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Medication for Alcohol Addiction, Withdrawal, and Detox Programs

Alcohol is widely used throughout the United States. The 2020 National Survey on Drug Use and Health found that an estimated 50% of Americans aged 12 or over (138.5 million people) reported that they had consumed alcohol within the previous month (a time frame that indicates “current use” of alcohol).1 While many of these instances no doubt involve drinking responsibly, alcohol abuse and addiction can and does occur. Survey information also revealed that:1

  • 6 million people (44.4% of current drinkers) reported binge drinking (males having 5 or more drinks, or females having 4 or more drinks in a short period of time at least once in the last month).
  • 7 million people engaged in binge drinking at least 5 times within the last month.
  • 3 million people (10.2%) had an alcohol use disorder (AUD).

This page will explain more about what an AUD is, what to expect from alcohol withdrawal, how medication for both alcohol withdrawal and longer-term treatment can facilitate detox and recovery, what other supports are available, and how insurance plays a role in accessing these treatment medications.


What is Alcohol Use Disorder?

An AUD is a chronic brain condition characterized by continued drinking despite alcohol’s ongoing negative impact to your thoughts, behaviors, and various aspects of your health.2 People with an AUD often struggle to stop drinking even if they want to or have experienced a wide range of negative consequences to various areas of their lives.3 Often contributing to the cycle of compulsive drinking is the fact that chronic alcohol use can lead to changes in the brain such that when alcohol use is stopped, uncomfortable and potentially dangerous withdrawal symptoms may arise. The phenomenon of withdrawal is taken into consideration as one of several diagnostic markers for alcohol use disorders. When it is present, it can make it additionally difficult to stop drinking without help.4,5

Other signs and symptoms that professionals use to make a diagnosis of an AUD include the following:2,3

  • Drinking more or drinking over a longer period of time than intended.
  • Having a hard time cutting back or stopping, even if you really want to.
  • Spending a lot of your time getting alcohol, drinking it, or recovering from its effects.
  • Experiencing cravings or strong urges to drink.
  • Alcohol gets in the way of important responsibilities, such as those at school, work, or at home.
  • You can’t stop drinking even if it has caused or worsened problems with other people or in your relationships.
  • Taking time away from activities you once enjoyed because of your current alcohol use.
  • Repeatedly showing impaired judgment while drinking, such as getting behind the wheel or having unprotected, risky sex.
  • Inability to stop drinking even after you know it has caused or worsened a physical or mental health issue.
  • Developing tolerance or needing increasing amounts of alcohol to become intoxicated.
  • Going through withdrawal if you try to stop drinking.

Though AUD diagnoses may be made based on these criteria, assessment for problematic alcohol use also sometimes takes place in clinical settings using relatively simple screening tools such as the CAGE questionnaire or the 4Ps screening approach (originally developed for obstetrical patients; this latter screen includes questions about alcohol and/or drug use in parents and partners, whether drinking has resulted in difficulties in the past, and if drinking continues presently).


Checking Your Insurance Benefits

If you are looking for alcohol addiction treatment, it can feel overwhelming. As you consider your options, knowing exactly what your insurance plan covers can give you peace of mind while you or your loved one is in rehab. You can do the work of getting and staying sober without worrying about unexpected costs or financial struggles. For more information on what your insurance plan covers, call AAC at , click here, or fill out the form below.


What is Medication-Assisted Treatment (MAT)?

MAT refers to using medications paired with behavioral therapy to comprehensively treat an AUD.6 There are currently three medications that are FDA-approved to treat AUD. Though each of these work quite differently from each other, they all can be used to decrease continued drinking and help improve treatment outcomes.7 Medications for alcohol use disorder include acamprosate, disulfiram, and naltrexone.6,7 All three can be taken orally, and naltrexone may also be offered as a long-acting injectable, to be administered once a month.3,7

AUD treatment medications function very differently and should ideally be used as just one part of a larger treatment plan that is developed to meet your needs.6 Since everyone will respond to these medications differently, it is important to meet with a medical provider to discuss your needs and preferences so you can work together and figure out which medication and other supports will best help you achieve your goals.7


Types of Medication to Reduce Alcohol Craving and Addiction

The various types of MAT for alcohol addiction can help decrease the likelihood of relapse and deter continued drinking by limiting the rewarding or euphoric effects associated with alcohol, providing an aversive response to alcohol consumption, and balancing brain chemistry previously disrupted by chronic alcohol exposure and alcohol withdrawal.11 These medications are not habit-forming and are most effective when combined with behavioral therapy and other supports.3,6 Medications that are most commonly used to treat AUD include:6,7,8-11

