Alcohol Use Disorder Treatment in South Carolina

Alcohol Use Disorder Is Common and Treatable

Alcohol use disorder means drinking that has become hard to control and keeps causing problems with health, work or relationships. In the most recent national survey, about 27.1 million U.S. adults had alcohol use disorder in the past year, yet only about 7.5 percent received any treatment and about 2.4 percent received a medication for it.

Treatment works, and it does not have to mean a residential program. Many people do well with medication, counseling and regular follow-up while they keep working and living at home.

How Treatment Works at Hope

Care starts with a full evaluation: your drinking pattern, past attempts to cut back or stop, other health conditions, medicines, mental health and goals. Some people want to stop drinking entirely; others start by cutting back. Your plan reflects your goals and what is safest for you.

Medication-assisted treatment (MAT) for alcohol use disorder combines an FDA-approved medication with counseling and regular follow-up visits, in person in West Ashley or by telehealth.

Medication Options

Three medications are approved for alcohol use disorder, and all of them are non-addictive. Two other medications are sometimes used off-label when the approved options are not a good fit.

There is no single right medication for everyone. Your provider walks you through the options, and together you choose the treatment that fits your health, your goals and your other medicines, based on shared decision-making and a careful look at the risks and benefits of each option.

• Naltrexone, a daily pill or a monthly injection (Vivitrol), reduces cravings and the urge to drink. You must be free of all opioids, including opioid pain and cough medicines, for 7 to 10 days before starting.
• Acamprosate is a pill taken three times a day that eases the uncomfortable symptoms some people feel after they stop drinking. Your provider checks your kidney function first.
• Disulfiram (Antabuse) causes an unpleasant reaction, with flushing, nausea and vomiting, if you drink. It is only started after at least 12 hours without alcohol and only with your full knowledge, and hidden alcohol in products such as cough syrup can trigger the reaction.
• Gabapentin and topiramate are used off-label as second-line options for people who prefer them or who have not done well on the approved medications.

Withdrawal Safety

Whether withdrawal can be managed safely as an outpatient is decided at your evaluation. When the risk of severe withdrawal is high, we help arrange a higher level of care. Stopping heavy daily drinking suddenly can cause seizures or delirium tremens, which can be fatal. Talk to a clinician before stopping, and call 911 for confusion, hallucinations or a seizure.

Counseling and Support

Counseling helps you change drinking patterns, handle triggers and stress, and address anxiety, depression or trauma that often go along with heavy drinking. Medication can be used alone or together with counseling, and mutual-support groups can add another layer of support alongside care from your provider.

Telehealth visits are evaluation and management visits. A prescription can be part of your treatment when your provider, using professional judgment and deciding together with you after weighing the risks and benefits, finds it medically necessary. Whether you are seen in person in West Ashley or by telehealth, prescriptions are sent electronically to your pharmacy.

• Mental health care at Hope Integrative Medicine
• Addiction medicine services

Safety Notes

Vivitrol (naltrexone) requires being opioid-free for 7 to 10 days and is given as an in-person monthly injection; follow-up visits can be by telehealth. Using opioids on top of Vivitrol, or after a missed or stopped dose, can cause a fatal overdose because your tolerance is lower.

Hope Integrative Medicine is not an emergency service. In a crisis, call or text 988; for a medical emergency or overdose, call 911.

Sources

The facts on this page come from the National Institute on Alcohol Abuse and Alcoholism, MedlinePlus at the National Library of Medicine, and the American Psychiatric Association's practice guideline.

• NIAAA, Treatment for Alcohol Problems: Finding and Getting Help
• NIAAA, Alcohol Use Disorder in the United States
• NIAAA, Alcohol Treatment in the United States
• NIAAA, Alcohol Use Disorder: From Risk to Diagnosis to Recovery
• MedlinePlus, Naltrexone
• MedlinePlus, Acamprosate
• MedlinePlus, Disulfiram

Care in Your City

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