Options for long-term wellness

There are different treatments and supports that can help you reach your goals when it comes to your drinking. The ones recommended on this website have been studied scientifically and proven to be helpful in treating alcohol use disorder when the goal is maintaining sobriety. It’s important to remember that you may not see results right away, and it might take some time to figure out what works best for you.

It is normal to have relapses or other setbacks along the way. It doesn’t mean you have failed. It just means you might need to try a different kind of treatment.

Medications
Counselling
Community-based treatment and supports

Medications can be useful for treating alcohol dependence in the long term. They can help decrease the strong desire to drink, which makes it easier to stay away from alcohol if that’s your goal.

First-line treatments

There are 2 medications that are called “first-line” treatments for alcohol addiction. They are naltrexone and acamprosate. “First-line” medications are seen as the most dependable choices for treating alcohol addiction. This means that scientists have done research and found that these medications work well for a lot of people.

Naltrexone (Revia)

Naltrexone, also known as Revia, is a medicine for treating alcohol addiction. It works best when you use it for a long time. It works by stopping the good feelings that alcohol can give you, which can help you stop drinking. When people take this medication regularly, it can help them control their cravings for alcohol. This is a good option for people who want to quit or reduce their drinking.

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Acamprosate (Campral)

Acamprosate, also known as Campral, is a medicine for treating alcohol addiction. It works best when you use it for a long time. It helps bring back a balance in the brain that might have been affected by alcohol use. Taking acamprosate regularly can help people who want to stop drinking altogether.

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I didn’t know there were any other options until I went to an addictions treatment centre where I was referred to a psychiatrist who prescribed me naltrexone.

Ken, person in recovery from alcohol use disorder

Second-line treatments

There are 2 medications known as “second-line” treatments for alcohol addiction. They are gabapentin and topiramate. These medications have less research supporting how well they work and are usually tried when the “first-line” medications have not worked.

Gabapentin (Neurontin)

Gabapentin, also known as Neurontin, is a medicine that can be used to help with alcohol withdrawal or to treat alcohol addiction. It works best when it’s used for a long time. It can help decrease the desire to drink and improve sleep, which makes it easier to stay away from alcohol.

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Topiramate (Topamax)

Topiramate, also known as Topamax, is another medication that can be used for long-term treatment of alcohol addiction. It works by reducing cravings and helping to control the urge to drink.

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Gabapentin can help, but it doesn’t put alcoholism into remission. I didn’t take it as prescribed and quickly became dependent on it. You have to take care of your mental health too.

Kira, person in recovery from alcohol use disorder

Off-label use of medications

When doctors prescribe a drug for a reason that is generally seen as safe and helpful but that is different from what the government approved it for, it’s called an “off-label” use. The reason it’s called “off-label” is because the drug is being used in a way that isn’t mentioned on its packaging information. This practice is common in Canada and around the world.

Prescribers are able to do this using their own judgment. These are some medications that you may hear about that are used to treat alcohol problems “off-label”:

Baclofen (Lioresal)
Ondansetron (Zofran)
Bupropion (Wellbutrin)
Buprenorphine-naloxone (Suboxone)

I needed to try a number of medications before finding a combination that worked best.

Andy, person in recovery from alcohol use disorder

Medications that are not recommended

Some medications that used to be recommended for treating alcohol addiction are no longer recommended. For example, you might come across a medication called disulfiram, also known by the brand name Antabuse. This medication is supposed to discourage people from drinking by giving them very unpleasant side effects if they drink even a small amount of alcohol.

However, disulfiram is no longer recommended for treating alcohol addiction. Other medications are more effective and safer for this purpose.

Counselling can take place in person or online. If you live in an area without many options for in-person counselling or you have reduced mobility, online counselling might be a good option for you. Nowadays you can access counselling over the phone, by text or through video conferencing, so your location doesn’t have to stop you from getting the help you want.

Most people who go to counselling pay for it themselves, or they have health benefits through their employer that help cover the cost. Some counsellors offer sliding-scale fees based on how much you can afford to pay, and student counsellors often offer low-cost counselling.

There are also some short-term free and low-cost substance use counselling services that are publicly funded in different provinces and territories—they usually require a referral from a health care provider and are typically only offered in cities.

There are different types of counselling that can help with alcohol use disorder: one-on-one counselling, couples counselling, family counselling, or in a group with other people. It’s important to find the right type of counselling that suits your needs and goals. Combining counselling with medication treatment can be more effective, so it’s a good idea to talk to your health care provider about your options.

