How Bad Does My Drinking Have to Get Before I Need Rehab?

Drinking is a social norm for many people, but for some, it can become a problem. If you’re drinking excessively, and think it may have become a problem, you’ll need to do some self-exploration to determine if you have an alcohol use disorder that requires rehab. You can also speak with your primary care physician who can refer you to a mental health professional who can assess you to determine if you need treatment.

Alcohol Use Disorder Criteria

Alcohol use disorder (AUD) is formally defined in the Statistical Manual of Mental Disorders. This definition has 11 criteria that determine whether an AUD is present.

1. Drinking more than intended or for longer than intended
2. Wanting to reduce or stop alcohol use but not being able to
3. Spending excessive amounts of time drinking or recovering from drinking
4. Feeling cravings for alcohol
5. Failing to live up to responsibilities due to alcohol use
6. Having relationship problems because of alcohol use
7. Giving up activities that you enjoy in order to drink instead
8. Engaging in risky behaviors like driving while drinking or under the influence
9. Continuing to drink in spite of negative consequences like health issues
10. Needing more alcohol to get the same effects
11. Having withdrawal symptoms when you are not drinking

Having two to three of these symptoms indicates a mild AUD, four to five is considered moderate, while six or more is severe.

Any level requires treatment, but your level will indicate the intensity of the treatment that you need. A therapist or an addiction specialist can do a thorough assessment and create an individualized treatment plan for you.

Life Consequences of Alcohol Abuse

Another way to explore whether you need rehab is to acknowledge any consequences that have resulted from drinking excessively. These may include:

• Legal consequences such as a DUI.
• Making poor decisions or acting impulsively while drinking. These poor decisions may be anything from saying something you regret, to cheating on your partner, or going to work intoxicated.
• Relationship problems due to arguments about your drinking.
• Poor job performance or the loss of a job.
• Health consequences such as gastrointestinal problems, or high blood pressure.
• Missing out on activities or events due to drinking or hangovers.

Only you can evaluate your life and what negative consequences have come due to drinking. You need to be honest with yourself and decide if drinking is really worth the cost.

Alcohol Withdrawal

If you try to quit on your own without treatment, you may suffer from alcohol withdrawal, which can be very uncomfortable and even dangerous. Withdrawal symptoms include:

• Tremors
• Headache
• Anxiety
• Excessive sweating
• Insomnia
• Gastrointestinal issues
• Increased heart rate and blood pressure
• Elevated body temperature
• Confusion
• Hallucinations
• Seizures

The most serious consequence of withdrawal is delirium tremens, which is life threatening. Symptoms include:

• Tremors
• Confusion
• Agitation
• Hallucinations
• Paranoia
• Disorientation
• Heavy sweating
• High body temperature
• Seizures

Because alcohol withdrawal can have these dangerous consequences, you should go to a treatment facility for inpatient detox. You’ll be medically supervised and potentially given medications that can ease the withdrawal symptoms, but the main goal is to keep you safe. Detox is always the first step in any rehab program that you enter.

If you try to quit on your own and you have any of these serious symptoms, you should see medical attention immediately.

Alcohol Rehab Options

Many people with an AUD don’t seek treatment because they don’t want a disruption in their life while they are in an inpatient program. While inpatient treatment is the best option, particularly for those with moderate to severe AUDs, there are other choices.

Inpatient Treatment

A 30 to 90 day inpatient treatment program includes a detox period and intensive therapy, both individually and in groups. You’ll also be treated for any co-occurring disorders that you may have, such as anxiety and depression. Medication may be part of the treatment.

Most of your time will be spent in group therapy. Group therapy is central to the treatment process, giving you the opportunity to learn and to interact with peers. You’ll likely form mutually supportive relationships with some of these peers, which can be invaluable.

The type of therapy most commonly used in AUD treatment is cognitive behavioral therapy (CBT). CBT teaches you to recognize your irrational thoughts and to challenge and change them to more reality based, positive thinking. It also teaches healthy coping skills and strategies to avoid relapse.

Partial Hospitalization Programs (PHPs)

A partial hospitalization program (PHP) allows you to live at home while attending treatment for four to six hours per day, usually five days a week. The program may last anywhere from four weeks to ten weeks. The treatment consists of therapy similar to that of inpatient treatment, both in groups and individually.

More often than not, a PHP program is a transitional step that occurs after inpatient treatment, although it can be an alternative to inpatient treatment.

Intensive Outpatient Programs (IOPs)

An intensive outpatient program (IOP) consists of two to three hours of therapy five days a week for eight to twelve weeks. Often, sessions are held at convenient times so that you can still go to work or attend school.

An IOP can be a standalone treatment, or it can be attended after inpatient treatment, a PHP, or both.

Support Groups

Some people with AUDs don’t attend rehab at all but instead choose support group meetings through a program like Alcoholics Anonymous (AA). While this may be effective for some people,  it’s not recommended as a standalone option for those who need medically supervised detox or who have a moderate to severe AUD. Support groups can, however, be an effective long-term option after treatment.

Comprehensive Treatment

The most effective treatment plan for AUDs is a comprehensive treatment program that consists of an inpatient program, a PHP, and an IOP. Research shows that recovery success rates increase the longer you stay in treatment. After IOP, you can receive continuing support from individual therapy or a program like AA. Recovery from an AUD, or any addiction, is a lifelong process that requires dedication, work, and a strong support network.

In Closing

It’s time to do some honest self-assessment and determine what is best for you. The bottom line is that if you think your drinking is a problem, no matter how bad it is or isn’t, treatment can help you to move on with your life in a healthier way. Bridges of Hope is here to help with many treatment options. We are committed to providing comprehensive, personalized, compassionate care. Give us a call today to take the first step.