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Alcohol Use Disorder (AUD) Treatment
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Substance Use Disorders

Alcohol Use Disorder (AUD) Treatment

Effective treatment for alcohol use disorder often combines medical interventions, such as FDA-approved medications, with behavioral counseling to support long-term recovery.

What is an alcohol use disorder?

An alcohol use disorder (AUD) is drinking that causes distress and harm. It is a medical condition in which you drink alcohol compulsively, cannot control how much you drink, and feel anxious, irritable, or stressed when you are not drinking. An AUD can range from mild to severe, sometimes referred to as alcoholism or alcohol dependence.

What are the treatments for alcohol use disorder?

Most people with an AUD can benefit from treatment. Medical treatments include medicines and behavioral therapies; for many, using both provides the best results. Support groups such as Alcoholics Anonymous (AA) can also be helpful. If you have an AUD and a mental illness, it is important to get treatment for both.

Some people may need intensive treatment, such as a residential treatment center for rehabilitation (rehab). Treatment there is highly structured and may include various behavioral therapies, as well as medicines for detox (medical treatment for alcohol withdrawal).

Which medicines can treat alcohol use disorder?

Three medicines are approved to treat AUD:

  • Disulfiram: Causes unpleasant symptoms such as nausea and skin flushing whenever you drink alcohol, which may help you stay away from it.
  • Naltrexone: Blocks the receptors in your brain that make you feel good when you drink, which can reduce cravings and help you cut back.
  • Acamprosate: Works on multiple brain systems to reduce cravings after you have quit drinking, helping you maintain abstinence.

These medicines are not addictive and are used to manage AUD just as one would manage a chronic disease like asthma or diabetes.

Which behavioral therapies can treat alcohol use disorder?

Behavioral therapies, or alcohol counseling, involve working with a professional to change the behaviors that lead to heavy drinking:

  • Cognitive-behavioral therapy (CBT): Helps you identify feelings and situations that lead to heavy drinking and teaches coping skills to manage stress and change thoughts.
  • Motivational enhancement therapy: Helps you build and strengthen the motivation to change your drinking behavior through a series of sessions focused on goal setting and confidence building.
  • Marital and family counseling: Involves family members to help repair relationships and provide a strong support system for recovery.
  • Brief interventions: Short, one-on-one or small-group sessions where a counselor provides information about your drinking patterns and helps you set goals for change.

Is treatment for alcohol use disorder effective?

For most people, treatment is helpful. However, overcoming an AUD is an ongoing process, and relapse (starting to drink again) can occur. A relapse should be viewed as a temporary setback rather than a failure. If you do relapse, it is important to return to treatment immediately to analyze triggers and improve coping skills for future success.

Frequently Asked Questions

bruptly stopping alcohol after chronic, heavy use can destabilize the central nervous system, which has adapted to alcohol's continuous depressant effects. Within 6 to 48 hours, withdrawal can escalate from tremors, sweating, and nausea to severe complications, including generalized grand mal seizures and delirium tremens (DTs). DTs is a medical emergency marked by severe confusion, autonomic hyperactivity, and vivid hallucinations that carries a risk of death if not managed in a clinical setting with benzodiazepines or other supportive therapies.
Disulfiram irreversibly inhibits aldehyde dehydrogenase, an enzyme responsible for breaking down acetaldehyde, a toxic byproduct of alcohol metabolism. If alcohol is consumed while on disulfiram, acetaldehyde rapidly accumulates in the bloodstream within 10 to 30 minutes, causing severe throbbing headaches, intense facial flushing, nausea, vomiting, chest pain, and heart palpitations. Because the body takes time to regenerate new enzymes, this reaction can occur if alcohol is consumed up to 1 to 2 weeks after stopping disulfiram.
Yes, naltrexone does not cause sickness when combined with alcohol, unlike disulfiram. In fact, some clinical protocols encourage individuals to take naltrexone before drinking sessions to block the dopamine-mediated "reward" or euphoria produced by alcohol. Over time, this helps extinguish the physiological drive to drink, leading to reduced overall consumption and fewer binge episodes. However, patients must be completely free of opioids before starting naltrexone to avoid precipitated opioid withdrawal.
camprosate works by stabilizing chemical signaling in the brain—specifically balancing glutamate and GABA neurotransmitters that become dysregulated from long-term alcohol exposure. Rather than blocking euphoria (like naltrexone) or causing a physical toxic reaction to alcohol (like disulfiram), acamprosate relieves the persistent physical distress, restlessness, and anxiety associated with post-acute withdrawal. Because of this, acamprosate is initiated after alcohol detoxification is complete and is primarily used to maintain long-term abstinence.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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