What alcohol addiction involves and where alcohol craving comes from
In the international classification of diseases ICD, alcohol addiction carries the code 6C40.2, and in the older ICD-10 version the code F10.2. We therefore treat it in the same way as other chronic illnesses. A doctor makes the diagnosis from the history and the examination, not from the number of glasses someone has drunk.
Patients usually describe the same order of events: first the amount of alcohol needed for the same effect grows, then drinking moves from weekends to weekdays, and finally the thought of alcohol returns despite the resolution that this time the patient will not drink. That order follows from a change in how the brain works: regular drinking disrupts the reward system and the stress response system, so the decision not to drink stops being enough on its own.
The diagnosis rests on several symptoms that occur together over a longer period. They include alcohol craving, tolerance, that is the need for larger and larger amounts of alcohol, drinking despite the illnesses it has caused and despite conflicts in the family, withdrawal symptoms after a break in drinking, and no control over when the patient starts and stops drinking. Alcohol addiction follows a chronic, relapsing course, so we plan treatment in months and treat a return to drinking as part of the course of the illness and as something to work on in psychotherapy.
When a doctor calls drinking harmful and when they diagnose addiction
Patients usually ask one thing: whether this is already addiction. Medicine distinguishes three categories of drinking. Risky drinking has not caused harm yet, but it raises the probability that harm will appear. Harmful drinking has a separate code in the ICD classification, F10.1. Damage to health, family life or work has already occurred, but the patient keeps control over their drinking. Addiction, that is F10.2, we diagnose only once alcohol craving and withdrawal symptoms join in.
The line between these three categories is not set by the amount of alcohol drunk, but by what the drinking has caused. That is why the AUDIT questionnaire, developed by the World Health Organisation, asks not only about the number of drinks, but also about morning drinking, about gaps in memory and about whether anyone around the patient has been worried by their drinking. A high score is a reason for a medical consultation, not a diagnosis.
There is no line expressed in litres. The World Health Organisation stated in 2023 that no amount of alcohol is safe for health. Whether drinking calls for treatment is settled by the harm that has already occurred and by the loss of control over how much the patient drinks.
Why alcoholism treatment cannot be closed in a single appointment
At a single appointment the doctor makes the diagnosis and draws up a treatment plan, but alcoholism treatment itself takes months. At the medical consultation we take a history of the drinking and of coexisting illnesses, assess the risk connected with alcohol withdrawal and settle where we start: with detox, with medication or with psychotherapy.
From there the order stays the same: we begin by stabilising the patient's health, then we bring in oral medication or the Esperal implant to secure the months ahead, in parallel the patient starts psychotherapy, which we describe on the page about addiction therapy in Gliwice, and at the end we move to supportive care. Psychotherapy takes up the most time in this plan, because that is where the patient learns to cope without alcohol.
We set out the plan for one, three, six or twelve months. The monthly variant covers stopping the drinking, tests and setting up the medication. Longer variants give time to work on the situations in which the patient reached for alcohol and to consolidate the change. No procedure and no medicine will shorten alcoholism treatment to a week.
We work privately, so the patient does not wait months for an appointment. We do not provide anonymous treatment: every visit goes into medical records, which we store as the regulations require. We are bound by medical confidentiality, so without the patient's consent we tell neither their family nor their employer about the treatment.
Who is treated in Gliwice as an outpatient, who in a centre and who online
The setting is decided by the doctor at the consultation, after examining the patient. They check how severe the withdrawal symptoms may turn out to be, which illnesses coexist with the drinking and who at home can support the patient.
Outpatient alcoholism treatment in Gliwice
Outpatient care suits patients without severe health complications who are able to travel in for further appointments. Tests and procedures take place at Toszecka 18, and we arrange the remaining visits around the patient's own timetable, shift work included. The patient does not have to take sick leave or leave Gliwice for treatment.
