Alcohol Use Disorder Treatment
Alcohol use disorder is a medical condition, not a moral failing. Our evidence-based approach combines the latest pharmacological advances with structured psychotherapy to help you regain control, on your terms.
Dr. Paul Abramson is board-certified in addiction medicine and leads our seasoned, multidisciplinary team.
Understanding Alcohol Use Disorder
Alcohol use disorder (AUD) is recognized by the medical community as a chronic brain condition, not a character flaw. It develops from a combination of genetic predisposition, environmental factors, and the physiological effects of regular alcohol use on brain chemistry.
This is not about willpower. Chronic alcohol use changes the brain's reward and stress systems, making it extremely difficult to stop or control drinking without proper medical and psychological support.
We approach AUD as we would any other chronic medical condition: with evidence-based treatment, careful monitoring, and a long-term management plan.
Brain Changes
Alcohol alters dopamine and GABA pathways, creating physical dependence.
Withdrawal Risk
Severe withdrawal can be life-threatening and requires medical supervision.
Effective Medications
FDA-approved and off-label medications can significantly improve outcomes.
Recovery is Possible
With proper treatment, many patients achieve lasting recovery.
Our Approach
Three Pillars of Treatment
Effective treatment for alcohol use disorder requires addressing the condition from multiple angles simultaneously.
Medication-Assisted Treatment
We use the latest evidence-based medications to reduce cravings, block alcohol's rewarding effects, and support your brain's recovery.
We use adjunctive medications thoughtfully to improve outcomes and comfort, with a goal of avoiding unnecessary polypharmacy. Some of the medications we use specifically for alcohol treatment are listed below.
Psychotherapy
Our specialized addiction therapists work with you to understand triggers, develop coping strategies, and address underlying issues.
This centers on individual therapy, which may draw on motivational interviewing, cognitive behavioral therapy, dialectical behavior therapy, Internal Family Systems, and other modalities according to your needs and preferences, alongside couples work and family integration when appropriate.
Accountability & Monitoring
Structure and accountability are essential in early recovery. We use technology and frequent check-ins to support your goals.
Depending on the individualized treatment plan, this may include remote breathalyzer monitoring, lab testing, frequent check-ins, and family involvement.
Baclofen for Alcohol Use Disorder
We were among the first practices in the Bay Area to use baclofen for alcohol use disorder, based on emerging research from France showing its potential to reduce cravings and anxiety in patients with AUD.
Baclofen works on GABA-B receptors and may be particularly helpful for patients who experience significant anxiety when they stop drinking, a common trigger for relapse.
While not FDA-approved for this indication, baclofen has been used successfully in many of our patients when other medications haven't worked or aren't appropriate.
Our Medication Options
Naltrexone
Blocks opioid receptors, reducing alcohol's rewarding effects
Baclofen
GABA-B agonist that may reduce cravings and anxiety
Acamprosate
Restores glutamate balance disrupted by chronic alcohol use
Disulfiram (Antabuse)
Creates aversion to alcohol through unpleasant reaction
Topiramate
May reduce heavy drinking days and cravings
Gabapentin
May reduce drinking and ease the insomnia and anxiety of early recovery, particularly for patients with withdrawal symptoms
GLP-1 medications (semaglutide, tirzepatide)
Emerging evidence suggests reduced craving and drinking; early trials are promising and larger studies are underway
Safe Detoxification
Alcohol withdrawal can be medically dangerous. Depending on your drinking history and current consumption, stopping abruptly can cause seizures or other serious complications.
We provide medically supervised detoxification when necessary, carefully managing withdrawal with appropriate medications and monitoring. For very heavy drinkers, this may require coordination with an inpatient facility for the initial days.
Treatment Inside a Medical Practice
Alcohol use frequently coexists with other health problems, and sometimes obscures them: sleep disorders, liver disease, heart disease, anxiety, trauma, chronic pain. Because we are a medical practice first, we diagnose and treat these concurrent conditions with the same team, and bring in the right specialists when they are needed.
Research on integrated care supports the approach, particularly for patients whose medical conditions are connected to their drinking, and it matches what we have seen in practice.
There are two ways to work with us. Patients who already have primary care in place can join the treatment program on its own. Patients who want the full experience can join the concierge practice with the treatment program built in, so that overall health, medical conditions, and recovery are assessed, treated, and monitored together.
Your Treatment Team
Paul Abramson, MD
Medical Director & Founder
Kelly Yi, PhD
Psychotherapist
Orion Harris, LMFT
Psychotherapist
Rochelle RN
Nurse Specialist
Robert RN
Concierge Nurse
The Larger Goal
Treating alcohol use disorder is rarely the end in itself. It is often the foundational first step, necessary before we can work on the larger goal of restoring health, extending the years you spend functional and independent, and helping you achieve the life you want.
More Than One Way Forward
If alcohol is causing problems in your life or health, contact us for a confidential consultation. We can help you understand your options and create a treatment plan.