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Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Medical Editor:

Roxanne Dryden-Edwards, MD

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

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Alcoholism is best treated by professionals trained in addiction medicine. Physicians and other health care workers with such specialized training and experience are best suited to manage alcohol withdrawal and the medical disorders associated with alcoholism.

In fact, home therapy without supervision by a trained professional may be life threatening because of complications from alcohol withdrawal syndrome. Usually an alcoholic will begin to experience alcohol withdrawal six to eight hours after cutting down or stopping alcohol consumption.

Several levels of care are available to treat alcoholism. Medically managed hospital-based detoxification and rehabilitation programs are used for more severe cases of dependence that occur with medical and psychiatric complications. Medically monitored detoxification and rehabilitation programs are used for people who are dependent on alcohol and who do not require more closely supervised medical care. The purpose of detoxification is to safely withdraw the alcohol dependent person from alcohol and to help him or her enter a rehabilitation (rehab) treatment program. The purpose of a rehabilitation program is to help the individual with alcoholism accept the disease, begin to develop skills for sober living, and get enrolled in ongoing treatment and self-help programs. Most detoxification programs last just a few days. Most medically managed or monitored rehabilitation programs last less than two weeks. Many alcoholic individuals benefit from longer-term rehabilitation programs, day treatment programs, or outpatient programs. These programs involve education, therapy, addressing problems contributing to or resulting from the alcoholism, and learning skills to manage the alcoholism over time.

These skills include, but are not limited to, the following:

• Learning to identify and manage what leads to cravings for alcohol ("triggers")
• Resisting social pressures to engage in substance use
• Changing health care habits and lifestyle (for example, improving diet and sleep hygiene, and avoiding high-risk people, places, and events)
• Learning to challenge alcoholic thinking (thoughts such as, I need a drink to fit in, have fun, or deal with stress)
• Developing a recovery support system and learning how to reach out for help and support from others (for example, from members of self-help programs)
• Learning to deal with emotions (anger, anxiety, boredom, depression) and stressors without reliance on alcohol
• Identifying and managing relapse warning signs before alcohol is used
• Anticipating the possibility of relapse and addressing high-risk relapse factors

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