From the Guidelines
To maintain abstinence from alcohol and prevent relapse, I strongly recommend developing a comprehensive lifestyle plan that incorporates regular physical activity, mindfulness practices, creative hobbies, and strong social connections, as supported by the most recent and highest quality study 1.
Key Components of a Relapse Prevention Plan
- Regular physical activity: aim for at least 30 minutes of moderate activity most days to release endorphins that improve mood and reduce stress, as suggested by the importance of managing triggers for drinking 1
- Mindfulness practices: engage in meditation, yoga, or deep breathing exercises to manage cravings and emotional triggers, which is a crucial aspect of psychosocial treatment for alcohol dependence 1
- Creative hobbies: pursue activities like painting, music, cooking, gardening, or photography to provide healthy dopamine stimulation, replacing the stimulation once provided by alcohol
- Strong social connections: build alcohol-free relationships by joining clubs, volunteer organizations, or recovery support groups like AA, SMART Recovery, or Refuge Recovery, which is essential for successful therapy and maintaining abstinence 1
Importance of Professional Support
- Combine lifestyle changes with professional support, including counseling or medications like naltrexone or acamprosate, when necessary, as recommended by 1 for patients with alcohol abuse/dependence
- Establish consistent daily routines with regular sleep patterns, proper nutrition, and scheduled activities to provide structure and support abstinence
- Prepare coping strategies for when cravings occur, such as calling a support person, engaging in physical activity, or using distraction techniques, which can be developed through individual psychotherapy and group therapy 1
Effective Psychosocial Treatment
- Active psychological support should focus on the environment, reasons, and expected consequences of drinking, accompanied by family and group therapy, as outlined in the psychosocial treatment guidelines 1
- Brief interventions, such as motivational interviewing and counseling, can be effective in reducing risky drinking behavior and risk of ALD, and can be implemented in various healthcare settings 1
From the FDA Drug Label
Treatment with acamprosate calcium delayed-release tablets should be part of a comprehensive management program that includes psychosocial support Acamprosate calcium delayed-release tablets have been shown to help maintain abstinence only when used as a part of a treatment program that includes counseling and support.
Lifestyle and hobby recommendations to maintain abstinence from alcohol and prevent relapse are not explicitly stated in the FDA drug label. However, it is mentioned that treatment with acamprosate should be part of a comprehensive management program that includes psychosocial support.
- This implies that patients should engage in activities that provide emotional and social support, such as:
- Counseling
- Support groups
- Therapy
- Patients should also be advised to continue therapy as directed, even in the event of relapse, and to discuss any renewed drinking with their physicians 2, 2.
From the Research
Lifestyle and Hobby Recommendations
To maintain abstinence from alcohol and prevent relapse, several lifestyle and hobby recommendations can be suggested based on the available evidence:
- Balancing one's lifestyle is crucial, as suggested by the relapse prevention model proposed by Marlatt and Gordon 3
- Developing positive addictions, such as hobbies or other interests, can help individuals cope with high-risk situations and reduce the likelihood of relapse 3
- Engaging in cognitive-behavioral interventions, such as identifying high-risk situations and enhancing coping skills, can also be beneficial in preventing relapse 3, 4, 5, 6
- Combining pharmacotherapies, such as naltrexone and acamprosate, with cognitive-behavioral therapy may be superior to either medication alone for achieving alcohol abstinence 6
Pharmacotherapies for Alcohol Use Disorder
Several pharmacotherapies have been approved for the treatment of alcohol use disorder, including:
- Disulfiram, naltrexone, and acamprosate, which are approved by the US Food and Drug Administration (FDA) 7
- Naltrexone has been shown to be effective in reducing the risk of heavy drinking and improving drinking outcomes 4, 5
- Acamprosate has been shown to be effective in reducing drinking outcomes, although its efficacy may be limited compared to naltrexone 4, 5, 6
Cognitive-Behavioral Interventions
Cognitive-behavioral interventions, such as cognitive-behavioral therapy (CBT), can be effective in preventing relapse and achieving alcohol abstinence: