What is AUD?

To determine if you have AUD, a healthcare provider might ask these questions:

In the past year, have you…

Any of these symptoms may be cause for concern. The more symptoms, the more urgent the need for change.

Some things can increase a person’s risk of AUD.  A person’s risk depends on how much, how often, and how quickly they drink alcohol. Alcohol misuse, which includes binge drinking and heavy alcohol use, increases the risk of AUD. Other factors also increase the risk of AUD, such as:

There are three main medication treatment paths. Though each medication works differently, Medications for Alcohol Use Disorder (MAUD) have proven to be effective to:

• Keep individuals in treatment
• Improve rate of survival for people with alcohol-related liver disease
• Increase the number of non-drinking days a person has
• Reduce the risk of falling back into alcohol use

MAUDs are FDA-approved treatments for people diagnosed with AUD.

Source: Medications for Substance Use Disorders | SAMHSA

1. Naltrexone

Pronounced “nal-TREK-sohn.” Naltrexone works by blocking the effects of alcohol, reducing alcohol cravings and the amount of alcohol consumed. Naltrexone is not commonly misused since it causes no effects, but it must be taken by mouth daily or injected monthly to prevent cravings from returning.

Brand name: Vivitrol (long-acting injectable), ReVia or Depade (oral tablets)

2. Acamprosate 

Pronounced “uh-KAM-pruh-sayt.” Acamprosate works by restoring the natural balance of neurotransmitters in the brain that is disrupted by chronic alcohol use, reducing alcohol cravings and the amount of alcohol consumed. Acamprosate cannot be misused and has no significant drug interactions. Acamprosate must be taken by mouth. 

Brand name: Campral

3. Disulfiram

Pronounced “dai-SUHL-fir-am.” Disulfiram interferes with the way the body breaks down alcohol, causing an unpleasant reaction when a person drinks. If an individual uses alcohol when taking disulfiram, they will feel sick. Disulfiram helps individuals choose not to drink, but it does not reduce cravings or treat withdrawal. Disulfiram works best when combined with behavioral therapy and support groups as part of a comprehensive treatment plan. Disulfiram must be taken once daily by mouth.

Brand name: Antabuse

1. Detox

Detox, or detoxification, is medically directed withdrawal management that will improve a patient’s health and support their participation in a rehabilitation program. Though this treatment is usually not necessary for alcohol addiction, it will help individuals consider a life without alcohol, because they can think more clearly once difficult withdrawal symptoms have passed.

In a medically directed withdrawal, a doctor provides medication to reduce the effects of withdrawal symptoms and continuously monitors the patient to make sure they are safe and comfortable throughout all stages of withdrawal. MAUDs can be started in a detox program. MAUDs do not encourage alcohol use.

The effects of detoxing without help from medication can range from an uncomfortable process, like a bad case of the flu, to a very painful physical experience. However, withdrawal is usually not life-threatening. It is smart to check with a doctor or counselor before quitting the use of alcohol on your own if you are a heavy or long-term user.

Get more information on availability for detox programs in Connecticut.

Source: SAMHSA (2016)

2. Inpatient/Residential

Some individuals seeking treatment benefit the most by changing their behavior in an organized residential setting. A residential treatment center is a setting where you live for a period of time and recover with support available to you around the clock. Residential treatment promotes recovery in a place that is supportive, away from any desire to use, and typically provides counseling and Substance Use Disorder (SUD) education.

This care can be short-term (3-4 weeks) or long-term (3-12 months) and may be provided in different residential settings, such as SUD facilities and SUD hospital units.

Recovery houses also provide a supportive, sober environment but do not offer on-site treatment. Residents of recovery houses usually stay 1-3 months and get outpatient treatment elsewhere.

Get more information on availability for residential treatment, including Recovery Houses in Connecticut. 

Source: SAMHSA (2004)

3. Individual Counseling

Alcohol counseling, also known as behavioral treatments or “talk therapy,” provided by licensed therapists are aimed at changing drinking behavior. Examples of behavioral treatments are brief interventions and reinforcement approaches, treatments that build motivation and teach skills for coping and preventing relapse, and mindfulness-based therapies. Find an addiction facility near you or get timely access to residential addiction treatment and recovery house beds.

4. Peer Support Groups

Peer support groups, which include options such as Alcoholics Anonymous (AA), offer a safe space among other people who are on the path to recovery. These groups can provide an added layer of support to stop or reduce drinking. Group meetings are available in most communities, at low or no cost, at convenient times and locations—including online options. This can be especially helpful to individuals at risk for relapse. Find an AA support group.

