Alcohol dependence: how to get help in the UK, from first conversation to recovery

The NHS describes alcohol-use disorder as drinking alcohol in a way that is harmful, which people sometimes call alcoholism. Dependence is the more severe end: the NHS says that if you have become dependent on alcohol you will have found it difficult to fully control your drinking in some way, and you will probably need help either to cut down and control it or to stop completely, plus plans to maintain the improvement afterwards.

Dependence is a health condition, not a failure of willpower. Its signs, according to the NHS, include regularly drinking more than you mean to, difficulty stopping or reducing even if you want to, feeling guilty after drinking, people you know being concerned, continuing to drink despite problems for health, work or relationships, craving alcohol, needing increasing amounts for the same effect and getting withdrawal symptoms when you stop or reduce.

If you recognise several of these, you are not alone and you do not have to wait until things are at crisis point to ask for help.

The NHS says realising you have a problem with alcohol is the first big step to getting help. You may need help if you often feel the need to have a drink, other people warn you about how much you are drinking, or you think your drinking is causing you problems.

A GP appointment is the usual starting point. The GP may suggest different types of assessment and support from local community alcohol services, and you can ask about free local support groups and other alcohol counselling. The NHS says a GP or alcohol service will ask about your drinking and how it affects your life, may ask you to fill in a questionnaire and may offer blood tests to check whether drinking is affecting your health.

If you are not sure how serious the problem is, the NHS points to a drinking self-check on the Alcohol Change UK website. You can also speak to a GP or alcohol service if you are worried about someone else's drinking.

The NHS says it can be very dangerous to stop drinking suddenly if you are dependent on alcohol, and that if you get withdrawal symptoms you should get medical help before trying to stop. Withdrawal symptoms begin within 6 to 12 hours of the last drink and usually last from 3 to 7 days, although some symptoms may last for a few months, especially if you drink heavily.

Milder symptoms listed by the NHS include anxiety, difficulty sleeping, feeling or being sick, a racing heartbeat, sweating and shaking. The NHS says the sorts of mild or moderate symptoms that suggest you may need medicine include anxiety after waking, sweating and mild tremors, and nausea, retching or vomiting in the morning.

Call 999 or go to A&E if you or someone else has severe withdrawal symptoms such as visible shaking, unusual restlessness or irritability, confusion, seeing, hearing or feeling things that are not there, or a seizure. Do not drive yourself; ask someone to drive you or call 999 and ask for an ambulance.

You can get treatment from your GP or from a specialist alcohol addiction service. The NHS lists the elements below as possible parts of treatment, and the mix depends on your situation.

The NHS says self-help or mutual aid groups, such as Alcoholics Anonymous (AA) and SMART Recovery, are accessible in most areas. AA is a free self-help group with a 12-step programme, and SMART Recovery groups help people decide whether they have a problem, build motivation to change and offer tools and techniques to support recovery.

The NHS also says that relying only on family, friends or carers for long-term support often is not enough, and suggests asking a GP or alcohol service what longer-term support is available locally. Drinkline is the national alcohol helpline for people worried about their own or someone else's drinking; the NHS gives its opening hours and number on its alcohol support page.

The NHS lists Al-Anon Family Groups for families and friends of problem drinkers, Alateen for 12 to 17-year-olds affected by someone else's drinking, Adfam for families affected by drugs and alcohol, and the National Association for Children of Alcoholics (Nacoa) for children of alcohol-dependent parents. The Carers Trust website has information about caring for someone with alcohol or substance misuse issues, and Alcohol Change UK has guidance for friends and family.

Supporting someone with dependence can be draining. Seeking help for yourself is not selfish, and it often makes you better able to support them.

The NHS says drinking too much alcohol is very bad for health and that stopping is the best way to reduce the risk of serious problems. Short-term risks include serious accidents or injuries and alcohol poisoning. Longer-term risks include liver damage such as alcohol-related liver disease, an increased risk of many types of cancer, high blood pressure and stroke, heart problems including cardiomyopathy and heart failure, pancreatitis, mental health conditions such as anxiety and depression, and alcohol-related brain damage.

If you are pregnant or planning a pregnancy, the NHS recommends not drinking any alcohol, because it increases the risk of miscarriage, stillbirth and premature birth and puts the baby at risk of long-term problems such as fetal alcohol spectrum disorder. If you find it hard to stop while pregnant, speak to a GP or alcohol support service.

The NHS says local authorities are responsible for alcohol treatment services, and that intensive residential rehabilitation may require an additional assessment to determine whether there is funding. It is also possible to pay for residential rehabilitation privately, and medical insurance companies may fund it for a certain period. Detoxification, where needed in a unit, may be in an NHS inpatient unit or a medically supported residential service, depending on your situation and the assessed medical need.