How to Sober Up: What Actually Works?

Substance use disorders, such as alcohol or drug use, are medical conditions. Addiction can be a chronic disease, so treating it often isn’t as simple as not consuming that substance for a few days.

People who are addicted to substances may require treatment in the form of medication, counseling, and in some cases, medical care. Treatment is typically long-term, and requires a lot of effort and commitment from the individual.

If you are struggling with substance use, you may require treatment by one or more healthcare professionals, such as physicians, psychologists, psychiatrists, or social workers, who can:

• Evaluate your behavior and consumption patterns
• Diagnose your condition and determine its severity
• Decide the goals of treatment with you and determine a treatment plan accordingly
• Provide medical care and prescribe medication, if needed
• Offer counseling services
• Work with you to help you achieve your goals and keep you safe

According to Jeanette Tetrault, MD, an addiction medicine specialist at Yale Medicine, the terms "sobering up" or "getting sober" are stigmatizing.

“Overall, if an individual’s goal is to stop using substances, it is important to recognize that harmful substance use and abstinence exist on a continuum. The term ‘sobering up’ suggests that it is an all or none phenomenon, which is inaccurate,” says Tetrault.

Treatment and Therapy Options

Tetrault outlines some short- and long-term treatment and therapy options that can help you achieve abstinence.

Detoxification

This is a short-term approach that allows you to safely detoxify a substance out of your body. 

Some individuals can do this on their own with community or peer support; however, others will require the help of providers through medically-supervised detoxification. This can be done in outpatient or inpatient settings. 

It’s important to note that while detoxification may be one step in helping you achieve health and safety, it is not treatment. Treatment may involve medication and counseling options, which can help you achieve your goals with regard to substance use.

Counseling

These are some evidence-based counseling options that can help treat substance use disorders:

• Cognitive-behavioral therapy (CBT): CBT can help you identify negative thoughts and behaviors that lead to substance use. It can improve impulse control, help you avoid triggering situations and develop coping strategies.
• Motivational enhancement therapy (MET): Unlike the step-wise recovery approach, MET aims to engage you, help you build internal motivation to stop using substances, and evoke rapid change.
• Motivational interviewing (MI): MI can help you develop motivation to make positive changes. It can help you resolve any ambiguity or conflict you have regarding changing your behavior.
• Peer support: The peer support model connects you with others struggling with the same condition, as well as people who have achieved significant recovery and can offer support and guidance.
• 12-step programs: Self-help groups such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and Cocaine Anonymous (CA) follow a 12-step recovery program. These programs offer an element of community support and are often recommended alongside or after the completion of formal treatment.
  

Medication

The medication and treatment plan your healthcare providers recommend can depend on several factors, such as the type of substance you’re using, your health status, and the goals of treatment.

For opioid use disorder, medications like methadone and buprenorphine are evidence-based treatment options that help reduce patient harm and improve outcomes, including achieving abstinence. 

For alcohol use disorder, medications like naltrexone and acamprosate are evidence-based treatment options that may help patients reduce harmful drinking or achieve abstinence.

How Long Does It Take?

The amount of time it takes to achieve abstinence can depend on the individual, says Tetrault.

According to the National Institute on Alcohol Abuse and Alcoholism, within one year of treatment, approximately one-third of people who are treated for alcohol use don’t have symptoms and are able to substantially reduce their drinking and have fewer alcohol-related issues.

For drug use, 12 months is considered the minimum treatment time. Shorter treatment times of around three months have limited effectiveness, in both inpatient and outpatient settings, according to the National Institute on Drug Abuse.

“The most important thing to focus on with an individual who is working to decrease their substance use or achieve abstinence is to promote safety and reduce harm. This is the approach healthcare providers employ when treating any other chronic health condition and substance use should be no different,” says Tetrault.

A Word From Verywell

Battling substance use can be challenging and feel impossible at times. However, it’s important to realize that there are providers who can help you, says Tetrault. She recommends being honest with your healthcare providers about your goals, so that they can help you and keep you safe.