Alcohol addiction in the ICD classification and the symptoms that reveal it
Alcohol addiction has its own code in the International Classification of Diseases: 6C40.2 in ICD-11 and F10.2 in the older ICD-10. The doctor makes the diagnosis after taking a history and examining the patient, using the criteria set out in that classification, not by comparing how much someone drinks with the people around them.
The symptoms come from changes that regular drinking causes in the brain. Alcohol alters how the reward system and the stress response work, so tension and difficult emotions ease quickly after a drink and return once its effect wears off. That is how alcohol craving develops: the urge to drink comes back regardless of the patient's resolutions, and control over the amount drunk weakens along with it.
The diagnosis rests on several features that persist over time: alcohol craving, loss of control over how much and when the patient drinks, rising tolerance, meaning the need for ever larger amounts, drinking despite the illnesses and conflicts it causes, and withdrawal symptoms after a break in drinking. Under ICD-10, three of these features occurring together within the past year are enough for a diagnosis.
Alcohol addiction runs a chronic, relapsing course. A resolution not to drink rarely holds on its own, because the changes in the brain persist long after the patient stops drinking. This is why we plan treatment in months, and if the patient returns to drinking, we adjust the plan and continue treatment.
When drinking is no longer the patient's decision, but the illness's
Medicine describes two stages of drinking that come before addiction. Risky drinking has not yet caused damage to health, but it raises the probability that it will. Harmful drinking has its own code in the ICD classification, F10.1. Damage to health has already occurred, for example raised liver enzymes, high blood pressure or a depressive episode, but the patient still controls when and how much they drink. We diagnose alcohol addiction, F10.2, only once alcohol craving, loss of control over the amount drunk and withdrawal symptoms are added to that picture.
Before the consultation, patients can fill in the AUDIT questionnaire themselves: ten questions from the World Health Organization about the amount and frequency of drinking and its consequences, or just the first three in the shortened AUDIT-C version. The result is not a diagnosis. It only indicates whether drinking is worth discussing with a doctor, because alcohol addiction is diagnosed from a history and an examination, not from a questionnaire score.
In 2023 the World Health Organization concluded that no amount of alcohol is safe for health. This is why, at the consultation, we ask about the number of drinks consumed, the harm drinking has already caused, and how many hours a week the patient spends drinking and recovering from it the next day.
The stages of alcoholism treatment in Zielona Góra, from consultation to maintaining abstinence
We start alcoholism treatment with a medical consultation at the practice on al. Wojska Polskiego 11. We ask about the pattern of drinking over recent months and about earlier treatment attempts, examine the patient and assess whether stopping alcohol risks seizures or delirium. Only after this assessment do we decide where treatment begins.
We stabilise the patient's health first, and if they are breaking off a long binge, we start with alcohol detox. We then introduce oral pharmacotherapy or place the Esperal implant, to reduce the risk of reaching for alcohol in the first weeks. Alongside this we run addiction psychotherapy in Zielona Góra, which takes up the largest share of the whole plan and teaches the patient to cope with tension without alcohol.
We schedule care for one, three, six or twelve months. A one-month plan covers stopping drinking, setting medication doses and the first psychotherapy sessions. Longer plans include consolidating abstinence and working through the situations in which the patient used to reach for alcohol.
We provide treatment privately, and patients book the first appointment without a referral. We do not treat anonymously, and neither does any other facility, because the regulations require every visit to be recorded in medical documentation and kept on file for a set period. We understand discretion this way: we do not pass on information about the patient to their family or employer without their written consent.
Who we treat in the practice, who in a centre, and who online
The doctor's assessment decides the treatment setting. We check how the patient coped with earlier breaks in drinking, what illnesses accompany the addiction, and whether abstinence can be kept up at home.
Outpatient alcoholism treatment in Zielona Góra
We treat patients on an outpatient basis when stopping alcohol does not risk severe symptoms. We do require that the patient can travel to appointments at the scheduled times. The patient then stays at work and at home, without sick leave and without leaving the city, and we lengthen or shorten the intervals between visits depending on whether they stay abstinent.
Alcoholism treatment at the centre in Zielona Góra
We propose a residential stay for advanced alcohol addiction and coexisting illnesses, after unsuccessful outpatient treatment, and when alcohol is a constant presence in the patient's home. We describe the admission rules and the course of the stay on the page about the addiction treatment centre in Zielona Góra.
Online alcoholism treatment and e-prescriptions in Zielona Góra
At remote appointments we monitor the course of treatment, run part of the therapy sessions and issue e-prescriptions to patients who work outside Zielona Góra. Online, however, we cannot assess a patient in acute withdrawal or qualify them for the Esperal implant, because both decisions require an examination at the practice.
