What Is Alcohol?

Alcohol is a central nervous system depressant and the most widely used substance in the United States. It is legal for adults over 21 and socially accepted in most contexts, which often makes alcohol use disorder harder to recognize than other substance use disorders — both by the person using and by the people around them. Alcohol use disorder (AUD) is defined in the DSM-5 by a set of clinical criteria; meeting even a few of them is enough for a mild-severity diagnosis.

Physical dependence on alcohol develops through repeated, heavy use and reflects changes in brain chemistry. Over time, the brain adapts to the presence of alcohol by shifting the balance of excitatory and inhibitory neurotransmitters. When alcohol is removed, that shifted balance produces withdrawal symptoms — and for patients with severe long-term dependence, withdrawal can be medically dangerous.

Alcohol use disorder affects a significant portion of adults in Southeast Tennessee and North Georgia, and effective outpatient treatment is available. Vivitrol, a monthly injection of naltrexone, is one of the most effective FDA-approved medications for alcohol use disorder and forms the medical foundation of our treatment program.

The Tennessee Picture

Alcohol use disorder affects a significant portion of adults in Tennessee. While the state’s overdose surveillance (SUDORS) excludes alcohol-only deaths, the broader health burden is substantial — and alcohol often appears alongside other substances in fatal overdoses.

  • Tennessee’s overdose death rate in 2023 was 57% higher than the national rate, the fourth-highest in the United States — and alcohol is frequently present in polysubstance cases.
  • Alcohol was detected in roughly 19% of Tennessee’s 2023 fatal drug overdoses, most often mixed with opioids, benzodiazepines, or both.
  • When alcohol is mixed with opioids or benzodiazepines, the combined respiratory depression sharply increases overdose risk — a common and often underrecognized pattern in Tennessee.

The wider public health data on alcohol use disorder in Tennessee is tracked separately from SUDORS, but the clinical picture is clear: alcohol remains one of the most-used substances in the state, one of the most harmful, and one of the most treatable with the right support.

Sources: Tennessee SUDORS Report 2025 (Tennessee Department of Health, June 2025); Tennessee Overdose Response Coordination Office Annual Report 2023/24 (TDH, May 2025).

Signs of Alcohol Use Disorder

Alcohol use disorder is diagnosed using DSM-5 criteria. Common signs include:

  • Drinking more or longer than intended. Starting with one drink and ending with several, or planning to stop at a certain hour but continuing past it.
  • Unsuccessful attempts to cut down. Wanting to drink less but being unable to stick with it.
  • Spending significant time on alcohol. Drinking, obtaining alcohol, or recovering from its effects.
  • Cravings. Strong urges to drink, especially in particular situations or times of day.
  • Interference with responsibilities. Drinking affecting work, family, or daily responsibilities.
  • Continued use despite consequences. Health, relationship, financial, or legal consequences that haven’t led to stopping.
  • Giving up activities. Dropping hobbies, social activities, or commitments because of drinking.
  • Drinking in risky situations. Driving after drinking, operating machinery, or other behaviors with physical risk.
  • Tolerance. Needing more alcohol to feel its effects.
  • Withdrawal symptoms when you stop drinking: tremors, sweating, anxiety, insomnia, nausea, or — in severe cases — seizures.

You do not need to meet every criterion to benefit from treatment. If even a few of these apply, a professional evaluation can help clarify where you are and what options exist.

Alcohol Withdrawal: Timeline and Symptoms

Alcohol withdrawal is different from most other substance withdrawals in one important way: severe alcohol withdrawal can be medically dangerous and, in rare cases, fatal. Most patients with mild-to-moderate alcohol use disorder can stop drinking safely on an outpatient basis, but patients with a long history of heavy daily drinking may need a higher level of care during the initial withdrawal period.

A general timeline for alcohol withdrawal looks like this:

  • First 6 to 12 hours. Early symptoms: mild anxiety, restlessness, tremors, headache, nausea, sweating, insomnia.
  • 12 to 24 hours. Peak mild-moderate symptoms: worsening anxiety, tremor, rapid heart rate, elevated blood pressure. Some patients may experience brief hallucinations or confusion.
  • 24 to 48 hours. Highest risk period for alcohol withdrawal seizures, typically in patients with a long history of heavy use.
  • 48 to 72 hours. Risk of delirium tremens (DTs) in patients with severe dependence — marked by confusion, severe agitation, autonomic instability, and hallucinations. DTs is a medical emergency.
  • Day 4 to day 7. Acute symptoms gradually subside in most patients.
  • Week 2 and beyond. Post-acute symptoms may continue: sleep disruption, mood changes, and intermittent cravings.

Your provider will assess your drinking history to determine whether outpatient treatment is appropriate or whether a higher level of care is needed first. For patients with severe dependence or a history of seizures or DTs, we coordinate with regional detox partners before starting Vivitrol-based outpatient care.

How We Treat Alcohol Use Disorder

At Restoration Recovery, alcohol use disorder is treated with a combination of medication and psychosocial support. The primary medication offered is:

  • Vivitrol (naltrexone monthly injection). Vivitrol is an extended-release form of naltrexone, administered as a once-monthly injection. It blocks the reward signals associated with drinking, reducing cravings and lowering the risk of relapse. Vivitrol is non-addictive and can be discontinued at any time without withdrawal effects. At our clinic, Vivitrol is used specifically for alcohol use disorder.

