What Is Rehab?
Alcohol rehabilitation is the medical or therapeutic treatment of alcohol dependence (alcohol use disorder).
The rehab process aims to enable the patient to stop alcohol intake and take responsibility for alcohol addiction.
Most treatment involves alcohol cessation including detoxification. Pharmacological intervention is followed by psychosocial support to improve the reactions which led to alcohol misuse.
Treatment normally aims to resolve underlying psychological factors behind alcohol use disorder to prevent further negative consequences in the patient's life.
Alcohol Use Disorder & Alcohol Abuse
DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) attributes the cause of alcohol use disorder to approximately 50% environmental factors and 50% genetic factors. 
Since 2013, an alcohol use disorder diagnosis may include alcohol dependence (ICD-11) and alcohol abuse. 
In the UK, the National Institute for Health and Care Excellence (NICE) provide specific recommendations for the treatment of alcohol use disorder and alcohol addiction. 
Types Of Alcohol Dependence
Physical Dependence On Alcohol & Withdrawal Symptoms
Long term alcohol misuse changes the brain's structure, and neurotransmitter function. 
These imbalances leave the addict's brain more prone to relapse, even after the detox phase is complete.
Ceasing alcohol intake abruptly without pharmacological help can result in Alcohol Withdrawal Syndrome. 
Medication can be used to detoxify the body following cessation. Or, different medication may be used to discourage further drinking in future.
Benzodiazepine drugs are used in residential treatment clinics to manage common symptoms after the last drink.
Prescribed by medical professionals, diazepine drugs can be used to mimic the chemical effects of alcohol in the brain.
Diazepam may be used, on a "sliding scale" reduction of dosage, to minimise physical withdrawal symptoms.
Chlordiazepoxide, also known as Librium, is often used in residential settings for detoxification purposes due to the long half-life of its metabolic products (desmethyldiazepam).
Medications To Discourage Further Drinking
Naltrexone (Revia)(Vivitrol) is an opioid antagonist medication used to reduce the pleasurable feelings that commonly occur with alcohol use.
The Sinclair method is a form of deconditioning, which reduces the positive feelings people experience from drinking.
The Sinclair Method involves taking a single dose of Naltrexone one hour before drinking.
The antagonist effects of Naltrexone reduce the pleasurable feelings obtained from drinking alcohol.
It can take 3-9 months for users of the Sinclair Method to achieve reduced desire to drink alcohol.
A derivative of Naltrexone, Nalmefene (trade name Selincro), is an opioid antagonist medication.
In the UK, NICE recommends combined use of Nalmefene with psychosocial support to reduce alcohol consumption.
Acamprosate rebalances neurotransmitter levels in the brain after you stop drinking.
Excess glutamate is released during cessation from alcohol, and Acamprosate works as an antagonist on glutamate receptors.
Disulfiram (Antabuse) is a drug which stimulates sensitivity to alcohol by inhibiting enzymes the body normally uses to break it down.
Disulfiram usage results in experiencing symptoms and negative effects of acute hangover very quickly.
In this way Disulfiram acts as a deterrent to continued intake.
Psychological Dependence On Alcohol
Psychotherapy and behavioural therapies are used to tackle the underlying psychological symptoms behind alcohol addiction.
Rehabilitation centre programmes commonly include psychosocial support such as individual therapies, Twelve Step programmes, cognitive behavioural therapy (commonly referred to as CBT), and relapse prevention planning.
Communities such as AA, and SMART Recovery extend social support into the community environment.
Types Of Alcohol Addiction Treatment
The alcohol rehabilitation treatment process differs based on the type of addiction help being sought.
How does outpatient treatment work?
Outpatient treatment is considered suitable only for individuals at low risk of withdrawal symptoms.
Treatment programme components are based on individual needs, and usually do not include any residential element.
Private outpatient treatment may consist of prescribed antagonist medication combined with psychotherapy.
Local authority outpatient alcohol rehab programmes usually include regular keywork meetings with an assigned case worker or clinical manager.