  • Acamprosate (Campral). This medication must be started after you have fully detoxed from alcohol and does not work if you are currently drinking or abusing any type of substances. Acamprosate must be taken regularly, three times a day, and works by relieving some persistent withdrawal symptoms that can linger for weeks or months in certain people. It also works to lessen cravings to drink, especially early in recovery, and works best on people with severe AUDs.
  • Disulfiram (Antabuse). This medication works by impairing alcohol breakdown in your body, resulting in a very unpleasant reaction should you consume alcohol while this medication is in your system. If you drink alcohol while taking this medication, you may quickly experience unpleasant symptoms such as flushed skin, headaches, and nausea. Such symptoms can make you much less likely to drink while regularly taking it. This medication works best for people who are very focused on maintaining sobriety and can be used on an as-needed basis, such as situations where they will be exposed to alcohol and do not want to relapse.
  • Naltrexone. This medication is available as a pill that can be taken daily or as a long-acting injection given monthly to make it easier for people who are less likely to take pills regularly. Naltrexone is an opioid receptor antagonist and is thought to work by interfering with some of the reinforcing or rewarding effects otherwise sought after by drinking . This can help to reduce the urges you have to drink, make you less likely to continue drinking, and lessen the likelihood of relapse.

Types of Medication for Alcohol Withdrawal Treatment

Alcohol withdrawal symptoms can be very uncomfortable, and, in severe cases, they can be dangerous.12 To make the withdrawal process more comfortable and safer, alcohol detox medication can be prescribed. Relatively long-acting benzodiazepines, which act on similar areas of the brain as alcohol, are commonly used to manage alcohol withdrawal and minimize the risk of withdrawal complications such as seizures.11,12 Once your condition is stable, your dose will be slowly decreased as you prepare to complete detox and transition into additional rehabilitation or treatment.12 Two benzodiazepines indicated for use in managing alcohol withdrawal include:11,12

  • Chlordiazepoxide (Librium). This is a long-acting benzodiazepine widely used for alcohol withdrawal, as it lessens symptoms of alcohol withdrawal and provides prophylaxis against seizures.
  • Diazepam (Valium). This is another relatively long-acting benzodiazepine that can relieve acute withdrawal symptoms such as agitation and tremor and reduce the risk of developing delirium tremens or seizures.

Alcohol Withdrawal Symptoms

Alcohol withdrawal symptoms can range from mild to severe. The severity of your withdrawal symptoms may be influenced by factors such as how much you typically drink, how often, how long you have been drinking for, whether you use other substances, and if you have concurrent mental or physical health issues.12,13 Alcohol withdrawal symptoms include:2,12

  • Anxiety.
  • Agitation.
  • Irritability.
  • Insomnia.
  • Sweating.
  • Nausea and vomiting.
  • Increased blood pressure and heart rate.
  • Greater sensitivity to light and sounds.
  • Hallucinations.
  • Tremors in the hands and arms.
  • Seizures that can be potentially fatal.

Delirium tremens (DTs) is a severe progression of acute alcohol withdrawal. This life-threatening syndrome may involve disorientation, altered states of consciousness, hallucinations, and difficulty regulating body temperature, blood pressure, and heart rate.12 Fatality rates for under- or un-managed DTs are unacceptably high, further underscoring the frequent need for medical guidance during acute alcohol withdrawal management.


Do Rehab Programs Use Medication for Alcohol Use Disorder Treatment?

Medications are commonly used to treat AUD, but whether a program incorporates medications into your treatment and recovery can depend on various factors. Some facilities may not utilize MAT in their treatment protocol, but even for those that do, not all treatment medications will be a good fit for everyone.10 Treatment plans, including which medications are used, should be tailored to each person’s individual needs.3,10 When you first begin treatment, a thorough assessment will be conducted to gather information about your substance use, physical health, mental health, and any other issues that you may have that might influence whether medications are used or not.11

The information provided during your assessment will be used to determine a treatment plan, which may include being prescribed medication to help with your sobriety, as well as incorporating other supports.10,11 If you are a good candidate for medication, the provider will work with you to decide which medication is likely to work best for you.9,15 Then they will monitor your progress, see how well the medication is working for you, and make any changes if needed.10,11 These medications can’t cure AUD, but they can help you stay focused and lower your risk of relapse.9


