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Treatment
Medication management for drinking, in the open: the evaluation, the safety screen, the medicine classes, the measurement, and what happens when the plan needs to change.
Every plan here starts the same way: a full hour of history, an honest count of drinks per week and heavy drinking days, an AUDIT-C score, and a withdrawal screen that covers how much you drink, for how long, what your mornings look like, and what happened on past attempts to cut down or stop. Labs are drawn where they matter, including the liver and kidney numbers that decide which medicines are safe candidates. Nothing is prescribed before that screen, because for a heavy daily drinker, stopping suddenly can be dangerous, and the level of care has to be set before the first prescription is written.
What you drink, how often, and what a typical week actually looks like, counted plainly. Your drinking history, your past attempts, and everything else you take all go on the table. A plan built on an edited number fails the person, not the prescriber.
Withdrawal risk is graded from your amount, your duration, your mornings, and your past attempts. If the screen shows significant risk, a medically supervised withdrawal comes first and this practice picks the plan up afterward. Labs follow where they will change a decision.
The first medicine is picked for your goal: a class that lowers craving, a class that takes the reward out of a drink, or a class that steadies the system and prevents relapse. The choice is made with you, after evaluation, and no medicine is promised to any reader in advance.
At every Follow-up Appointment the count is reviewed: drinks per week, heavy drinking days, and craving, against the goal you set. The AUDIT-C is re-scored at intervals, including at week 12. If the numbers are moving, the plan holds. If they are not, the medicine, the timing, or the goal is adjusted with the data on the table.
A reduction plan that keeps failing is information, and so is a stopping plan that starts to work. Goals change as the data comes in, and a lapse is treated as data about where the plan is thin, never as a verdict on the person running it.
Medicines that lower craving. Craving is the engine of the pattern: the thought that arrives at the same hour every day and negotiates. This class turns that volume down, so a decision made in the morning survives the evening.
Medicines that take the reward out of a drink. Alcohol pays out in the brain's reward system, and that payout trains the habit. This class blocks the payout, so a drink delivers less of what keeps the pattern going, and the pattern weakens over weeks.
Medicines that steady the system and prevent relapse. After stopping, the brain chemistry alcohol was supplying has to rebalance. One medicine in this group supports that rebalancing; another makes drinking physically costly, so the decision is made once, in the morning. None of them is a controlled substance, none is habit-forming, and none will make you feel medicated.
The sedative family used in hospital withdrawal settings is not started here for drinking. It overlaps with alcohol in the brain, which makes it the wrong tool outside a supervised withdrawal: it can form a dependence of its own, and mixing it with alcohol is dangerous. The medicines on this page manage craving and relapse. They are never a home detox, and no plan here asks you to stop suddenly on your own.
Follow-up Appointments are 30 minutes. Each one reviews the count, the craving, side effects, and the goal, and includes brief solution-focused work on the situations the plan is not covering yet. Early on, visits run close together while the medicine is chosen and the count is settling; the cadence after that is set by your numbers, and it is reviewed out loud, not assumed.
With your written consent, your prescriber coordinates with your therapist and your primary care physician, so the medication decisions and the rest of your care pull the same direction. If you came here looking for talk therapy itself, Solutions Psychiatry offers it at psych.us. This practice is medication management.
Book a Comprehensive Initial Appointment. The safety screen and the honest count come first, and the plan is built on both.
Book appointmentThe same care and the same prescriber, whether your plan pays or you do.