Activities in outpatient treatments will include goal setting, and a managed care plan for reducing alcohol intake over time.
Outpatient programmes normally last 3-6 months or longer.
Outpatient alcohol programmes usually involve more self-managed aspects of care, compared to residential in-patient treatment in a clinic.
Inpatient Alcohol Centres
Inpatient rehab clinics are most suited to people at high risk of withdrawal symptoms or delirium tremens.
A 2020 survey by Recovery Village suggests that 34.9% begin their recovery journey in residential or inpatient treatment. 
Rehabilitation clinics ("rehab") are a type of live-in treatment unit providing detox and psychotherapy for alcohol use disorder.
Some clinics also offer treatment for the mental health disorders associated with alcohol addiction, in an integrated programme.
Rehabs frequently provide behavioural interventions and family support programmes.
An alcohol clinic programme will usually include setting up supports to avoid regression to alcohol use in future.
Alcohol Addiction Treatment Programme
A structured addiction treatment programme can contain multiple treatment approaches.
People suffering from alcoholism usually need a multi-faceted physical and psychological programme, run by experienced professionals, and overseen by medical staff.
Rehab clinics usually require clients to commit to abstinence. This means living an alcohol free life, indefinitely.
A 2007 study found that abstinence from alcohol was the most stable means of maintaining recovery from alcoholism over time. 
With prolonged abstinence, reward pathways of the brain can begin to recover normal function. 
Alcohol addiction treatments normally begin by completing safe alcohol detox and withdrawal. Medical treatment helps to minimise unpleasant withdrawal symptoms.
Benzodiazepine medication is frequently prescribed by a medical professional to minimise risk of alcohol withdrawal symptoms occurring.
Beyond the surface symptoms of dependency, recovery requires an understanding of the underlying issues, through various therapies.
Therapies utilised in rehab programmes include:
Cognitive therapy teaches patients to consciously recognise exactly what thoughts, feelings, and behavioural aspects are associated with physical and psychological addiction. 
Cognitive behavioural interventions have among the highest level of empirical evidence for successfully treating alcohol and drug use disorders. 
Patients can use cognitive therapeutic work in alcohol addiction recovery to improve coping skills in difficult situations which previously acted as triggers for alcohol use.
Group therapy allows people to see the progress of others, and improve belief that recovery from alcohol addiction is possible. 
There are two approaches used in group work for alcohol use disorder: (i) psychoeducational and (ii) process-oriented.
Psychoeducational group counselling sessions are led by the therapist.
The process-oriented approach can increase each individual's sense of belonging.
In individual counselling for alcohol use disorder, the patient works in private sessions with a therapist, psychologist, or counsellor.
One-on-one sessions for excessive alcohol consumption can be delivered as part of an inpatient rehabilitation programme, or on an outpatient basis.
The aim of alcohol counselling is to address the underlying causes of addictive behaviours.
One on one counselling allows the patient to talk openly about uncomfortable emotions.
Progress toward goals is monitored by the therapist. Sessions normally last 50 mins.
Twelve Step Programmes
The Twelve Step programme refers to the addicted person working through the Twelve Steps of Alcoholics Anonymous to become alcohol free.
People can use the Twelve Step programme as part of support groups in the community, or as part of a structured treatment approach in a private residential rehab centre.
Alcohol Rehab Without 12 Steps
Programmes such as SMART Recovery, and Secular Organizations For Sobriety, were set up to provide the benefits of the Twelve Step programme, but without the religious overtones which some people do not appreciate.
Mindfulness has been shown to increase self awareness and reduce the likelihood of lapse back to addiction, by slowly retraining old neural pathways over time. 
Mutual aid groups are non-profit organisations providing members with peer-led support.
Meetings provide social connectedness, but do not provide medical alcohol detox.
Alcoholics Anonymous (AA) is a non-professional fellowship, whose purpose is to enable attendees to stay sober via the Twelve Steps program.
Bill Wilson (1895-1971) and Robert Holbrook Smith (1879-1950) co-founded Alcoholics Anonymous in 1935 in Akron, Ohio, United States.
