Treating alcohol problems: a comprehensive guide

Recognising and seeking treatment for an alcohol problem is a courageous act. It represents a significant and daunting step forward in someone’s life. This individual requires support and encouragement not only from professionals but also from family members, friends, and caregivers. Treatment for excessive alcohol use and dependence is lengthy (sometimes lifelong) and challenging. It must be well-structured and relies heavily on the individual’s commitment and willingness to make comprehensive lifestyle changes.

Revered consultant in adult mental health and addiction psychiatry Dr Christos Kouimtsidis explains how alcohol addiction can be treated, and provides tips for family and friends to support their loved ones on the road to recovery.

The following 3 stages treatment programme for people who are alcohol dependent has proven to be extremely effective. We hope that you will find this information helpful and empowering.      

The clinical part of the treatment is structured, time limited and consists of 3 stages. It is complemented by lifelong aftercare support options such Alcoholic Anonymous.

For those people who are not physically dependent but nevertheless have problems with their alcohol use, for example binge drinkers, those who drink daily but in smaller amounts or those who would like to reduce and control the amount they drink rather than stop altogether we offer a brief intervention consisting of three face to face sessions with a keyworker and access to the above aftercare support options such as AA and SMART Recovery.

Principles of treatment for alcohol dependence

• Abruptly stopping alcohol consumption is extremely risky, even with medication. The individual may experience severe withdrawal symptoms, such as seizures or hallucinations, which can be life-threatening.
• The person should keep drinking at a stable level until they have their assessment by us and advised how to proceed. Although it may sound strange to family members and friends, it is recommended that they consider alcohol “as if it was medication”.
• Abstinence for life (stop drinking for life) is the best and easier option for dependent drinkers. It should be achieved in a structured and planned way and be maintained for life.
• Having several detoxifications and relapses increase the risk and make future attempts for abstinence more difficult.
• The person should be empowered to take full responsibility for both the problem as well as the solution to the problem.
• The person is extremely vulnerable to stress and need as much support as possible.
• Trust is usually broken and communication between the person, family and friends has been compromised and takes long-time to be restored.
• Transitioning and achieving recovery is facilitated within a supportive and abstinent environment.

Stage 1: Preparation

The aim of this stage is to help the person stabilise drinking, regain some control, reduce gradually and safely and most importantly, start preparing and organising the support needed after stopping alcohol.

Your role:

• YOU as family, friend or carer you are expected to consider reducing and even stopping YOUR drinking, as well as change your overall lifestyle to compliment and support your beloved person to achieve and maintain abstinence.
• YOU are expected to support the person to follow the programme.
• YOU are welcome to attend the reviews.

Facts

• If the person completes this stage, there is 74% chance (as opposed to 43%) to maintain abstinence for the first month and 49% (as opposed to 40%) for 3 months
• Furthermore, there is 50% chance that the person will be able to reduce and stop drinking gradually during this stage without needing a detoxification.
• The person will be better prepared to attend and make best use of the aftercare support provided.

Stage 2: Detoxification

Detox means that we prescribe medications in a reduced regime over 7-10 days, to protect the brain from stopping alcohol and reduce the risk from major withdrawal symptoms such as seizures or hallucinations. This medication does not offer protection against relapse into drinking. There are other medications that could help with this (see next section).

Your role:

Your support is imperative in reducing the risks which are linked to the detoxification process. We are only able to facilitate home detoxification if you, along with other family members' support, can remain with the individual continuously for the initial three days of the detoxification period. During the subsequent days, your presence at home is essential for as much time as possible.

Facts

• All types of detoxifications are equally effective. The choice of which one (if any) is appropriate, depends on medical risk factors and it is a medical decision.
• Medically assisted detoxification is a risky clinical intervention and should be done with the full support and monitoring of compliance provided by our team.
• Not all people need a medically assisted detoxification. This is solely a medical advice.

If you require treatment for alcohol addiction and would like to book a consultation with Dr Kouimtsidis, do not hesitate to do so by visiting his Top Doctors profile today