—Laura Diamond, LMHC, EdM, MA
About Alcohol Use Disorder
Understanding Alcohol Use Disorder is a crucial component of understanding what your friend or family member is going through, how you are (or aren’t) involved, and how to support sustained recovery. Alcohol Use Disorder (AUD) is a medical condition, like heart disease is. It is not a moral failing. Like other medical problems, AUD has symptoms, a natural history, and treatment options.
AUD is characterized by drinking more than you want and for longer than you want, despite wanting to cut down. It’s also characterized by having strong urges to drink during certain times of the day. And this is more common than you think. An estimated 15 million people in the United States alone live with AUD. Statistically speaking, AUD is 50–60% genetically determined. Gene interactions are complex, so there are hundreds of genes that shape how someone ends up developing AUD, and to what degree. The range of severity comes down to how these genes are expressed.
For a deeper dive into the AUD spectrum, you can read more about Alcohol Use Disorder and its signs. What’s most important to know is that your loved one is dealing with a health condition that can be treated with an evidence-based approach.
If someone you love joined Monument, they are putting in the work to change their drinking. Monument connects our members to physicians and therapists specialized in treating Alcohol Use Disorder. We also provide community support via an anonymous forum, and therapist-moderated online alcohol support groups. Here’s a closer look at our treatment plans:
Physician Care: Members connect with a licensed physician to share their medical history and goals. Their physician will prescribe FDA-approved medication if they deem it safe and appropriate, and recommend next steps on their recovery journey. Members can get in touch with their physician via chat at any time.
Total Care (Bi-Weekly or Weekly): Members connect with a licensed physician to share their medical history and goals. Their physician will prescribe FDA-approved medication if they deem it safe and appropriate, and recommend next steps on their recovery journey. Members also meet with a specialized therapist to develop a custom curriculum of therapy sessions that can empower them to reach their goals. Depending on their plan and desired level of support, members will meet with their therapist on a biweekly or weekly basis. Alcohol therapy is an incredibly effective tool to make a long-lasting change.
Unfamiliar with medication options to support goals for sobriety or moderation? You’re not alone! Only 9% of people who are good candidates are currently prescribed them. We’re working to change that. Read more about medication to stop drinking with Monument.
If you have any questions about our online alcohol treatment plans, we encourage you to post in the community. We’re here to help you understand what your loved one is experiencing, and how we’re going to support them in making a change. Here’s more about what you can expect during the first few months of treatment.
Making progress together: For family, friends, and those in recovery
What To Expect In Early Recovery
Early recovery can be particularly challenging for many reasons, and several of them have to do with brain chemistry, and brain recovery. If your loved one seems unlike themselves in the early days, weeks, and months of sobriety or moderation, that is to be expected for the following reasons.
Your loved one may experience acute withdrawal
Alcohol is what’s known as a sedative hypnotic, or more commonly, a ‘downer.’ When one’s alcohol consumption increases significantly, they will confront the physiological effects of that, like sedation, inability to accomplish tasks, and beyond. Our body realizes that our drinking is increasing, and reacts to achieve a new steady state.
Without heavy alcohol use, the brain self-moderates the electrical activity and racing thoughts taking place every day. With heavy alcohol use, those self-moderating signals are replaced with alcohol. The brain thinks: I don’t need to do the work anymore, alcohol has it covered. When we remove alcohol from the equation after heavy drinking (AKA ‘get sober’), our brain needs to play catch up. We’re left to confront those racing thoughts with no moderation, natural, or alcohol-induced. Restlessness, tremulousness, anxiety, and panic are common. Acute withdrawal can take on many forms of varying severities. If someone you know is considering quitting alcohol cold turkey or experiencing withdrawal symptoms, they should check in with a physician immediately to understand the best course of action and treatment. Supervised detox may be recommended for safety.
Here’s the good news: our brain heals. And it often can get back to that more regulated, steady state in only a few days with the appropriate care.
They might also experience post-acute alcohol withdrawal
When people hear the word “withdrawal,” they often think about acute withdrawal. There’s also a chance of post-acute withdrawal, which is often defined by longer periods of sleep disturbances, fogginess, restlessness, irritability, and anxiety.
Post-acute alcohol withdrawal lasts anywhere from weeks to months. It can be very discouraging because while someone might be making significant progress on cutting back on drinking, they might not feel improvements in their mood. However, this will get better. And in the meantime, that’s where recovery resources (like therapy and support groups), and friends and family’s encouragement can play an especially important role.
For those navigating AUD, co-occuring conditions can be very common. AUD is often accompanied by disorders such as anxiety or depression, and is intensified by trauma, stressors and societal impact. Alcohol is often used to self-soothe the uncomfortable feelings, and when someone stops drinking, they confront these feelings in full force. That can be very challenging, which is why we offer personalized therapy to meet specific needs and alleviate multiple issues. For example, a therapy program might address the interaction between alcohol and depression, how alcohol relates to anxiety, and other mental health factors.
How you can support them while also supporting yourself
Now that you know more about what to expect in early recovery, it’s important to talk about how to take care of yourself throughout this journey. Sabrina Spotorno, therapist on the Monument platform, shared her insight into how to support yourself while supporting someone in recovery. She shares how to build resiliency at any stage of coping with a loved one’s disordered drinking cycle, and how to prioritize your needs.
Making progress together: For family, friends, and those in recovery
If someone you love has joined Monument, they’ve made a choice to get more out of life, and give more to those around them. Joining Monument is both an act of self-love, and love for those they care most about. And while there might be challenges for both of you along the way, you are never alone, and all of your feelings are valid. We’re here to support you.
Disclaimer: Our articles and resources do not constitute clinical or licensed therapy or other health care services. If you or anyone else need counseling or therapy services please contact a licensed provider. If this is a medical emergency, call 911.