Withdrawal can begin soon after the cessation of drug use and will likely peak in intensity in the first 24 to 48 hours. If severe withdrawal is left unchecked, in some instances it can be fatal. Anyone experiencing the symptoms of withdrawal should be under a doctor’s care, and for drug addicts entering treatment medical detox is often required before therapy for addiction can begin.
If the patient has an antisocial personality (ie, severe problems with family, peers, school, and police before age 15 y and before the onset of alcohol problems), recovery is less likely. If the patient has primary depression, anxiety disorder, or another potentially contributory disorder (the other disorder must antedate the problems with alcohol or it must be a significant problem during long periods of sobriety), treat this primary problem aggressively.
Inpatient alcohol rehab treatment is intended for men and women who are struggling with an alcohol use disorder (AUD). This includes alcohol abuse and alcohol addiction. Many who struggle with alcoholism find the most success with inpatient rehab treatment. Clients in this program typically begin with inpatient alcohol detox to rid their bodies of any harmful toxins from the drugs or alcohol. If necessary, they may also be prescribed medications to help reduce alcohol cravings or reduce withdrawal symptoms.
Outpatient treatment is the most flexible level of care. Recovery services are provided in a day center, clinic, rehab facility, or other location, while the patient lives at home. Outpatient clients can participate in counseling, therapy, 12-step programming, and other recovery services without giving up their self-determination. This level of care is recommended for patients who have completed an inpatient program, or for medically stable individuals who have a high level of motivation to reach sobriety.
An additional cognitively-based model of substance abuse recovery has been offered by Aaron Beck, the father of cognitive therapy and championed in his 1993 book Cognitive Therapy of Substance Abuse. This therapy rests upon the assumption addicted individuals possess core beliefs, often not accessible to immediate consciousness (unless the patient is also depressed). These core beliefs, such as "I am undesirable," activate a system of addictive beliefs that result in imagined anticipatory benefits of substance use and, consequentially, craving. Once craving has been activated, permissive beliefs ("I can handle getting high just this one more time") are facilitated. Once a permissive set of beliefs have been activated, then the individual will activate drug-seeking and drug-ingesting behaviors. The cognitive therapist's job is to uncover this underlying system of beliefs, analyze it with the patient, and thereby demonstrate its dysfunctional. As with any cognitive-behavioral therapy, homework assignments and behavioral exercises serve to solidify what is learned and discussed during treatment.
The Addiction Center elaborates that outpatient rehab is best for those who wish to stop abusing substances but cannot escape commitments, thereby requiring a flexible schedule. Outpatient rehab facilities will likely require patients to check in at pre-specified times for treatment. Treatment in outpatient rehab facilities can include medication and counseling. Outpatient treatment is a popular choice amongst those with less serious addictions.