To get an idea of the Canada-wide and region-specific health and support services you might be able to access to help with your alcohol use, check out this Government of Canada website.

get help with substance use

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) is a type of counselling that’s often used for mental health and substance use problems, including alcohol use. It can be helpful if you want to change your drinking habits and develop healthier thoughts and behaviours. A lot of counsellors and therapists are trained in CBT, and it’s offered in both individual and group settings.

Family-based therapy

If you’re struggling with alcohol use, family-based therapy is a type of counselling that can be very effective. It looks at what could have caused your problems with alcohol and includes family and sometimes friends in the treatment.

This therapy can be helpful if you have supportive family or friends who are willing to join. It’s all about building healthier relationships that will help you feel better and support your overall well-being.

A common type of family-based therapy is behavioural couples therapy, where you and your significant other go to therapy together. It usually lasts for 12 to 20 sessions and involves a daily “recovery contract” to encourage you to stay away from alcohol, be more positive in your relationships and improve your communication skills.

Mindfulness-based therapy

Mindfulness-based programs are about becoming more aware of yourself and not being too hard on yourself. They help you learn skills to deal with tough times and emotions, and to not judge yourself in a bad way. These programs can be useful if you want to change your thoughts and how you think about yourself.

One of the most important things is honesty. I wouldn’t tell them how much I was really struggling, but once I got honest, there was hope.

Andy, person in recovery from alcohol use disorder

Community programs are resources in your area that can help with alcohol problems. These programs can include peer support groups, inpatient and outpatient treatment programs, supportive recovery housing, and other organizations that offer help and guidance with challenges related to alcohol and promote long-term well-being.

For more information about AA and SMART Recovery, click here.

where to start

I have found a close group of recovery friends that I am now free to share my experience, strength, hope and struggles with any time I need to. The trust that I would not allow into my life and relationships has returned. I am now proud to be a person in recovery and fully transparent and open about my past and emerging recovery story. It is so much easier and free to be authentic, I am who I am, I have a past and it’s all OK.

– Tim, person in recovery from alcohol use disorder

Intensive outpatient treatment programs

Intensive outpatient programs are treatment programs where you spend several hours each day in structured activities. These programs usually offer different types of therapy, connect you with supportive people, teach life skills and job training, and include group meetings with others who understand what you’re going through. They also involve fun activities and focus on teaching you ways to cope with challenges and prevent going back to old habits.

Inpatient treatment programs

If you and your doctor feel that outpatient treatment isn’t enough for you, your doctor might recommend a program where you can stay overnight. This is called an “inpatient program”. These programs are more common in big cities and urban areas. They provide a safe place for people with alcohol and substance use problems, offering around-the-clock support, counselling, help with life skills, and advice on nutrition.

People in inpatient programs usually stay for anywhere from a few weeks to a few months to get the intensive treatment they need. Not all of these treatment programs follow the standards set out by the health authority or provincial/territorial regulations for live-in health care facilities. It’s important to do your research to find a facility that fits your needs and provides the quality of care that you’re looking for.

Supportive recovery housing

You might also consider looking for supportive recovery housing, which is a place where people with various addictions live together in a community. In these homes, the focus is on regaining a healthy and structured lifestyle. They provide a daily schedule, meals and support to help you on your recovery journey. These programs offer different activities like counselling, yoga and support from others who understand your experiences. They also help you learn important life skills to prepare you for independent living.

To live in supportive recovery housing, you usually need to be sober before you can move in and continue to stay sober while you’re there. Most people stay for around 1 to 3 months. Not all recovery services follow the standards set out by the health authority or provincial/territorial regulations for live-in health care facilities. It’s important to do your research to find a facility that fits your needs and provides the quality of care that you’re looking for.

Peer support groups

Peer support groups are places where people with similar experiences come together to offer each other emotional and practical support. When it comes to alcohol use, a peer supporter is someone who has gone through their own journey with alcohol and is trained to help others on their journeys. These groups can be found in many cities and are usually free and open to new members. Examples of common peer support groups include Alcoholics Anonymous (AA), SMART Recovery and LifeRing.

With every effort on the path to sobriety, there was something each experience gave me as an added tool towards getting sober. And getting sober was never the end goal. Getting back to the world of living was.

Heather, person in recovery from alcohol use disorder