Possible Diagnostics and Treatment from Alcoholism

Diagnosis

You're likely to start by seeing your doctor. If your doctor suspects you have a problem with alcohol, he or she may refer you to a mental health professional.

To assess your problem with alcohol, your doctor will likely:

• Ask you several questions related to your drinking habits. The doctor may ask for permission to speak with family members or friends. However, confidentiality laws prevent your doctor from giving out any information about you without your consent.
• Perform a physical exam. Your doctor may do a physical exam and ask questions about your health. There are many physical signs that indicate complications of alcohol use.
• Lab tests and imaging tests. While there are no specific tests to diagnose alcohol use disorder, certain patterns of lab test abnormalities may strongly suggest it. And you may need tests to identify health problems that may be linked to your alcohol use. Damage to your organs may be seen on tests.
• Complete a psychological evaluation. This evaluation includes questions about your symptoms, thoughts, feelings and behaviour patterns. You may be asked to complete a questionnaire to help answer these questions.
• Use the DSM-5 criteria. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association, is often used by mental health professionals to diagnose mental health conditions.

Treatment

Treatment for alcohol use disorder can vary, depending on your needs. Treatment may involve a brief intervention, individual or group counselling, an outpatient program, or a residential inpatient stay. Working to stop the use of alcohol to improve the quality of life is the main treatment goal.

Treatment for alcohol use disorder may include:

• Detox and withdrawal. Treatment may begin with a program of detoxification or detox — a withdrawal that's medically managed — which generally takes two to seven days. You may need to take sedating medications to prevent withdrawal symptoms. Detox is usually done at an inpatient treatment centre or a hospital.
• Learning skills and establishing a treatment plan. This usually involves alcohol treatment specialists. It may include goal setting, behaviour change techniques, use of self-help manuals, counselling and follow-up care at treatment centres.
• Psychological counselling. Counselling and therapy for groups and individuals help you better understand your problem with alcohol and support recovery from the psychological aspects of alcohol use. You may benefit from couples or family therapy — family support can be an important part of the recovery process.
• Oral medications. A drug called disulfiram (Antabuse) may help prevent you from drinking, although it won't cure alcohol use disorder or remove the compulsion to drink. If you drink alcohol, the drug produces a physical reaction that may include flushing, nausea, vomiting and headaches. Naltrexone, a drug that blocks the good feelings of alcohol causes, may prevent heavy drinking and reduce the urge to drink. Acamprosate may help you combat alcohol cravings once you stop drinking. Unlike disulfiram, naltrexone and acamprosate don't make you feel sick after taking a drink.
• Injected medication. Vivitrol, a version of the drug naltrexone, is injected once a month by a health care professional. Although similar medication can be taken in pill form, the injectable version of the drug may be easier for people recovering from alcohol use disorder to use consistently.
• Continuing support. Aftercare programs and support groups help people recovering from alcohol use disorder to stop drinking, manage relapses and cope with necessary lifestyle changes. This may include medical or psychological care or attending a support group.
• Treatment for psychological problems. Alcohol use disorder commonly occurs along with other mental health disorders. If you have depression, anxiety or another mental health condition, you may need talk therapy (psychotherapy), medications or other treatment.
• Medical treatment for health conditions. Many alcohol-related health problems improve significantly once you stop drinking. But some health conditions may warrant continued treatment and follow-up.
• Spiritual practice. People who are involved with some type of regular spiritual practice may find it easier to maintain recovery from alcohol use disorder or other addictions. For many people, gaining greater insight into their spiritual side is a key element in recovery.