Vivitrol is paired with:

  • Individual counseling with licensed therapists experienced in substance use disorder.
  • Certified peer support from specialists who have lived experience with recovery themselves.
  • Intensive outpatient programming (IOP) for patients who benefit from a more structured treatment schedule — delivered in a group format by design.
  • Integrated care for co-occurring conditions, including anxiety, depression, trauma, and other mental health concerns that often accompany alcohol use disorder.

Restoration Recovery is an outpatient clinic. We do not provide medical detox or residential care. Most patients with alcohol use disorder can begin treatment on an outpatient basis. For patients with severe physical dependence or a history of complicated withdrawal, we coordinate with regional detox partners before starting Vivitrol.

What to Expect at Your First Appointment

Your first visit typically lasts 60 to 120 minutes and follows a four-step clinical flow:

  1. Intake. You’ll complete paperwork and a clinical intake. For alcohol use disorder, this includes a DSM-5 assessment covering AUD criteria and severity, plus a review of your drinking history, current health, and any relevant lab work.
  2. Counseling. You’ll meet with a counselor to discuss your drinking history, prior treatment, and personal recovery goals.
  3. Doctor evaluation. A medical provider reviews your intake and counselor notes, determines whether Vivitrol is clinically appropriate, and explains what to expect before, during, and after the injection.
  4. Treatment plan & Vivitrol ordering. If clinically appropriate, your provider will order your Vivitrol injection during this visit — we don’t stock Vivitrol on-site. Your injection appointment is scheduled as a follow-up once the medication arrives, typically within a few days to a week depending on your insurance and pharmacy. Counseling and peer support begin right away so treatment doesn’t wait on the injection.

Bring a valid photo ID, your insurance card if applicable, and a list of any medications you currently take.

Why Vivitrol and Counseling Work for Alcohol Use Disorder

Vivitrol is endorsed as an evidence-based treatment for alcohol use disorder by the American Society of Addiction Medicine and the Substance Abuse and Mental Health Services Administration. Large randomized controlled trials have demonstrated that Vivitrol:

  • Significantly reduces the number of heavy drinking days compared with placebo
  • Helps patients stay engaged in treatment longer
  • Reduces alcohol cravings and the reinforcing effects of drinking
  • Works best when combined with counseling and psychosocial support
  • Has no abuse potential and can be discontinued at any time without withdrawal

Alcohol use disorder is a medical condition — not a moral failing — and medications like Vivitrol are a legitimate part of treatment. The goal is to reduce cravings and the pull of drinking enough that counseling, peer support, and lifestyle changes become genuinely workable. Many patients describe Vivitrol as “taking the edge off” the constant pull of alcohol, making the rest of recovery more achievable.

Why Restoration Recovery

Choosing where to start treatment matters. Restoration Recovery brings together the clinical depth, the practical access, and the kind of care that keeps patients in treatment long enough to get well.

  • Chattanooga’s longest-running outpatient addiction treatment clinic. Our providers have decades of clinical experience treating opioid and substance use disorders in Southeast Tennessee.
  • CARF accredited. The Commission on Accreditation of Rehabilitation Facilities is the gold standard for outpatient addiction care — our accreditation is reviewed on an ongoing basis, not a one-time stamp.
  • Four clinic locations across Southeast Tennessee and North Georgia, with telehealth follow-up available for established patients.
  • Most major insurance accepted — TennCare, Georgia Medicaid, commercial plans, Medicare, and supplemental Medicare. Our patient services team verifies your benefits before your first visit so there are no surprises.
  • Same-day appointments in most cases. You don’t have to wait weeks to start.
  • One integrated team. Medical providers, counselors, certified peer support specialists, and psychiatric care under one roof — not parallel referral tracks that leave you coordinating your own care.
  • Licensed in both states. Licensed in Tennessee and Georgia, HIPAA compliant, 42 CFR Part 2 compliant — your treatment is confidential from the first phone call.

Insurance and Access

Restoration Recovery accepts most major insurance plans, including TennCare, Georgia Medicaid, a broad range of commercial plans, and Medicare (plus supplemental Medicare plans). Our patient services team can verify your benefits before your first appointment so you know exactly what to expect in terms of cost.

If you do not have insurance, contact us anyway. We can help you explore options and will walk you through self-pay pricing. For a full list of accepted carriers and details on the verification process, visit our insurance page.

Four Clinic Locations

We operate four outpatient clinics across Southeast Tennessee and North Georgia. All locations offer alcohol addiction treatment with same-day appointments in most cases:

  • Chattanooga, TN — 6141 Shallowford Rd, Suite 100, Chattanooga, TN 37421
  • Cleveland, TN — Serving Bradley County and surrounding areas
  • Soddy-Daisy, TN — Serving Hamilton County north and the Sequatchie Valley
  • Ringgold, GA — Serving Catoosa County and Northwest Georgia

Telehealth follow-up visits are available for established patients who have completed their initial in-person evaluation. For directions, hours, and contact information, visit our locations page.

Take the Next Step

Alcohol addiction is survivable, and treatment works. You don’t have to figure this out alone — and you don’t need to have all the answers before you call. You don’t need to be clean before your first appointment. Our team will walk you through the process from your first phone call to your first visit and every follow-up after that.

Same-day appointments are available in most cases. Contact us today to schedule your evaluation, or call 423-498-2000 to speak with our team directly.