AA has no commercial affiliations and is self-sustained through members' contributions.
AA meetings take place weekly.
SMART stands for Self Management And Recovery Training.
SMART Recovery aim to equip people with the practical tools and skills required to quit drinking and maintain a sober life over time.
SMART Recovery run weekly meetings internationally and online training courses promoting abstinence from any addictive behaviour.
Joe Gerstein founded SMART Recovery in 1994 .
Women For Sobriety
Women for Sobriety (WFS) is an addiction recovery group specifically for women, founded by Jean Kirkpatrick in 1976.
The group recognises self-esteem as the main cause of female alcoholism, and provides a programme which addresses self-esteem issues.
Secular Organizations For Sobriety
Secular Organizations for Sobriety (SOS) (or Save Our Selves), is a network of self-governing addiction recovery groups.
SOS focuses on rational thinking and non-spiritual or religious methods of support to maintain sobriety.
SOS does not view surrender to a higher power as a pre-requisite for sobriety.
SOS does not support sponsor/sponsee relationships as part of its approach.
SOS was founded in 1985 by James Christopher.
Other Recovery Organisations
Rational Recovery sells informational products and material for overcoming alcoholism and addiction.
Rational Recovery has no religious affiliation, and considers alcoholism to be a voluntary behaviour.
Rational Recovery was founded in 1986 by Jack Trimpey, a clinical social worker.
Individuals diagnosed by a psychiatrist as having both a mental health disorder and alcohol use disorder, are known as having a dual diagnosis.
2018 research by Public Health England indicates that 54% of people receiving help for addiction to alcohol also need mental health treatment.  
Each person's combination of addiction and mental health issues is unique, and requires individual assessment to determine appropriate treatment options.
An alcoholic relapses if they re-use alcohol following treatment.
People typically view an alcoholic as either "relapsed" or "in recovery," however this binary definition is being challenged.
Researchers are increasingly redefining alcoholic relapse as a spectrum or process, instead of binary definition. 
Social Behaviour Change
A drug and alcohol rehab centre will normally discourage people from social contact with individuals who still consume alcohol.
Self-distancing from old social peers helps to remove the conditions which first led to alcohol addiction.
In recovery, social life can continue, but usually means trying to connect with more positive influences.
A 2011 study suggests that regular aftercare attendance is an important factor in lower levels of drug and alcohol misuse 6 months after treatment.
Data from the same study suggests that longer durations of residential treatment are associated with greater engagement levels in ongoing care.
Addiction treatments help individuals change how they react to stimuli that previously triggered addictive behaviours.
In rehab therapeutic sessions, patients gain insights into the events, people, places and situations which trigger alcohol addictive behaviour in their life.
During aftercare planning, clients can plan ahead to reduce the impact of trigger situations on their behaviour in future. This can help stabilise long term recovery outcomes with the right mindset.
Other Relapse Prevention Methods
Gordon Alan Marlatt (1941-2011) popularised the concept of "urge surfing" as a means to visualise cravings for alcohol as physical waves which ultimately dissipate.
Dr Mary Latimer, Dr G. Alan Marlatt, and Rebekka S Palmer have proposed multiple cognitive behavioural intervention-based strategies to avoid relapse.
Alternative therapies such as neuromodulation have shown promise in short term studies, but mixed results in sustaining recovery in the long term. 
Alcohol Home Detox
Due to risk of seizures and delirium tremens during alcohol cessation, medically unsupervised alcohol rehab in your own home is usually not recommended.
At home alcohol rehab options usually consist of semi-supervised detoxification with appropriate medication and medical oversight.
Home-based rehab programmes usually do not include psychotherapeutic intervention or cognitive help to assist with the root cause of alcohol addiction.
Alcohol home detox may have reduced success rates since it often places the person in the same circumstances and environment that initially led to alcohol use.
Mental health issues underlying the urge to drink alcohol are not usually addressed in a home detox.
Always speak with your GP re help for alcoholism, in the first instance.
