An addiction specialist who has treated alcohol use disorder for 9 years shares his most important pieces of advice if you're on that path
- Alcohol use disorder can be lethal if gone unaddressed.
- Below, addiction specialist Aaron Weiner shares his 8 best tips for overcoming alcoholism.
More than 85% of Americans have consumed alcohol at some point — often in social settings like celebrations, or gatherings. But despite its cultural prevalence, alcohol can be dangerous, especially for the one in eight Americans who have alcohol use disorder, commonly known as alcoholism.
Alcohol use and misuse is "so integrated, we do not talk about it nearly enough," says Aaron Weiner, a licensed clinical psychologist and president of the Society of Addiction Psychology.
That's more important than ever, since alcohol-related deaths increased more than 22% between 2019 and 2022.
Alcohol use disorder criteria
Weiner says he's been treating people with alcohol use disorder (AUD) for nine years.
While there are official diagnostic criteria for AUD, he finds it more helpful to think about four aspects when evaluating your alcohol use:
- Why are you drinking? People who are drinking to relax or cope with stress are more likely to develop a problem than people who only drink socially, he says.
- What are the consequences of your drinking? From hangovers to legal charges like driving under the influence (DUI), consequences are "often signs of a problem," Weiner says.
- Are you in control? If you're not able to abstain from alcohol for a set period of time (like dry January) or you drink more than you intend to, that's a sign of AUD.
- The quantity that you drink. The amount you consume is "less important than the first three considerations," but still important to consider, says Weiner.
"If someone wants to change their relationship with alcohol, they can. We have medications, we have therapies, we have communities that help get you where you want to go," Weiner says.
Here are his tips for starting and maintaining recovery.
1. Take it seriously
Because alcohol use is so widespread in our society, it can be easy to downplay the seriousness of alcohol use disorder, Weiner says. But that's a mistake because AUD has such serious health consequences, including liver disease and cardiovascular disease.
"Treat it like any other health condition that honestly could hurt or kill you," Weiner says. Make an aggressive treatment plan, and prepare for hard work.
"If you're at a point where you're thinking, 'I should take this seriously,' it's not necessarily something that will easily go away on its own," he says.
2. Find a provider who is experienced at treating addiction
Working with a counselor or therapist who is experienced in treating addiction can help you not only curb your drinking, but also address the underlying issues, like depression or anxiety, that may be contributing to it, Weiner says.
Cognitive behavioral therapy is particularly effective for treating AUD, but acceptance and commitment therapy, dialectical behavioral therapy and others may also help, Weiner says.
The key is to find a provider who has experience working with people who have AUD. Look for therapists certified by the The National Certification Commission for Addiction Professionals (NCC AP), programs accredited by The Joint Commission, or other providers with third-party certification.
"These are specialists with in-depth knowledge about the treatments," Weiner says.
3. Give AA a try
Alcoholics Anonymous, or AA, is one of the oldest support systems for people struggling with their alcohol use. It's also one of the best: multiple studies have found that AA is up to 60% more effective than other treatment options. During meetings, people who identify as having AUD talk about their experience and share support and advice for living with the condition.
"The evidence is very clear that it can and likely will help you," Weiner says.
AA is the best place to start, but if you give a 12-step program an honest try and it doesn't resonate for you, there are other options, including SMART Recovery and Refuge Recovery, he adds.
4. Reevaluate your community
In addition to surrounding yourself with a community that supports sobriety through 12-step or other peer-support programs, you may need to distance yourself from the people and places that encourage your alcohol use.
"A lot of times when people have an alcohol use problem, they are surrounded by people who promote the problem and are doing the same thing," Weiner says. You may not need to cut these people off entirely or forever, but distancing yourself can help during the early days of recovery, Weiner says. After deciding what boundaries you want to set, like not being around people who are drinking, communicate them clearly and stick with them.
5. Consider medication-assisted treatment
Science has come a long way in recognizing AUD as a true medical condition. These days, there are medications available to help you get and stay sober.
"There's a lot of biological treatments that are FDA approved that people should be aware of," Weiner says. These include disulfiram, a medication that causes you to vomit if you consume alcohol, and naltrexone, a medication that decreases the urge to drink.
Treatments like these are known as medication-assisted treatment (MAT). MAT is most effective when it is used alongside counseling and peer support groups.
6. Fill your time
When you have an addiction, it often takes up a lot of your time. "So when you take that behavior and activity out, you're left with a lot of time. You're left with a void that you need to fill," Weiner says.
To stay busy, pursue your passions or interests that you weren't able to focus on when you were drinking frequently. Start a new gym routine, take a class, or visit museums.
"There's actually a lot of richness to life that you miss out on when you're walking through it in a haze or when you're walking through drunk," Weiner says.
7. Avoid your triggers
When you have a bit of sobriety beneath your belt, you might be tempted to "test" yourself by going to events where people will be drinking. And yet, staying away from temptation and triggers will set you up for success.
"Don't make the road ahead any more difficult than it needs to be by putting yourself in environments that make it more difficult," Weiner says. "If there are triggers in your outside environment that make it harder for you to meet your goals, do what you can in the short term to not have to deal with all of those triggers."
Later on, you can work with your therapist and peers to develop a plan for how best to handle the triggers that you can't avoid forever.
8. Be prepared to work hard
Following the tips above helps you create an environment that will work with your sobriety, rather than against it.
"Start where you can create an environment, a care team, a mentality and a mindset within yourself for success," Weiner says.
And yet, you'll need to follow through at every step: taking medication, seeing your counselor, going to meetings, and avoiding triggers.
"You've got to go and do the work" to see lasting change in recovery, Weiner says.
Recognizing that you experience challenges with alcohol can be scary, but it's important.
Drinking too much, especially over the long term has serious health consequences. And while recovery is difficult, there are many ways to support your sobriety, from counseling and peer support to medications.
"Someone who has alcohol use disorder need not reinvent the wheel every time," Weiner says. "There's so many ways for them to get where they're going and to have support while doing it."
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