Please note: People with severe AUD may need medical help to avoid alcohol withdrawal if they decide to stop drinking. Alcohol withdrawal is a potentially life-threatening process that can occur when someone who has been drinking heavily for a prolonged period of time suddenly stops drinking. Doctors can prescribe MAUDs to address these symptoms and make the process safer and less distressing.

1. Get Covered

The cost of rehabilitation, detox, and MAUD can change based on the level of care needed. There are options to pay for treatment—including self-pay, private insurance or State insurance coverage, or financing through the rehab center.

Connecticut has many insurers who offer individual and group health insurance plans. It is important to know who your provider is; if you are not insured, it is recommended that you get coverage in case of a health emergency. For a list of available health insurance companies in Connecticut, visit the Connecticut Office of the Health Care Advocate website. 

2. I Don’t Have Insurance

If you don’t have insurance, the State offers affordable health care options for you or your loved one to consider.

HUSKY: This State insurance program includes federal Medicaid and offers a program for adults. “Husky D” provides insurance for low-income adults without children and covers behavioral health services. There are programs offered for families, those with disabilities, and those with children as well. For more information or to see if you qualify, visit the HUSKY website.

To apply for HUSKY healthcare, visit Access Health CT and apply online, dial 1 (855) 805-4325 to apply over the phone, or visit your local Department of Social Services (DSS) field office to apply in person.

If you don’t qualify for HUSKY, there are other plans available to you. You can buy an individual healthcare plan through Access Health CT.

3. I Have State Insurance

If you have insurance, it is important to know what your plan covers in case you need addiction treatment services. HUSKY provides complete coverage which includes Behavioral Health Services. Behavioral Health Services include, but are not limited to:

• Detoxification
• Residential rehabilitation (HUSKY D only)
• Partial Hospitalization
• Day Treatment
• Outpatient Services
• Prescription Coverage (through the CT Medical Assistance Program – CMAP)
• All outpatient substance use clinic services, including medications

To find out what other services are covered under your HUSKY plan, dial 1 (855) 805-4325 or visit Access Health CT.

4. I Have Individual or Group Insurance

If you have a private insurance plan, such as Aetna, Cigna, Anthem, ConnectiCare, or others, you may want to talk to your employer or call your provider to see what services are covered under your plan. The Mental Health Parity and Addiction Equity Act of 2008 requires insurance companies to make mental health benefits comparable to general medical coverage. This means copays, treatment limitations, out-of-pocket expenses, etc. are all treated similar to other physical conditions. As of 2017, Connecticut passed a law requiring insurers to cover medically necessary inpatient detox services.

It would be helpful for you or your loved one to call your insurance company to determine your coverage. If you are unsure what questions to ask, see Suggested Questions to Ask below.

5. What’s Covered?

Coverage depends on your health insurance plan. However, Connecticut law requires all individual and group policies to provide benefits for the examination and treatment of substance use disorders. 

The State requires the following services:

• Residential Treatment
• MAUD

The State considers the following as “essential health benefits” in any plan:

• Office Visits
• Inpatient Services
• Partial Hospitalization
• Intensive/Routine Outpatient
• Substance Abuse Detoxification
• Emergency Room & Urgent Care

When asked by the CT Insurance Department, most insurance providers covered all of the above. Each plan’s coverage may be different, so it is important for you or your loved one to get in touch with your insurance provider to learn about what benefits you have, how long you will have them, and if you are responsible for any additional costs.

6. Suggested Questions to Ask

To determine what kind of insurance you have and to learn more about your treatment options, you should call the Member Services Department of your insurance company. Be sure to have your insurance card and member ID number ready. It would also be helpful to take notes on your phone, or have a pen and paper nearby.

• What type of plan do I have? (i.e. EPO, HMO, POS, PPO, etc.)
• What levels of care are covered? Inpatient services? Outpatient services? Medication Assisted Treatment/Chemical Maintenance Treatment?
• If so, what is my deductible, or out-of-pocket cost? What is the cost of each copay?
• If I want inpatient treatment, is there a limit for my stay? If so, how many days?
• Will my coverage change based on my stage of treatment? (Detox vs. continuing care)
• Can you provide me with a list of providers covered by the insurance plan?
• Do I need to be pre-approved or be recommended by a doctor to get coverage for treatment?
• Ask them to send you a document that lays out what is considered a “medical necessity.”

7. Office of the Healthcare Advocate

Health insurance can be a bit difficult to understand sometimes. Thankfully, the Connecticut Office of the Healthcare Advocate (OHA) is available to answer questions about your insurance plan and make sure you get the treatment you need! To contact the OHA, visit the OHA website or call 1 (866) 466-4446.

Source: CDC (2019)