28 Day Rehab Programmes
In the UK, most private residential rehab treatment clinics operate a 28 day alcohol rehab programme.
This is the minimum primary care term considered to provide sufficient time to complete alcohol cessation and gain therapeutic insights into the cause of alcohol problems.
Long Term Alcohol Treatment
Common longer residential clinic durations are 12-24 weeks.
Data suggests that a longer residential rehab process is associated with greater engagement levels in continuing care.
Some rehab centres offer additional secondary care options which transition the person from acute 28 day inpatient treatment into longer term 6-12 month residential or semi-residential supported living.
Emergency Alcohol Addiction Treatment
There is a distinction here between emergency treatment for excessive alcohol consumption vs an urgent need for residential alcohol rehab.
Dependent on the amount of alcohol consumed, someone requiring emergency treatment for alcohol poisoning will require hospitalisation.
A residential treatment centre is usually not appropriate for someone suffering from acute alcohol poisoning .
Urgent alcohol rehab usually describes the speed with which someone seeking treatment requires admission to a residential clinic.
Someone seeking quick access to alcohol rehab may have less acute symptoms, and require a standardised tapering protocol of alcohol detox medication to begin treatment successfully.
In this case an admission can usually be arranged to a residential clinic within 48 hours.
Low Cost Rehab
Since stopping drinking safely usually requires medical supervision, low cost alcohol rehab centres are in demand.
Quasi-residential alcohol rehab centres offer a rehab programme during daylight hours, but users reside in shared accommodation overnight.
In a quasi-residential rehabilitation centre, the programme is less intensive and has less professional monitoring or oversight.
Therapeutic work is often community-led and will not include specialist staff offering cognitive behavioural work or counselling.
Local Community Addiction Teams/Drug-Alcohol Teams
Local authority healthcare services in the UK run statutory alcohol programmes.
Local area drug and alcohol teams provide regular keywork sessions, encourage users to keep a drinks diary, and monitor usage over time.
Treatments For Young Adults
Most UK treatment centres work with adults aged 18 years and over.
In the UK, NICE provides specific guidelines for alcoholism in young people.
Treatments For The Elderly
Effective addiction treatment options for older adults and seniors are available at most UK residential rehab centres.
Inpatient alcohol rehab for seniors may be more complex due to a greater incidence of co-occurring healthcare issues.
Therefore, treating alcoholism in the elderly should be evaluated on an individual basis, to ensure the patient's needs are fully met. All pre-existing conditions and medications should be accounted for in the treatment plan.
Alcohol And Depression
A 2018 United States national survey found 31.3% of people with mental health issues had been binge drinking in the past month.
Alcohol itself acts a depressant in the human nervous system.
In our experience at Abbeycare, a majority of those seeking alcohol addiction help also suffer from depression, simultaneously.
Individuals with depression can suffer low motivation and anxiety symptoms while taking part in an addiction rehab programme.
Whilst integrated treatment centres for substance abuse treatment and mental health are available in the United States, there are few in the UK.
However, in practice at Abbeycare, when clients tackle the psychological components of addiction itself, depression often alleviates also.
Programmes For Women
In a women-only rehab centre, it is easier to work through any psychological issues normally exacerbated by other genders. In a female rehab centre, it is more likely that progress is maintained over time.
Female-only rehab clinics for alcoholism can be particularly beneficial where the person has therapeutic issues around males.
Loved Ones And Alcohol Treatment
How does alcohol use disorder affect the alcoholic's loved ones?
More than 100 million family members are affected by a relative who is addicted to alcohol.
Evidence suggests that family level intervention and the right support play a significant role in alcohol addiction treatment outcomes.
How Does Rehab Support The Family Of The Alcohol Addict?
Most people assume the addicted person is worst affected, however, addiction is a real challenge for family members.
What help is available for families affected by addiction to alcohol?
Many rehab clinics hold family meetings led by addiction specialist staff to offer support and answer family members' questions.
Telephone support can also help the family of the alcoholic to discontinue any behaviours enabling the addiction. Remote support can also help family learn how to set appropriate boundaries with the alcohol dependent person.
