
HCO ID: 715830

LOC Designated Number/DHCS State License Number: 191309BP

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Alcohol use disorder (AUD) is a medical condition recognized by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). It is not a moral failing or a lack of willpower. It is a brain-based disorder that changes how a person thinks about, craves, and uses alcohol.
According to the 2023 National Survey on Drug Use and Health, about 28.9 million Americans ages 12 and older had alcohol use disorder in the past year— roughly 1 in 10 people. About 1 in 7 men and 1 in 11 women meet the criteria.
According to the 2023 National Survey on Drug Use and Health, about 28.9 million Americans ages 12 and older had alcohol use disorder in the past year — roughly 1 in 10 people. About 1 in 7 men and 1 in 11 women meet the criteria.
Yet fewer than 10% of people with AUD receive any treatment in a given year, according to NIAAA’s 2024 report to Congress. The gap between need and care is one of the largest in U.S. medicine.
Alcohol addiction develops slowly for most people. What starts as social drinking can become a daily habit, and over time the brain adapts to alcohol’s presence. When alcohol is removed, the brain reacts — sometimes mildly with anxiety and poor sleep, and sometimes severely with seizures or delirium tremens (DTs). This is why alcohol is one of the few substances where stopping without medical supervision can be life-threatening.
The good news: alcohol use disorder is treatable. With medical detox, evidence-based therapy, and ongoing support, people recover every day. The first step is understanding what’s happening and what care looks like.
Alcohol is a central nervous system depressant. It slows down brain activity and changes the way nerve cells communicate. With repeated use, the body adapts. That adaptation is what makes alcohol so hard to stop without help.
Alcohol increases GABA, a chemical that calms the brain, and lowers glutamate, a chemical that excites it. Over time, the brain compensates by producing less GABA and more glutamate. When a person stops drinking, the brain is left in an over-excited state — which is why withdrawal can include anxiety, tremors, and seizures, according to NCBI StatPearls on Alcohol Withdrawal Syndrome.
Heavy drinking raises blood pressure and can cause an irregular heartbeat (atrial fibrillation), cardiomyopathy, and stroke, according to the CDC.
The liver processes most of the alcohol a person drinks. Chronic heavy use can lead to fatty liver, alcoholic hepatitis, and cirrhosis. The CDC reports alcohol-associated liver disease is one of the leading causes of liver-related death in the U.S.
Long-term alcohol use shrinks brain regions linked to memory and decision-making. Severe deficiency of thiamine (vitamin B1) caused by chronic drinking can lead to Wernicke-Korsakoff syndrome, a serious memory disorder.
Alcohol often makes anxiety, depression, and trauma worse — even though many people drink to manage those feelings in the short term. SAMHSA’s 2023 National Survey on Drug Use and Health found that about 21.5 million U.S. adults had both a mental illness and a substance use disorder in the past year.
Heavy alcohol use weakens the immune system, raising the risk of pneumonia and other infections. It also disrupts hormones tied to sleep, mood, and reproductive health.
— one drink turns into many, or a night out stretches into the early morning.
— repeated attempts to drink less that don’t last.
— hangovers, lost mornings, or planning the day around alcohol.
— wanting a drink so much it’s hard to think about anything else.
— wanting a drink so much it’s hard to think about anything else.
— continuing even after conflict, job issues, or legal trouble.
— hobbies, friendships, or exercise replaced by drinking.
— driving, swimming, or operating equipment after drinking.
— continuing despite anxiety, depression, liver issues, or doctor’s warnings.
— building tolerance, or feeling shaky, anxious, sweaty, or sick when alcohol wears off.
Diagnosis is made by a licensed clinician — usually a physician, psychiatrist, or licensed therapist — using the DSM-5 criteria for alcohol use disorder. The clinician reviews drinking history, physical and mental health, family history, and how alcohol use has affected daily life.
Two screening tools are widely used in primary care and treatment settings:
AUDIT-C — a 3-question screen used by many doctors. A score of 4 or more in men, or 3 or more in women, suggests further evaluation is needed.
