Treatment for Alcohol Use Disorder: What Works?

“There are a lot of negative consequences of ongoing alcohol use,” says Jonathan Avery, MD, director of Addiction Psychiatry at Weill Cornell Medicine and NewYork-Presbyterian Hospital. Not only can it mess with your life and potentially ruin relationships and jobs, but it can also deteriorate your physical health, including liver damage, brain damage, and an increased risk of certain types of cancer.

If you fear you may be drinking more than you should be, but you’re having trouble cutting back, don’t be afraid to reach out for help, even if the situation isn’t dire yet. “Talk about it with your healthcare providers,” says Dr. Avery. “Don’t let things get to the point where things are so severe that you’re forced to treatment.”

Treating any type of substance use disorder can be challenging. Your brain has essentially been rewired to depend on the substance, so it’s not as simple as just having “discipline.” 

“I argue that the first step when you have an alcohol use disorder is to, one, make sure everyone in your life knows, and then let a healthcare provider know [who] can give you some good advice,” says Dr. Avery.

Treatment Options for AUD

“Treatment for alcohol use disorder … can involve self-help groups like Alcoholics Anonymous, or alternatives to AA like SMART Recovery, which are basically both free, peer-based groups that you can work the Steps, get the sponsor, and have the sober community that can usher you into recovery,” says Dr. Avery.

The “steps” Dr. Avery refers to are the 12 Steps of recovery. It’s a formalized program to eliminate alcohol use (but it has also been adapted to treat other addictions and substance use disorders). 

“Increasingly, we’re also recommending medications to help with alcohol use disorder,” says Dr. Avery, “and we feel sometimes that that combination of psychosocial support and medications can help people achieve sobriety.”

The main type of medication used to treat alcohol use disorder works by suppressing cravings for alcohol “so you feel less compelled to use,” says Dr. Avery. “They help with the neurocircuitry that’s been rewired in your brain.” 

Another treatment for alcohol use disorder works by causing very unpleasant side effects if you drink while taking them, thus discouraging drinking. Within minutes of consuming alcohol, you might experience headache, vomiting, sweating, and impaired vision. This was actually one of the first drugs created for alcohol dependency, approved by the Food and Drug Administration in 1951.

“It can be hard to get treatment for alcohol use disorder because it’s such a part of our lives and culture, [but it’s] important to intervene early so you can learn to live life without it,” says Dr. Avery.