Fully integrative family programmes aim to improve function of the overall family unit. Family therapy programmes usually include guidance on reducing circumstances and behaviours conducive to addiction.
A SAMSHA 2020 published guide instructs treatment providers and rehab clinics on how to include families in addiction treatment.
In England in 2018/2019, the average age of someone receicing help for alcohol use disorder was 46, and 60% of people in treatment were male.
Rehab Success Rates
NICE Guidelines For Alcohol Use Disorders
In the UK, NICE (National Institute for Health & Clinical Excellence) publish detailed guidelines for the management of alcohol use disorder.
We can help you stop drinking. The Abbeycare residential alcohol rehab programme utilises evidence based therapies, and takes a holistic approach:
Lasting recovery is possible, with the right help, and the right rehab programme.
Going to rehab is perhaps the most important decision you'll ever make.
Our friendly team are available for advice based on your unique needs.
Recover with Abbeycare: 01603 513 091.
Please note key elements of our programme may be altered under Covid-19 conditions.
Do I need rehab for alcohol?
If drinking habits cause distress or harm, it is likely that rehabilitation for alcohol use is required. The extent of damage caused by excessive drinking can be evaluated by tests such as CAGE, or a diagnosis of alcohol use disorder.
Alcoholics may check in to a rehab centre when the negative impact of battling addiction outweighs the positive effects of drinking.
The most common signs that alcohol addiction treatment may be required are when normal lifestyle patterns are affected, or physical health declines as a result of alcohol consumption.
For example, missing appointments, or struggling with school or work, may indicate that problematic drinking needs treatment.
Or, you may know you need to stop drinking when serious negative consequences result from drinking, e.g. an accident, hospitalisation, legal incident, or relationship breakup.
Other alcoholics know that it's time to quit drinking when they lose access to their children or family.
Always consult your GP re any decision to go to rehab.
Call us on 01603 513 091 for a free initial assessment.
Does alcohol rehab work?
Alcoholism is considered to be an incurable chronic disease.
Effective addiction treatment aims to help individuals stop drinking, undergo alcohol detox safely, receive therapy, and set up supports for the future.
Evidence indicates that ongoing long term care following primary care rehabilitation improves long term outcomes.
What is the chance of relapse after alcohol rehabiliation?
The relapse rate after alcohol rehab is similar to that of other major chronic diseases.
Statistics from drugabuse.gov show that incidence of relapse for substance abuse disorders is in the range of 40-60%, compared to hypertension and asthma, which have regression rates of 50-70%.
What is recovery from alcohol addiction?
The definition of being "in recovery" is not fixed, but usually this means the person is receiving some form of ongoing support for alcohol addictions.
The recovery process is ongoing, in perpetuity.
Recovery from alcohol addiction acknowledges that there is no "cure", and that alcohol recovery is an ongoing process.
An alcoholic in sustainable long term recovery usually has a wide range of support channels to help maintain long-term sobriety.
What is alcohol rehab like?
Residential alcohol rehab is a controlled environment similar to a private medical clinic. Clients stay residentially in the treatment facility. Each day, clients take part in the rehab clinic's treatment programme daily agenda.
Rehab clinics provide alcohol detox via prescription drugs, therapeutic sessions, and structured supports to prevent future alcohol use.
What do they do in alcohol rehab?
Alcohol inpatient treatment involves medical detoxification from alcohol, therapy sessions, and preparing long term supports to prevent a recurring drinking problem in future.
People live residentially in the rehab centre, with their own room.
You'll complete therapeutic work to understand the triggers behind urges to drink alcohol.
In a typical day in a rehab clinic, you'll take part in meditation, attend therapy sessions, take detoxification medication, group work, individual counselling, and planning future supports.
To go into rehab, select a facility and complete a telephone assessment with their admissions team.
How long is alcohol rehab?
Alcohol inpatient treatment usually lasts 28 days. Some clinics provide residential rehab for 14 days or less.
