How is rehab for alcoholics

Alcohol addiction (alcohol dependence) and rehab

Alcohol addiction is a mental illness

Alcohol addiction (alcohol dependence) is a mental illness that gradually develops over the years. Although most adults in this country drink alcohol, alcohol consumption only leads to dependence in some people. Find out everything about the causes of alcohol addiction, therapy and rehabilitation here.

Alcohol addiction: general

Alcohol addiction is the physical and psychological dependence on the chemical substance ethanol. In this country, alcoholic beverages such as beer, wine and schnapps are an integral part of the culture and are socially recognized. In Germany, more than 95 percent of adults drink alcohol occasionally. 9.5 million Germans show drinking behavior that goes beyond the normal level of alcohol consumption. 1.3 million are alcohol dependent (1). 10 percent of young people between the ages of 12 and 17 report that they drink alcohol at least once a week. In 2013, every German consumed an average of 9.7 liters of pure alcohol. The addiction can affect young and old, men and women alike. However, men are three times more likely to be affected than women.

9.5 million Germans show drinking behavior that goes beyond the normal level of alcohol consumption. 1.3 million are alcohol-dependent (1) - Photo: © Photographee.eu / panthermedia.net

Alcohol addiction: causes / risk factors / addiction prevention

Causes of dependence

Consuming the same amount of alcohol makes some people dependent, others not. The causes lie in a genetic predisposition, the reasons for alcohol consumption and the social environment. Alcohol in small amounts brightens the mood, reduces inhibitions and promotes the willingness to communicate. That is why many people already have positive experiences with alcohol in their adolescence. There is a higher risk of addiction if alcohol consumption has already been normal in the family and a means of coping with the problem. Peer pressure among friends also plays a role, especially with young people. Traumatic experiences, especially in childhood, favor the development of alcoholism.

Prevention of alcohol addiction

Only through complete abstinence can one reliably prevent alcohol addiction. If you want to consume alcohol, you should take a few precautionary measures: The amount you drink should be as low as possible and not increased. Experts assume that the consumption of more than 12 grams of alcohol per day (for women) and 24 grams of alcohol for men is to be classified as “risky consumption” and poses a risk of addiction (2). For comparison: 0.33 liters of beer correspond to around 13 grams of alcohol. Drinking should not be used as a remedy for frustration, inhibitions or fears. Alcohol should not be drunk for at least two days a week. The most important measure is to seek help at a counseling center or a doctor in good time if you are using it (your own or that of friends and relatives).

Alcohol addiction: appearance / symptoms / course

Course of addiction development

The transition from regular alcohol consumption to addiction is fluid. Over time, tolerance develops: more and more alcohol is needed to experience the pleasant effect. Gradually, signs of physical dependence (withdrawal symptoms) appear if no alcohol is consumed. As alcohol activates the reward center in the brain, it leads to psychological dependence and a strong desire to consume alcohol again. After all, everything revolves around the alcohol. Interests and social life are neglected.

Acute effects of alcohol consumption

Larger amounts of alcohol cause perception disorders, speech disorders ("babbling") and coordination disorders. In the worst case, alcohol poisoning can lead to death from circulatory failure or respiratory failure. Psychologically, alcohol consumption leads to disinhibition, which can lead to a complete loss of control. This makes crime, accidents, or rash acts while under the influence of alcohol more likely. During pregnancy, alcohol can cause physical and psychological damage to the unborn child.

Symptoms of chronic alcohol abuse

Alcohol also acts as a cell poison. Regular and excessive alcohol consumption leads to

  • Liver damage,
  • Inflammation of the gastrointestinal tract and pancreas,
  • Cardiovascular diseases,
  • Brain damage.

Alcohol abuse also increases the risk of cancer of the mouth, throat and esophagus. Withdrawal symptoms such as nausea, sweating, tremors and restlessness occur. The risk of anxiety and depression increases. Other common consequences of alcohol addiction are social exclusion, family problems, and the loss of friends or jobs. Typical signs of alcoholism include hiding alcohol and secretly drinking.

