. For many, continued followup with a treatment 

provider is critical to overcoming problem drinking. 

Relapse Is Part of the Process 

Relapse is common among people who overcome alcohol problems. People with drinking 

problems are most likely to relapse during periods of stress or when exposed to people 

or places associated with past drinking. 

Just as some people with diabetes or asthma may have flare-ups of their disease, 

a relapse to drinking can be seen as a temporary set-back to full recovery and not a 

complete failure. Seeking professional help can prevent relapse — behavioral therapies 

can help people develop skills to avoid and overcome triggers, such as stress, that 

might lead to drinking. Most people benefit from regular checkups with a treatment 

provider. Medications also can deter drinking during times when individuals may be 

at greater risk of relapse (e.g., divorce, death of a family member). 

Mental Health Issues and Alcohol Use Disorder 

Depression and anxiety often go hand in hand with heavy drinking. Studies show 

that people who are alcohol dependent are two to three times as likely to suffer 

from major depression or anxiety over their lifetime. When addressing drinking 

problems, it’s important to also seek treatment for any accompanying medical 

and mental health issues. 

12 
Advice For Friends and Family Members 

Caring for a person who has problems with alcohol can be very stressful. It is important 

that as you try to help your loved one, you find a way to take care of yourself as well. 

It may help to seek support from others, including friends, family, community, and 

support groups. If you are developing your own symptoms of depression or anxiety, 

think about seeking professional help for yourself. Remember that your loved one is 

ultimately responsible for managing his or her illness. 

However, your participation can make a big difference. Based on clinical experience, 

many health providers believe that support from friends and family members is important 

in overcoming alcohol problems. But friends and family may feel unsure about how 

best to provide the support needed. The groups for family and friends listed on p. 14 

may be a good starting point. 

Remember that changing deep habits is hard, takes time, and requires repeated 

efforts. We usually experience failures along the way, learn from them, and then keep 

going. Alcohol use disorders are no different. Try to be patient with your loved one. 

Overcoming this disorder is not easy or quick. 

Pay attention to your 

loved one when he or 

she is doing better or 

simply making an effort. 

Too often we are so angry 

or discouraged that we 

take it for granted when 

things are going better. 

A word of appreciation 

or acknowledgement of a 

success can go a long way. 

13 
 

 

 

 

 

 

Resources 

Professional help 

Your doctor. Primary care and mental health 

practitioners can provide effective alcoholism 

treatment by combining new medications 

with brief counseling visits. To aid clinicians, 

NIAAA has developed two guides: Helping 

Patients Who Drink Too Much, and for 

younger patients, Alcohol Screening and Brief 

Interventions for Youth: A Practitioner’s Guide. 

Both are available at www.niaaa.nih.gov/ 

publications/clinical-guides-and-manuals 

Specialists in alcohol use disorders. For 

specialty addiction treatment options, contact 

your doctor, health insurance plan, local health 

department, or employee assistance program. 

Other resources include: 

Medical and non-medical 

addiction specialists 

American Academy of 


Addiction Psychiatry
 

www.aaap.org 


401–524–3076 


American Psychological Association 

www.apa.org 


1–800–964–2000 (ask for your State’s 


referral number to find psychologists 


with addiction specialties)
 

American Society of 


Addiction Medicine 


www.asam.org 


301–656–3920 (ask for the phone 


number of your State’s chapter)
 

NAADAC Substance 


 Abuse Professionals
 

www.naadac.org 


1–800–548–0497 


National Association 


 of Social Workers
 

www.helpstartshere.org 


(search for social workers with 


addiction specialties)
 

Treatment facilities 

Substance Abuse Treatment 


Facility Locator 


www.findtreatment.samhsa.gov 


1–800–662–HELP
 

Mutual-support groups 

Alcoholics Anonymous (AA) 

www.aa.org 

212–870–3400 or check your local 

phone directory under “Alcoholism” 

Moderation Management 

www.moderation.org 


212–871–0974 


Secular Organizations for Sobriety 

www.sossobriety.org 


323–666–4295 


SMART Recovery 

www.smartrecovery.org 


440–951–5357 


Women for Sobriety 

www.womenforsobriety.org 


215–536–8026
 

Groups for family and friends 

Al-Anon Family Groups 

www.al-anon.alateen.org 


1–888–425–2666 for meetings 


Adult Children of Alcoholics 

www.adultchildren.org 


310–534–1815
 

Information resources 

National Institute on Alcohol Abuse 

and Alcoholism 

www.niaaa.nih.gov 


301–443–3860
 

National Institute on Drug Abuse 

www.nida.nih.gov 


301–443–1124
 

National Institute of Mental Health 

www.nimh.nih.gov 


1–866–615–6464 


National Clearinghouse for Alcohol 

 and Drug Information 

www.samhsa.gov 


1–800–729–6686
 14 
Research shows that most 

people who have alcohol 

problems are able to reduce 

their drinking or quit entirely. 

There are many roads to 

getting better. What is 

important is finding yours. 

Understanding the available 

treatment options — from 

behavioral therapies and 

medications to mutual-support 

groups — is the first step. The 

important thing is to remain 

engaged in whatever method 

you choose. 

Ultimately, receiving treatment 

can improve your chances 

of success. 

15 
Notes 


16 

NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM
 

NIH . . . Turning Discovery Into Health 

NIH Publication No. 14–7974 

Published 2014