Residential centre stays of 28-84 days or longer, are suitable for people with chronic long-term alcoholism, or a history of alcohol relapses.
The exact duration of your stay will depend on frequency and recency of usage, history of usage, previous relapses, previous detox process, and other general health indicators.
Is alcohol rehab free in the UK?
While local authorities do administer addiction services, qualifying for such help is extremely difficult as resources are limited, and demand is extremely high.
Local addiction healthcare teams evaluate each patient's needs individually.
A very small percentage of people seeking help may be referred to a rehab centre or treatment partner as part of their overall care plan to stop drinking.
However, the majority of patients will not qualify for local authority assistance help unless suffering from the most severe physical or psychological complaints.
Conversely, private alcohol rehabs in the UK are not government funded, and therefore must charge fees for the services provided by their employees and specialists.
How much does alcohol rehab cost?
How much does rehab cost?
The cost of private inpatient alcohol rehab clinic treatment is typically between £3,000 to £6,000 or more per week in the UK.
Are grants available for rehab, alcohol treatment from the government?
Grants for alcoholism help are not usually available from local government in the UK.
To explore any available options for publicly funded treatment, the first step is to ask your doctor for a referral to the regional healthcare addiction team.
I can't afford alcohol rehab.
Everyones' financial circumstances are different and cost is one of the key factors in finding suitable help.
To make addiction treatment more affordable, many people pool funds together from friends and family, to meet the rehab cost.
Is addiction to alcohol covered by insurance policies?
Insurance policies in the UK may pay for alcohol rehab, where the policy level is appropriate, and the insurance provider agrees admission.
Abbeycare accept BUPA, Aviva, WPA, and Cigna.
Getting someone into alcohol rehab
An alcoholic cannot be forced to go into alcohol rehab against their will.
Rehab is a voluntary process. To help someone access residential rehab voluntarily, contact the admissions team for your chosen clinic.
The admissions representatives normally conduct an initial assessment over the telephone.
Once the clinic's medical staff have approved an admission, treatment usually begins within 48hrs.
For a free confidential assessment, call direct on 01603 513 091.
Can an alcoholic be sectioned?
An alcoholic cannot be sectioned solely for their alcohol misuse.
Rehab clinics in the UK have no jurisdiction under the Mental Health Act (1983).
An alcoholic can be sectioned under the Mental Health Act (1983) if they represent a serious danger to themselves or others. In the UK this would be determined by NHS staff, or a psychiatrist.
What to do after alcohol rehab?
Life after rehab will be different. After attending an alcohol rehab clinic, you cannot drink alcohol again.
When you return home you should expect your daily routine to change significantly. Significant time is usually spent attending local support forums during the first year following treatment.
You should expect to spend a lot of time acting upon the plan for aftercare you made, whilst in treatment.
To stay sober after rehab and achieve a sustainable recovery, follow through on the plans prepared whilst in the clinic.
To help an alcoholic loved one, keep firm boundaries and do not enable any addictive behaviours. Help the alcoholic to co-ordinate the people and assistance they need in daily life.
Long term recovery after alcohol rehab requires you to seek help quickly for addictive triggers, consistently, and repeatedly, over time.
Can I admit to rehab with pets?
Attending rehab with pets, e.g. cats or dogs is not usually offered at UK rehab centres, due to health and safety issues involved in running a group programme in a communal environment.
What questions to ask an alcohol rehab centre?
Ask an alcohol service these questions:
The complete guide to finding the right rehab centre, called "Finding The Right Rehab" is available under the Help & Advice menu above.
Time for professional help? If you're looking to stop drinking, the admissions process is easy and straight-forward. For an initial assessment, or to find out about treatment options available, call us 01603 513 091.
All information is reviewed by medical professionals. Information provided is not intended to be a substitute for appropriate medical advice from your doctor. Always ask your GP's advice in the first instance when considering treatment for problem drinking. For a free confidential assessment, please call us on 01603 513 091. Or, request a free callback.
 https://www.nice.org.uk/guidance/cg115/evidence/full-guideline-136423405, Ch 5.22