What Is Alcohol Use Disorder?
Alcohol use disorder is a chronic brain disorder, with symptoms of an inability to stop drinking (compulsive drinking), loss of control over using alcohol, and negative emotions when not drinking (when not drinking, the person becomes preoccupied with drinking again).
There are different degrees of alcohol use disorder. It can be mild, moderate, or severe. No matter how serious it is, there is treatment available. Many people who are diagnosed with alcohol use disorder learn how they can control the urge to drink.
In 2019, the National Survey on Drug Use and Health found that 14.5 million people over the age of 12 met the criteria for having alcohol use disorder. Of this 14.5 million, 9 million were men, and 5.5 million were women.
The numbers are stark, but treatment (if maintained over the long term) has been very successful in helping many people live healthier lives. As many as 89 percent of people who go through the entire rehabilitation process remain sober in the first month after they are discharged. Upward of 76 percent of people who go to treatment for alcohol use disorder report maintaining their sobriety at the three-month mark; 69 percent are still sober six months after being discharged; and 70 percent are still sober nine months after they are discharged.
What Is Medication-Assisted Treatment?
One reason the success rate of treating alcohol use disorder is so high is because of Medication-Assisted Treatment, or MAT for alcohol use disorder. This refers to the use of medications, in collaboration with counseling and behavioral therapy, to offer a holistic approach to treating the psychological and emotional causes and fallout of alcohol use disorder. Medication-Assisted Treatment also takes into consideration other health conditions and factors that every person brings with them into treatment.
There is much research to suggest that Medication-Assisted Treatment is among the most beneficial and effective methods available today to treat alcohol use disorder. Addiction specialists have found that using MAT for alcohol use disorder successfully minimizes the withdrawal symptoms of discontinuing alcohol use, reduces cravings for more alcohol, and significantly increases a person’s chances of maintaining their sobriety.
Medications Used in Alcohol MAT
The U.S. Food and Drug Administration has approved three medications for alcohol use disorder. While these therapies are safe and effective, less than 9% of people who enter treatment get them. Knowing what they are and how they work could entice you to look for an MAT program to boost your recovery.
Disulfiram works by blocking alcohol’s breakdown in the liver and the brain. When people drink while on disulfiram, alcohol byproducts build up and cause unpleasant symptoms like the following:
These episodes are so unpleasant that they can make people resist the urge to drink again.
Common side effects include drowsiness, but some people experience serious problems like liver disease, neuropathy, and confusion.
Naltrexone was FDA approved for alcohol dependence in 2006. It works by blocking alcohol’s receptors in the brain, making each sip less rewarding. When people drink alcohol and feel less reward from it, the link between consumption and happiness weakens. In time, people may feel fewer urges to drink.
Naltrexone can cause liver problems, so doctors must monitor their patients for problems often. Other side effects include reduced appetite, abdominal pain, and insomnia.
Naltrexone can also block euphoria from opioids. People addicted to both alcohol and opioids could use this medication for both disorders simultaneously.
Acamprosate was FDA approved in 2004. It works by blocking the GABA receptors responsible for alcohol’s euphoria and emotional reward. It’s not as understood as the other alcohol MAT medications, but it seems to work to reduce heavy drinking episodes.
Acamprosate is the only medication of the three safe for people with liver disease. However, it can cause uncomfortable digestive side effects like nausea and flatulence. Doctors typically start the doses small to ensure their patients can tolerate the medication.
How MAT Helps Recovery
Other research has also spoken to the effectiveness of using Medication-Assisted Treatment for alcohol use disorder. A study of over 5,700 adults with alcohol dependence showed that those who received MAT “were less likely to require mental health hospitalization” and visits to the emergency department than study participants who didn’t use MAT. Additionally, they were also found to be more likely to stay with their medication plans than adults who didn’t receive Medication-Assisted Treatment.
Researchers in the Biological Psychiatry journal wrote that treating individuals who have substance use disorders with Medication-Assisted Treatment “is more likely to improve their mental health, quality of life, employability, and family relations.” Furthermore, this kind of engagement has a good chance of reducing the likelihood that they will return to alcohol abuse or other forms of substance abuse, and reduces the risk of them participating in criminal activity.