CIWA-Ar — the Clinical Institute Withdrawal Assessment, used in detox to measure withdrawal severity and guide medication. Reviewed in NCBI StatPearls.
A diagnosis is not a label — it’s a starting point that helps a clinical team build the right treatment plan.
Alcohol is one of the only substances where withdrawal can be life-threatening. The same brain adaptations that make alcohol use disorder hard to stop also make stopping dangerous if it is done suddenly and without medical care.
According to research published in Brain and Behavior, 4 to 15% of people with alcohol dependence experience seizures or DTs during withdrawal, and the rate rises to 20–30% in hospitalized patients. Without treatment, delirium tremens can be fatal.
Medical detox provides 24/7 monitoring, medications such as benzodiazepines to ease symptoms and prevent seizures, IV fluids and nutrition (including thiamine), and a quiet, safe environment. The CIWA-Ar protocol allows nursing staff to score symptoms hour by hour and adjust care in real time.
Withdrawal looks different for every person. Drinking history, age, other health conditions, and other substances all affect the timeline. The general pattern, drawn from NCBI StatPearls on Alcohol Withdrawal Syndrome, is:
Anxiety, mild tremors, sweating, headache, nausea, and trouble sleeping. Most people are still able to talk and walk, but symptoms build quickly.
Symptoms peak. Tremors get stronger. Blood pressure and heart rate rise. Withdrawal seizures are most likely in this window. Some people experience alcoholic hallucinosis — seeing or hearing things that are not there, while still aware of their surroundings.
The most severe phase, when delirium tremens may begin. DTs include confusion, severe agitation, fever, fast heartbeat, and full hallucinations. This is a medical emergency that requires inpatient care. After Day 7, acute symptoms usually fade, but anxiety, low mood, poor sleep, and cravings can linger for weeks — a phase known as post-acute withdrawal syndrome (PAWS).
Many people with alcohol use disorder also live with a mental health condition. This is called a co-occurring disorder, or dual diagnosis. SAMHSA reports that about 21.5 million U.S. adults had both a mental illness and a substance use disorder in the past year.
Conditions that most often appear alongside alcohol use disorder include:
Anxiety disorders — including generalized anxiety, social anxiety, and panic disorder. Learn more about our anxiety dual diagnosis treatment.
Depression — major depressive disorder and persistent depressive disorder.
Post-traumatic stress disorder (PTSD) — often connected to past trauma or military service.
Bipolar disorder — manic and depressive episodes that may be masked by drinking.
ADHD — adults with untreated ADHD are at higher risk for AUD.
SAMHSA’s clinical guidance is clear: integrated treatment — care that addresses both conditions at the same time, with the same team — produces better outcomes than treating one and ignoring the other. At 1st Choice Detox Treatment Center, mental health care is built into the detox and treatment plan from day one.
1st Choice Detox Treatment Center is a licensed residential and detox facility in Granada Hills, in the northern San Fernando Valley of Los Angeles County. The program is built for adults whose drinking has reached the point where home detox is unsafe or where past attempts to stop haven’t held.
A brief, no-pressure clinical screening
A free insurance verification (most PPO plans accepted)
A discussion of timing, transportation, and what to bring
Coordination with a family member if requested
All calls and admissions information are protected under 42 CFR Part 2 — the federal rule that keeps substance use treatment records confidential. Nothing is shared with employers, family, or insurers without written consent.
— nursing staff on site around the clock
— hourly withdrawal scoring and medication adjustment
— benzodiazepines during detox, plus FDA-approved medications for AUD after stabilization
— within the first 72 hours for co-occurring conditions
— with a licensed therapist 3 to 5 times a week
— daily evidence-based and process groups
— optional family sessions and education materials
— meals, IV fluids, and thiamine to repair common deficiencies
— step-down to PHP, IOP, sober living, or outpatient before discharge
— help with FMLA paperwork, employer letters, and continuing care referrals
Therapy is the foundation of long-term recovery. The therapies below have the strongest evidence base for alcohol use disorder, as reviewed by NIAAA and the American Psychological Association.