Alcohol addiction: examinations & diagnosis

If alcohol addiction is suspected, the doctor first clarifies the typical symptoms and behaviors in a conversation: How often do you drink? How often do you think about alcohol? Have you ever reduced your alcohol consumption and how did you feel then? What does alcohol do to you? Do you have physical symptoms such as difficulty sleeping, tremors, sweating? Additional information is provided by certain blood values, such as liver values. If the suspicion is confirmed, a referral is usually made to a specialist doctor or clinic.

According to international criteria, there is an addiction if three of the following points apply:

  • Strong cravings for alcohol
  • No more control over the amount of drink possible
  • Withdrawal symptoms occur when alcohol is not consumed
  • The amount of alcohol consumed increased continuously (tolerance development)
  • The focus is on alcohol, other interests are neglected
  • Despite the negative consequences, those affected do not stop drinking

Alcohol Addiction: Therapy & Rehabilitation / Life After Withdrawal

The aim of every therapy and rehab for alcohol addiction is to achieve abstinence or at least a severe reduction in alcohol consumption over the long term. Compared to other diseases, the treatment of addictions is always tedious. In most cases, acute therapy is followed by rehab, which helps those affected to live permanently without alcohol.

Phases of therapy for alcohol addiction

Alcohol addiction therapy can be divided into four phases:

  1. Contact phase: The focus here is on advice and medical examinations. Those affected have to recognize the alcohol problem themselves and find an inner motivation for the therapy.
  1. Withdrawal phase or reduction phase: In order to achieve abstinence, those affected must first be weaned from alcohol as part of a withdrawal. In order to be able to intervene medically in the event of withdrawal symptoms, this phase usually takes place in the hospital. If the person concerned does not (yet) want withdrawal, a medically controlled reduction in the amount consumed is possible.
  1. Weaning phase (rehab): After the acute detox, further hurdles have to be overcome. Specialist clinics support those affected on an outpatient or inpatient basis in getting along again in everyday life without alcohol. This phase can take several months.
  1. Follow-up phase: Returning to everyday life is always difficult for those affected. There you often find yourself confronted with the previous fears and problems. Regular discussions in addiction clinics, with specialists, counseling centers or in self-help groups can maintain the psychological motivation to abstain.

Rehabilitation for alcohol addiction

In the case of alcohol addiction, rehabilitation means outpatient or inpatient care during the weaning phase. It usually lasts between 8 and 16 weeks.

Measures in rehab

Therapeutic measures take place either in individual discussions or in groups. In behavior therapy, those affected learn strategies to overcome the urge for alcohol. An accompanying drug treatment, relaxation techniques and movement therapies can support the treatment. The ultimate goal is to avoid relapses. For this purpose, the handling of risk situations is trained (psychological pressure, visiting parties or restaurants, arguments with the partner). The triggers and backgrounds of the addiction are worked out. Partner or family conversations give relatives the knowledge how to support those affected and counteract alcohol consumption.

Clinical focus

When choosing the clinic, you should pay attention to your individual requirements. There are rehabilitation clinics where you can carry out work preparation measures and receive extensive support with your professional reintegration. Other clinics offer extensive creative and musical activities, sports or alternative healing methods that support the therapy.

Opportunities and benefits of rehab for alcohol addiction

Alcohol addiction cannot be "cured". Most of those affected, however, manage to give up alcohol consumption through rehab and become "dry". Experts recommend rehab after withdrawal (3). This is particularly effective when it is carried out as an inpatient in a clinic. 85 percent of all patients who only go through a detox without subsequent weaning will relapse again (4). Rehabilitation improves the chances considerably. One year after withdrawal treatment, around 70 percent are still abstinent.

about the author

Dr. Silvia Nold holds a doctorate in biology with many years of experience in medical and scientific diagnostics.

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  • (1) Federal Government Commissioner for Drug Issues, Brochure: Drug and Addiction Report 2016, June 2016.
  • (2) German headquarters for addiction issues. Addiction medicine series, Volume 1: Alcohol addiction. 2013.
  • (3) Guidelines of the German Society for Addiction Research and Addiction Therapy and the German Society for Psychiatry, Psychotherapy and Neurology: Screening, Diagnosis and Treatment of Alcohol-Related Disorders. 2016.
  • (4) M. Bottlender: One drink, one drunk - Is controlled drinking possible? PPmP Psychotherapy, Psychosomatics, Medical Psychology 2007; 57 (1): pp. 32-38