The Role of Counseling in MAT
It’s easy to focus on the medication aspect of MAT, but it doesn’t work in isolation. MAT programs also involve counseling. This aspect helps you learn how to build a healthy life that supports your long-term sobriety.
Types of counseling included in alcohol MAT may include the following:
- Cognitive behavioral therapy (CBT): This type of therapy is designed to change thought processes that lead to drinking. Your counselor may also help you to build up sobriety skills.
- Motivational enhancement therapy: This counseling is designed to help strengthen your commitment to quit drinking.
- Family counseling: This form of therapy is designed to help repair relationships, so you’ll have a solid support group when MAT is over.
Some programs also use educational sessions to help you learn more about how alcohol works and how drinking problems develop.
How to Find an MAT Program
Health insurance companies cover the costs associated with addiction treatment. If you’re struggling with alcohol, call your company and ask for a list of preferred providers. Ask how much your plan will cover and how much you’ll pay in copayments and deductibles.
As you’re interviewing MAT partners, follow advice from the Substance Abuse and Mental Services Administration and ask questions about the following issues:
- Qualifications: Is the facility licensed in the state? Is it accredited by a national compliance organization?
- Options: Does the program use evidence-based care for alcoholism, including using MAT? Do they offer both counseling and medications?
- Support: Does the facility include families in the treatment program?
- Continued care: Does the facility provide long-term care options, such as counseling or alumni meetings?
Once you’ve chosen the right partner, ask about the enrollment process. Find out how much the program will cost, what to pack, and how to prepare for the treatment to begin. A qualified, compassionate program will have staff members dedicated to answering all of your questions.
What Else Can You Do to Promote Recovery?
Medication-Assisted Treatment for alcohol use disorder does not exist in a vacuum, and there is a lot that someone can do on top of MAT to help their chances of recovery. First and foremost, stick with the program. Recovering from alcohol use disorder can be a gradual journey, and the temptation to relapse is never far. Developing an accountability network through friends, family, and medical staff is invaluable to maximizing the effectiveness of the MAT part of the treatment. A person who takes their benzodiazepines as prescribed but who doesn’t attend meetings or follow the other guidelines laid out by their program will likely struggle to maintain their recovery.
It can also help to move away—literally, if necessary—from the lifestyle that encouraged alcohol use disorder. This might entail ending relationships that directly or indirectly triggered unhealthy thought processes that led to drinking. It might entail cultivating healthy new habits and hobbies, which offer more productive outlets for stress, boredom, or other emotions.
Even as Medication-Assisted Treatment addresses some of the physical and psychological stresses of leaving alcohol use behind, cultivating a healthy and rich life addresses the long-term implications of building a new life without the dependence on alcohol.
- Alcohol Facts and Statistics. (June 2021.) National Institute on Alcohol Abuse and Alcoholism.
- Treatment and Recovery. (July 2020). National Institute on Drug Abuse.
- MAT Medications, Counseling, and Related Conditions. (August 2020). Substance Abuse and Mental Health Services Administration.
- Maintenance Medication for Opiate Addiction: The Foundation of Recovery. (July 2012). Journal of Addictive Diseases.
- An Overview of Medication-Assisted Treatment for Opioid and Alcohol Use Disorders. (October 2020). The American Journal of Managed Care.
- Medication-Assisted Treatment for Alcohol-Dependent Adults With Serious Mental Illness and Criminal Justice Involvement: Effects on Treatment Utilization and Outcomes. (July 2018). American Journal of Psychiatry.
- Medication Treatment of Opioid Use Disorder. (July 2019). Biological Psychiatry.
- How Effective Is Medication-Assisted Treatment for Addiction? Here’s the Science. (May 2017). STAT News.
- Evidence-Based Pharmacotherapies for Alcohol Use Disorder. (May 2020). Mayo Clinic Proceedings.
- Struggling with Addiction? Tips on Finding Quality Treatment. (January 2019). Substance Abuse and Mental Health Services Administration.
- Alcohol’s Effects on Health. (September 2023). National Institute on Alcohol Abuse and Alcoholism.