Three general steps are involved in treating the alcoholic person: intervention, detoxification, and rehabilitation.

Intervention

The goal in the intervention step is to break through feelings of denial and help the person realize the adverse consequences likely to occur if the disorder is not treated. This step often involves convincing patients that they are responsible for their own actions while reminding them of how alcohol has created significant life impairments.

Detoxification

Most persons with alcohol dependence have relatively mild symptoms when they stop drinking. If the patient is in relatively good health, is adequately nourished, and has a good social support system, the depressant withdrawal syndrome usually resembles a mild case of the flu. To aid in the patient’s alcohol withdrawal, a brain depressant such as chlordiazepoxide or lorazepam may be given for 4-5 days. For patients with severe withdrawal symptoms, either benzodiazepines or antipsychotic agents, such as haloperidol, may be given.

Symptoms of anxiety, insomnia, and mild autonomic overactivity are likely to continue for 2 to 6 months after the acute withdrawal period has passed. In some cases, medications such as acamprosate (Campral) may help diminish some of the symptoms.

Rehabilitation

The treatment process used in both inpatient and outpatient settings involves intervention, optimizing physical and psychological functioning, enhancing motivation, reaching out to family, and using the first 2 to 4 weeks of care as an intensive period of help. These efforts are followed by at least 3 to 6 months of less frequent outpatient care.

Counseling

Whether in an inpatient or outpatient setting, individual or group counseling is usually offered a minimum of three times a week for the first 2 to 4 weeks, followed by less intense efforts, such as once a week, for the subsequent 3 to 6 months.

Much time in counseling focuses on how to build a lifestyle free of alcohol. Discussions cover the need for a sober peer group, a plan for social and recreational events without drinking, and approaches for reestablishing communication with family members and friends.

An important aspect of recovery involves helping family members and close friends understand alcoholism and realize that rehabilitation is an ongoing process that lasts for 6 to 12 or more months.

Participation in self-help groups such as Alcoholics Anonymous is associated with improved outcomes for recovery from alcoholism.