Alcohol use disorder (AUD) – formerly known as alcohol dependence or alcoholism – is a matter of urgent concern in this country. Consider the statistics. The 2020 National Survey on Drug Use and Health (NSDUH) categorizes 17.7 million Americans – slightly more men than women – as heavy drinkers. That’s nearly 7% of the population. And they’re all at significant risk of developing AUD.
The social and economic costs of alcohol use disorder are considerable. Each year, an estimated 88,000 Americans die from alcohol-related causes. From job loss to accidents and injuries, to healthcare costs from associated medical problems, the burden on society from alcohol misuse is a significant one. This makes the prevalence of alcohol use disorder something that matters to us all.
It’s not surprising, then, that research into new treatments for alcohol abuse is ongoing. Researchers and clinicians seek and test new approaches constantly. Evidence shows many of these new approaches help people quit drinking, rebuild their lives, and move toward a healthy and productive future. Yet a recent study found that the rate of alcohol use disorder among adults in the United States increased dramatically over the past two decades.
If effective, evidence-based treatments are available, why does the problem persist?
A significant part of the answer lies in what addiction professionals call the treatment gap.
What is the Treatment Gap?
Simply put, the phrase means that not everyone diagnosed with alcohol use disorder receives care or intervention. Statistics show that in the United States, of the people diagnosed with AUD, only about 8.0 % of men and 7.7 % of women sought treatment.
This problem has multiple underlying causes. Stigma is one of the most powerful and pervasive. In recent history, particularly in the U.S., alcoholism was viewed as a personal weakness or failure. The idea that the disordered use of alcohol is a moral failing, rather than a medical issue, is tied to early cultural values of abstention, cleanliness, and discipline. Despite research suggesting otherwise, the notion that a person can and should give up drinking by relying on willpower alone persists today.
The Problem of Stigma
Though the roots of this attitude are rooted in our social and cultural norms, it’s perpetuated not only in society at large, but sometimes within the medical profession itself. That’s a place where people who seek treatment should be able to expect to find evidence-based support, sound scientific information, and compassionate care. Unfortunately, that’s not always the case. There’s a persistent stigma surrounding people with alcohol use disorder. There’s also a persistent stigma surrounding treatment for alcoholism.
Meanwhile, drinking alcohol has become increasingly less stigmatized in recent years. This has happened for demographics that were once strongly discouraged by social taboos from consuming alcohol at all, such as mothers and older women.
These attitudes are hard to pin down. Many people don’t realize they have them. Therefore, they don’t know they perpetuate them. Nevertheless, this embedded stigma has real and detrimental effects on people with alcohol use disorder and want to quit. In many cases, stigma prevents them from seeking life-changing and life-saving treatment.
For those looking to change their habits around drinking, stigma and misinformation also make it difficult to find reliable information. People want to quit, but stigma prevents them from finding safe and healthy methods for seeking sobriety. In addition, some may fear withdrawal symptoms, hold misconceptions about alcohol use disorder and sobriety, or simply lack knowledge of the various evidence-based and effective treatment options available to them.
Many will seek treatment only when forced by some extreme circumstance, such as a court order, a severe accident or injury, loss of employment, or family intervention.
Awareness and Access
The stigma surrounding alcohol use disorder (AUD) and seeking treatment might be less problematic if everyone diagnosed with AUD had equal access to all available treatments. However, this is not the case. The availability of support groups varies by geographic location. In some poor or rural areas, there may be little to no access to treatment at all. Although these geographic disparities in access are gradually being remedied by the increased use of virtual care and online community support meetings, not everyone in rural areas has reliable internet access. Also, many insurance programs don’t cover treatment. This makes cost a significant barrier to care even in well-served areas.
There’s also a lack of awareness about the latest advances in treatment. For example, some medications show promise for reducing the severity of withdrawal symptoms. There are also medications that reduce the craving for alcohol. These medications can facilitate behavioral change. They help break patterns of craving in the reward circuit in the brain. In the absence of intense cravings, a person in recovery has an increased chance of developing and reinforcing new, life-affirming skills and behaviors.
How Can We Close the Treatment Gap?
Though it won’t change overnight, increased knowledge and awareness of the medical model of addiction is a crucial piece of the puzzle. This awareness can help reduce the stigma surrounding the misuse of alcohol. The medical model prioritizes the perspective that addiction is a chronic medical condition that responds well to evidence-based treatment. It allows people to seek treatment without the fear they’ll be demonized or shamed for having a medical condition that’s analogous to other chronic conditions such as hypertension or diabetes.
Data also indicates that, when routine screening for problem alcohol use becomes part of a regular annual checkup, patients can begin to see alcohol use disorder as a medical problem. They understand AUD – like high blood pressure or diabetes – must be treated. And the best way to treat AUD is with professional treatment and support.
Evidence shows that the most effective treatment for alcohol use disorder follows a multi-modal, integrated model. High-quality residential programs for people with AUD typically include:
- Group therapy
- Individual therapy, which may include:
- Cognitive behavioral therapy
- Dialectical Behavior therapy
- Motivational interviewing
- Exercise
- Nutrition
- Yoga and meditation
- Music and art
These approaches help people develop the practical skills they need to achieve sobriety and abstinence. The best treatment programs are progressive, stepwise, and tailored to the individual. We can trust them because decades of clinical data prove they’re safe and effective.
Professional support and care can help people move past the painful, damaging cycles of addiction and create a sustained life in recovery. Committing to treatment is a big step. The work can be challenging. However, we know from experience that for those willing to take the step and do the work, treatment works – and can change their lives for the better.
The Ridge offers a complete detox program and an inpatient rehab center to help people fight addiction.