CBT teaches people to spot the thoughts and situations that lead to drinking and to build new coping skills. Multiple meta-analyses show CBT reduces drinking and improves long-term outcomes.
MI is a conversation-based approach that helps people resolve mixed feelings about change. It is especially effective in early treatment when motivation may be fragile.
DBT teaches emotion regulation, distress tolerance, and mindfulness — useful for people whose drinking is tied to intense emotions or trauma.
TSF connects people to Alcoholics Anonymous and other peer-support groups. Research published by NCBI shows TSF leads to higher rates of continuous abstinence than other psychosocial approaches.d
A non-12-step, science-based peer support model rooted in CBT. A good fit for people who prefer a secular approach.
For clients with PTSD or unprocessed trauma, evidence-based trauma therapies — including Cognitive Processing Therapy and EMDR — are offered alongside alcohol treatment.
Alcohol use disorder affects whole families. Family sessions help repair communication and build the support system needed for long-term recovery.
The FDA has approved three medications for alcohol use disorder. All are non-narcotic and non-addictive. Their use is supported by SAMHSA and by NIAAA’s clinical guidance.
| Medication | How it works | Typical use |
|---|---|---|
| Naltrexone (oral or Vivitrol injection) | Blocks the reward effect of alcohol; reduces cravings | Daily pill or monthly injection |
| Acamprosate (Campral) | Helps the brain re-balance after long-term drinking; eases post-acute symptoms | Three times daily, taken after detox |
| Disulfiram (Antabuse) | Causes a strong physical reaction if alcohol is consumed; acts as a deterrent | Daily, for highly motivated patients with supervision |
A meta-analysis published in the Journal of Therapeutics and Clinical Risk Management found acamprosate significantly improved rates of continuous abstinence compared to placebo. Medication choice is always individual and made with the prescribing physician.
Detox is the first step, not the whole journey. Most people benefit from a structured step-down so the brain and the body have time to heal.
— 24/7 care in a structured, alcohol-free environment, usually 28 to 45 days.
— full-day clinical programming, evenings at home or in sober living.
— 9 to 15 hours of clinical care per week while returning to work, school, or family.
— weekly therapy, group support, MAT management, and relapse prevention.
The clinical team reviews progress weekly and adjusts the plan as recovery moves forward.
Plans commonly accepted include:





Our dedicated team is here to guide you through every step of recovery.
under 42 CFR Part 2. https://www.samhsa.gov/about/who-we-are/laws-regulations/confidentiality-regulations-faqs
— psychiatric evaluation and mental health care from day one.

LOC Designated Number/DHCS State License Number: 191309BP
— fast verification, transparent cost discussion.
— Granada Hills facility designed for focused care.
during detox and the early stabilization period.
Your questions answered
For people who drink heavily and daily, stopping suddenly can be dangerous. Alcohol withdrawal can cause seizures and delirium tremens, a medical emergency. Research in Brain and Behavior reports 4–15% of people with alcohol dependence develop seizures or DTs during withdrawal. A medical detox provides 24/7 monitoring, medications to ease symptoms, and a safe environment for those first critical days.
Most people complete medical alcohol detox in 5 to 7 days, though it varies by drinking history and overall health. Symptoms usually peak within 24 to 72 hours of the last drink. After acute detox, post-acute symptoms such as low mood, poor sleep, and cravings can last weeks, which is why most clinicians recommend continuing into residential, PHP, or IOP care.
Under the Mental Health Parity and Addiction Equity Act, most PPO plans cover medical detox and treatment for alcohol use disorder at the same level as other medical care. 1st Choice Detox accepts most major PPO plans. A free verification call to (844) 944-3139 confirms benefits, deductible, and out-of-pocket cost before admission, with no obligation.
