The 5 Best Therapies for Treating Alcohol and Drug Use - GoodRx (2024)

If you’re struggling with drug or alcohol use, you’re not alone. Substance use disorders affect up to 1 in 12 adults in the U.S. Fortunately, there are good medications and therapies that can help you on the road to recovery.

If you’re hoping to make a change, it can be hard to know where to begin. There are many different types of medications and therapies used to support recovery. But how do you know which one is right for you?

Understanding which therapies are “evidence-based” (backed by science) can help you make the right choice. Read on for more information about how therapy can treat substance use disorders and which types of therapy have evidence to support them.

How are substance use disorders treated?

A substance use disorder is a mental health condition in which drugs or alcohol causes significant problems in your personal or professional life.

Substance use disorders are generally treated with:

• Therapy

• Medications

• A combination of therapy and medications

In some cases, your treatment might also include:

• Medical devices

• Smartphone and tablet apps

• Treatments for other mental or physical health problems

Substance use treatment is never one-size-fits-all. The type of treatment that is best for you will depend on your mental and physical health, what substance(s) you are using, and your personal preferences.

What does ‘evidence-based’ treatment mean?

Evidence-based is a term used in medicine to describe a treatment that has been rigorously tested and shown to be helpful.

An evidence-based treatment is:

• Supported by published scientific data

• A treatment that has been tested/tried successfully more than once

• A treatment that has worked for different groups of people and in different settings

Using therapy to treat drug and alcohol use disorders

Talk therapy (counseling) is the most commonly used treatment for substance misuse. Therapy is a treatment that helps people with emotional, physical, and mental health problems function better.

If you have a substance use disorder, therapy can help you:

• Feel hopeful

• Feel heard and seen

• Understand and change your behavior

• Understand your lifestyle choices

• Understand how your relationships affect your substance use

• Improve your relationships at home, school, and work

• Learn new life skills

• Cut down or stop your substance use

During therapy, you meet with a therapist or counselor. In some types of therapy, you meet one-on-one. Other types of therapy include your partner, your family, or your peers.

Keep in mind that most people need at least 3 months in treatment to significantly change their substance use. You can also choose to do more than one type of therapy. For example, you could have a couples therapist but also be involved in a 12-step program.

What are the best evidence-based therapies for substance use?

There are many different types of talk therapy that are backed by science:

1. Cognitive behavioral therapy (CBT): CBT is a one-on-one therapy during which you meet privately with a therapist over a period of time. It’s often considered the most effective therapy for drug and alcohol use disorders.

   CBT has been studied in many large trials. There’s evidence that it reduces substance use and improves life in other areas. It works for many different types of substance use disorders. CBT may also prevent relapses, even after you’ve stopped therapy.

2. Couples therapy: This is a therapy in which you and your partner meet with a therapist over a period of time. There is evidence that this type of therapy reduces substance use, improves your relationship with your partner, and decreases domestic violence.

3. Multidimensional family therapy (MDFT): MDFT is aimed at teens and young people with drug and alcohol problems. The whole family meets together with a therapist over a period of time. There’s evidence that MDFT can help uncover family influences on substance use as well as improve overall family functioning.

4. Motivational enhancement therapy (MET): MET is a short-term treatment in which you meet with a therapist or healthcare provider for one to four sessions. It’s also sometimes called motivational interviewing. There’s evidence that MET can have a positive effect on substance use disorders, especially if you’re still deciding on your personal goals.

5. 12-step therapy programs: Twelve-step programs (like Alcoholics Anonymous and Narcotics Anonymous) are self-help group therapy programs. There’s evidence that these programs are as good — and sometimes even better — as other types of therapy for achieving and maintaining sobriety from alcohol. These programs may also be more cost-effective and easier to find than other therapies.

Is medication-assisted therapy right for me?

Medication-assisted therapy (MAT) is a combination of medications and talk therapy.

Depending on your substance use, MAT could be the best option for you. MAT can help with recovery from alcohol and opioid use. In fact, there’s evidence that MAT is the most effective treatment for opioid use disorder.

Along with therapy, prescription medications can reduce withdrawal symptoms and substance cravings. Some can even be used long-term to help you stay in recovery.

What’s the difference between outpatient, inpatient, and residential treatment?

Substance use treatment usually takes place in one of these three settings:

• Outpatient treatment: This is treatment during which you live at home and go to therapy 1 to 2 times a week, either in person or through telemedicine (virtual visit). There are also more intensive outpatient programs during which you go to therapy multiple days a week.

• Inpatient treatment: In this treatment, you stay in a hospital for 24 hours. This is usually for people who need more daily structure or who need a supervised medical detox. Inpatient treatment is usually short-term, lasting for less than a month.

• Residential treatment: This is treatment during which you live in a therapeutic community, usually for months or years. The goal is to disconnect yourself from your current environment and habits and to gain knowledge about yourself and your substance use.

Need more information? Learn more about all of the different types of substance use treatments — and different levels of care — in our GoodRx guide to recovery.

Do I need to do a detox?

It depends. If you are physically dependent on drugs or alcohol, your treatment may need to start with a supervised detox.

A detox is the process of alcohol and/or drugs leaving your body. Detox is not a treatment by itself, but it can prepare you for starting other types of treatment,including therapy.

Detox can either be done as an inpatient or as an outpatient treatment with medical guidance.

Taking the next step

If you’re looking for help with substance use, the Substance Abuse and Mental Health Services Administration (SAMHSA) treatment locator can connect you with a provider in your area. You can also check out our GoodRx guide to finding a therapist as well as our resources for finding (or building) a support network for recovery.