Alcoholism treatment in a residential centre in Gliwice
We suggest a stay at the centre when the addiction is advanced, when other illnesses are present alongside it, or after attempts at outpatient treatment that ended in a return to drinking. A separate reason is a home where alcohol is drunk every day. A few weeks away from such a home give the patient room to start psychotherapy. The rules of the stay and the course of a single day are set out in our description of the addiction treatment centre in Gliwice.
Online alcoholism treatment and e-prescriptions in Gliwice
Online we run check-up visits and some of the psychotherapy sessions, and we issue e-prescriptions. Remote visits are chosen above all by patients travelling in from outside Gliwice and by drivers and service technicians who work on the road. We do not qualify a patient for the Esperal implant remotely. We do not treat acute withdrawal syndrome remotely either, because the doctor assesses the severity of withdrawal symptoms only after examining the patient at the practice.
When the doctor proposes the Esperal implant and when tablets
The Esperal implant is a disulfiram implant placed under the skin. As long as the medicine works, drinking alcohol ends in a disulfiram reaction: the skin reddens, the heart races, blood pressure falls and vomiting follows. The procedure discourages the patient from reaching for alcohol, but it does not treat alcohol addiction, because it does not reduce alcohol craving. The qualification for the procedure, the contraindications and the course of the appointment are described in detail on the page about the Esperal implant in Gliwice.
Oral medicines work differently from the implant and each of them solves a different problem. Naltrexone blocks the receptors through which alcohol gives pleasure: after a drink the patient does not feel the expected reward, less often goes on to the next glass, and alcohol craving weakens as well. Acamprosate stabilises the nervous system, which after years of drinking stays overactive for weeks after alcohol is withdrawn, and it helps the patient stay abstinent. Nalmefene is taken as needed, on a day when the patient expects an occasion to drink; the tablet weakens the urge to carry on drinking and serves to limit how much alcohol patients drink when they are not ready for abstinence yet. Disulfiram in tablets produces the same reaction to alcohol as the Esperal implant, but it works for a shorter time and the patient has to take it every day.
The doctor decides which medicine to use. Before the first prescription they order liver tests and a full blood count, review the medicines the patient takes regularly and ask about the goal for the coming months: full abstinence or reduced drinking. Pharmacotherapy on its own is not enough. Medicines lower alcohol craving, but they change neither the habits nor the reasons for drinking. The patient does that work in psychotherapy.
The risk of stopping alcohol abruptly and the role of detox
Detox is needed when the patient breaks off a binge lasting several days, when they have been drinking every day for weeks, or when earlier attempts to withdraw alcohol brought on seizures or alcohol-related delirium. Medical staff then guide the patient through withdrawal and give medicines that ease the symptoms. The name is misleading: detox is not about cleansing the body of toxins. The body breaks alcohol down on its own, and we give medicines to control the symptoms that appear once alcohol is withdrawn.
After a long binge, stopping drinking abruptly risks withdrawal seizures and alcohol-related delirium. Both are life-threatening and call for immediate medical help, so after a heavy binge the patient should not withdraw alcohol without supervision.
Detox breaks the binge and removes withdrawal symptoms. Alcohol craving stays afterwards, and so do the habits that led the patient to drink, so without further treatment the drinking comes back. That is why we set the date of the first psychotherapy session before the detox ends. What happens over the following days of detoxification and which medicines we give then are described on the page about alcohol detox in Gliwice.
What happens in treatment when the patient drinks alcohol again
A return to drinking during alcoholism treatment happens to a large proportion of patients and does not cancel out the earlier months of work. The longer the patient puts off calling us, the greater the risk that one evening turns into a binge lasting days.
Once the patient gets in touch, we first check their health and whether withdrawing alcohol calls for medical supervision. Then we go back to the interrupted treatment plan: we work out what came before the return to drinking, correct the pharmacotherapy and schedule the sessions more closely together for the coming weeks. A return to drinking usually announces itself: a medicine stopped, psychotherapy sessions missed, insomnia, a row at home, or going back to company where people drink every day.
The patient does not start the treatment from the beginning at that point and does not have to justify their drinking to us. We fix whatever did not work in the plan: the dose of the medicine, the frequency of sessions or the setting of treatment. The rest of the plan stays as it is, because the skills gained in the earlier months of psychotherapy remain with the patient.