Three medications are FDA-approved for alcohol use disorder: naltrexone, which reduces cravings; acamprosate, which helps the brain rebalance after long-term use; and disulfiram, which discourages drinking by causing an unpleasant reaction if alcohol is consumed. During detox, doctors often use benzodiazepines short-term to prevent seizures and ease symptoms. All medications are prescribed and monitored by a physician.
Dual diagnosis treatment addresses alcohol use disorder and a mental health condition — such as anxiety, depression, PTSD, or bipolar disorder — at the same time, with the same team. SAMHSA identifies integrated care as the standard for co-occurring disorders. If past attempts to stop drinking were followed by intense anxiety, low mood, or trauma symptoms, dual diagnosis treatment usually leads to better long-term outcomes.
Delirium tremens, often called DTs, is the most severe form of alcohol withdrawal. It usually appears 48 to 72 hours after the last drink and can involve severe confusion, hallucinations, high fever, and dangerous changes in heart rate and blood pressure. It is a medical emergency and can be fatal without treatment. DTs affect a minority of people withdrawing from alcohol, and the risk is higher for those who drink heavily and daily, who have withdrawn multiple times before, or who have other medical conditions. Medically supervised detox substantially reduces this risk, because the medications used to manage withdrawal are the same ones that prevent it from escalating.
A licensed clinician uses the DSM-5 criteria for alcohol use disorder, reviewing drinking patterns, physical and mental health, and how alcohol has affected daily life. Screening tools such as the AUDIT-C are often used in primary care. Meeting 2 to 3 of the 11 DSM-5 criteria indicates mild AUD, 4 to 5 moderate, and 6 or more severe. Diagnosis guides the right level of care.
Detox is the first step, not the whole treatment. Most people step down through residential care, a partial hospitalization program (PHP), or an intensive outpatient program (IOP). These programs provide therapy, MAT management, and relapse prevention while the brain continues to heal. The 1st Choice Detox clinical team builds an individualized aftercare plan before discharge, including referrals for therapy, sober living, or 12-step and SMART Recovery groups.
No, not unless you give written consent. Substance use treatment records are protected under 42 CFR Part 2, a federal regulation that is stricter than HIPAA. Information is not shared with employers, family members, or insurers without specific written permission. FMLA paperwork can be coordinated by the admissions team if a person wants protected medical leave.
Phone and work policies vary by program level. During acute detox, phones are usually limited so the body and brain can fully rest. As clients move into residential or PHP care, structured phone time is allowed, and some clients are able to handle limited work or school responsibilities. The clinical team will discuss individual situations and create a plan that supports both recovery and life obligations.
Cost varies based on level of care, length of stay, and clinical needs. Most clients use PPO insurance, and 1st Choice Detox provides free, no-obligation verification before admission. For clients without PPO coverage, the admissions team will discuss options, including private-pay rates, payment plans, and referrals to other community resources. A short call to (844) 944-3139 gives a clear picture of cost and coverage.
The first day is usually the hardest, and knowing what is coming makes it easier. Symptoms typically begin 6 to 12 hours after your last drink, starting with anxiety, tremors, sweating, nausea, and trouble sleeping. Between 12 and 24 hours, symptoms often intensify, and heart rate and blood pressure can rise. This is why our nursing staff assess you on a schedule using a standardized withdrawal scale rather than checking in occasionally, and why medication is given in response to what your body is actually doing. Most people describe the first 24 hours as uncomfortable rather than unbearable when it is medically managed. Doing it alone is what makes it dangerous.
Most people who reach out to us have tried before, often more than once. Relapse is common in recovery and it is not evidence that treatment does not work or that you are beyond help. What it usually indicates is that the level of support did not match what the situation required. Someone who tried to stop on their own, or who completed detox without continuing into treatment, was not given much of a chance. Alcohol use disorder is a chronic medical condition, and like other chronic conditions it often takes more than one course of treatment. Having withdrawn before also matters clinically, because repeated withdrawal can make each subsequent one more severe, which is worth telling us during your assessment.
A confidential admissions specialist is available 24/7. There is no obligation, and every call is protected under 42 CFR Part 2.