Additional Support Provided for Alcohol Rehabilitation

Medication can be an extremely helpful tool in the recovery process, but it may be more effective when combined with other treatments and supports.7,8 Combining multiple techniques can be a good way to address the various ways in which AUD affects your life. Specific therapeutic types, settings, and additional supports that may be encountered during treatment may include:3,8-11,15

  • Cognitive-behavioral therapy (CBT), which works to change behaviors by addressing unhealthy patterns of thoughts, identifying risky situations, developing coping strategies to lessen risk, improving problem-solving skills, increasing motivation to stay sober, and learning how to manage stress.
  • Family support, which can include attending family counseling sessions or support group meetings in order to learn how to work together to solve issues, communicate better, and support each other more effectively throughout the recovery process.
  • Group and individual counseling, which provide different settings to receive therapy. Group counseling offers a setting where you can give and receive support, while individual counseling offers more privacy to address personal issues in depth.
  • Self-help meetings, including 12-step meetings where you can build peer supports as you develop healthy coping skills and strategies to prevent relapse. The incorporation of 12-step or other mutual support programs into treatment can be helpful long after the initial period of treatment has ended, often serving as a valuable recovery support for years, if not indefinitely.

Does Health Insurance Cover Medication for Alcohol Addiction?

Most insurance plans do offer at least some coverage for AUD treatment and MAT, although the level of coverage can vary widely depending on your specific plan.16 The Affordable Care Act (ACA) led to increased access to health insurance, expanded coverage for substance use treatment, and ensures that physical and mental health services are covered equally.16 You should check with your insurance company to check what is covered, since not every plan covers all treatment services.


How to Find Medication-Assisted Treatment Programs for Alcohol Addiction Near Me

For more information about medication-assisted treatment for alcohol addiction, you may want to reach out to your doctor. Or you can contact one of our admissions navigators at for the information and support you are looking for as you look for alcohol addiction treatment. There are various treatment programs for individuals struggling with drug or alcohol addiction, so don’t give up if the first program you check out doesn’t meet your individual needs or accept your insurance. There are rehabs near me that can provide the treatment you need. Check out the directory to find a list of facilities and programs.

American Addiction Centers (AAC) has various rehab facilities around the country that provide drug and alcohol addiction treatment. The following AAC facilities may incorporate MAT as part of your individualized treatment program.


Sources

  1. Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health(HHS Publication No. PEP21-07-01-003, NSDUH Series H-56). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  3. National Institute on Alcohol Abuse and Alcoholism. (2021). Understanding alcohol use disorder.
  4. Banerjee, N. (2014). Neurotransmitters in alcoholism: A review of neurobiological and generic studies. Indian journal of human genetics, 20(1), 20-31.
  5. National Institute on Alcohol Abuse and Alcoholism. (2021). The cycle of alcohol addiction.
  6. Substance Abuse and Mental Health Services Administration. (2021). Medication-assisted treatment (MAT).
  7. Substance Abuse and Mental Health Services Administration. (2021). MAT medications, counseling, and related conditions.
  8. National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction DrugFacts.
  9. National Library of Medicine. (2021). Alcohol use disorder (AUD) treatment.
  10. National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: A research-based guide (Third edition).
  11. Substance Abuse and Mental Health Services Administration and National Institute on Alcohol Abuse and Alcoholism. (2015). Medication for the treatment of alcohol use disorder: A brief guide. HHS Publication No. (SMA) 15-4907. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  12. Center for Substance Abuse Treatment. (2006). Detoxification and substance abuse treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment.
  13. Newman, R.K., Stobart Gallagher, M.A., Gomez, A.E. (2022). Alcohol Withdrawal. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.
  14. Center for Substance Abuse Treatment. (2010). Protracted withdrawal. Substance Abuse Treatment Advisory, 9(1).
  15. Agency for Healthcare Research and Quality. (2016). Medicines used to treat alcohol use disorder: A review of the research for adults.
  16. Abraham, A.J., Andrews, C.M., Grogan, C.M., D’Aunno, T., Humphreys, K.N., … & Friedmann, P.D. (2017). The Affordable Care Act transformation of substance use disorder treatment. American journal of public health, 107(1), 31-32.

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