What we do in the months when the risk of relapse is highest
In the first months after alcohol is withdrawn the risk of relapse is at its highest, so we do not end care as soon as the intensive stage of treatment finishes. Visits become less frequent, but each one has a set goal.
Relapse prevention takes up the most time then. Together with the therapist, the patient lists the situations after which they used to drink: payday, a business trip, a family name day, an argument at home, a lonely evening after a shift. For each of them they prepare a response plan and practise it before such a situation returns. That is also when matters put aside during intensive treatment come back: the return to full-time work, sorting out debts and rebuilding family relationships.
In some patients we extend pharmacotherapy beyond the intensive stage of treatment: the patient takes naltrexone or acamprosate for as long as the doctor recommends. We also encourage patients to join free self-help groups, where they meet people who have been through similar treatment. Taking part is voluntary and does not replace psychotherapy.
Who in the family looks for help first and what they can do
A 2025 survey of Gliwice residents, cited by the city prevention programme, shows a difference in who speaks about the problem: men more often report difficulties with alcohol in themselves, women more often point to addiction in someone close to them. The authors give this difference descriptively, without percentages, and it comes from the same survey as the figures quoted below. We see the same pattern at our own reception: a relative calls more often than the person who drinks.
Life next to a person who drinks changes the rhythm of the whole household: relatives keep track of how much alcohol is drunk, hide the drinking from the wider family and the neighbours, pay off the debts of the person who drinks and explain their absences at work. We call this settled way in which a family functions codependency. We run therapy for codependency separately, including when the person who drinks does not want treatment. Children brought up in such a home enter adulthood with difficulties in relationships and with trust, and these do not pass without psychotherapy. The abbreviation DDA, for adult children of alcoholics, is the term commonly used for them.
The biggest change comes at the moment when relatives stop protecting the person who drinks from the results of drinking, yet keep in touch with them. If the person who drinks will not go for treatment, the family can notify the gminna komisja rozwiązywania problemów alkoholowych (the municipal commission for solving alcohol problems), and the commission, if it finds the case justified, submits a request to the district court for an obligation to undergo addiction treatment.
How we treat a patient who has depression alongside alcohol addiction
At the first consultation we ask every patient about symptoms of depression and anxiety and about the consequences of past traumatic events. Depression and anxiety disorders coexist with alcohol addiction in a considerable share of the patients we treat. In one patient the drinking started as a way of suppressing anxiety or insomnia, in another the depressive symptoms appeared after years of drinking.
When depression is left untreated, the patient usually goes back to drinking despite addiction therapy. It works the same way round: antidepressants bring no improvement as long as the patient drinks. That is why we treat both conditions in parallel, within one team. The psychiatrist diagnoses and treats the depression or the anxiety disorder, the addiction therapist leads the work on drinking, and the patient does not book appointments separately at two facilities.
We promise no quick result here. Treating two diagnoses takes longer than treating alcohol addiction alone, and we correct the medicines and the frequency of sessions several times along the way.
How many Gliwice residents see an alcohol problem in others and how many in themselves
The municipal programme for the prevention and resolution of alcohol problems and for counteracting drug addiction for 2026-2029, adopted by the Gliwice City Council in November 2025, rests on a diagnosis of social problems carried out in the same year. It shows that almost 40% of the residents surveyed notice an alcohol problem in the people around them, while 1.7% admit to difficulties with alcohol in themselves. Both figures are declarations from a survey completed by 1,136 residents who came forward on their own, so 1.7% is not the share of Gliwice residents who are ill.
We meet the same difference in calls from Gliwice: the problem is seen by the people around, and the person who drinks hears about it from the family. The authors of the diagnosis put this difference down to low self-awareness and fear of being judged by others, and they note that the real scale of the problem may be larger than the declarations show. At the first appointment we therefore settle whether this is harmful drinking or alcohol addiction. The patient does not have to call themselves an alcoholic beforehand.