When alcoholism treatment uses the implant, and when it uses tablets
The Esperal implant consists of sterile disulfiram tablets placed under the skin. As long as disulfiram remains in the blood, drinking alcohol triggers a disulfiram reaction: the skin flushes, the heart races, blood pressure drops, and nausea and vomiting follow. A patient who knows about this reaction does not reach for alcohol on impulse, which gives them several months to work in psychotherapy. The implant does not treat the addiction on its own. We describe the preparation for the procedure and the contraindications on the page about the Esperal implant in Zielona Góra.
In tablet form we use three substances, and each changes something different:
- naltrexone blocks the brain receptors through which alcohol produces a sense of relief and pleasure; a patient who drinks does not feel what they were reaching for, so they pour a second drink less often, and over time the urge to drink itself weakens;
- acamprosate eases the irritability, restlessness and shallow sleep that persist through the first months without alcohol, because it calms the excessive activity of nerve cells that lingers after years of drinking;
- nalmefene is taken 1 to 2 hours before a situation in which the patient expects to drink; the drug reduces the urge to have another glass, so the patient ends the evening having drunk less. We prescribe nalmefene to patients whose goal is cutting down rather than full abstinence.
We decide on the medication at the qualifying appointment, after reviewing liver test results and every medicine the patient takes regularly. We also ask directly about the goal for the coming months: full abstinence or cutting down on drinking. Pharmacotherapy alone will not cure the addiction, which is why we build medication into the plan together with psychotherapy and review it at follow-up visits.
How we assess the risk of alcohol withdrawal and when we order detox in Zielona Góra
Alcohol detox treats withdrawal syndrome, the symptoms that appear once someone who drinks every day stops. Hand tremor, sweating, a fast pulse and anxiety appear within the first day after stopping alcohol, and seizures and delirium tremens in the days that follow, which is why the patient stays under medical supervision throughout.
We order detox when the patient has been drinking daily for several weeks or is breaking off a binge lasting several days, when earlier attempts to stop drinking led to seizures or delirium tremens, and also when the patient has a chronic heart or liver condition, or is older.
Stopping alcohol without help after such a binge can end in seizures or delirium tremens, and both conditions require immediate medical attention. A patient who comes to us in the middle of a binge is not offered a first psychotherapy session, but detox run by medical staff. We describe the course of the first day and the medicines given on the page about alcohol detox in Zielona Góra.
Detox ends the binge and removes the withdrawal symptoms, but it does not reduce alcohol craving or change the situations in which the patient used to drink. This is why we arrange the consultation date while detox is still under way, so the patient does not leave withdrawal treatment without a date for the next appointment.
Why drinking returns, and what we then change in the treatment plan
A return to drinking during treatment happens often and is part of how the illness runs its course, not proof of failure. We do not end care because of it and we do not make the patient start over. What decides whether a drink stays a single evening is mainly how quickly the patient gets in touch: the longer they put it off, the greater the risk of returning to daily drinking.
Once the patient gets in touch, we first check their health, because a return to drinking after a longer break can require separate treatment of withdrawal symptoms. We also ask what happened in the days before the drink: whether the patient was taking their medication, whether they attended recent sessions, how they were sleeping, and what happened at home and at work.
We then change what failed in the plan: we choose a different medicine or go back to the implant, arrange more frequent sessions for the coming weeks and add the situation that ended in drinking to the plan. The rest of the plan stays as it is, because the patient still knows their risky situations and has practised responses to them.
What supportive care looks like in the first months of abstinence
In the maintenance stage the patient works with the therapist to list the specific days and situations in which they used to drink. In Zielona Góra, the September Winobranie wine festival almost always appears on that list, alongside family gatherings, coming home after a night shift, or payday. For each such situation the patient draws up a plan and rehearses it with the therapist before it arrives.
Returns to drinking happen most often in the first months of abstinence, which is also when the patient feels better than they have in years: they sleep well, and their appetite and energy come back. That is exactly when it is easiest to decide that further visits are no longer needed, which is why we set their dates well in advance.
Medication usually continues longer than psychotherapy. We do not stop naltrexone or acamprosate on the day of the last session: the patient keeps taking them for several more weeks, and the doctor sets the date to end pharmacotherapy at a follow-up visit.
Self-help groups also help many patients, who meet other people with a similar drinking history there. Taking part is voluntary and does not replace either psychotherapy or medical check-ups.
Codependency in the family and the request to the municipal commission
In a home where someone drinks, the other members of the household gradually take over their duties, cover for them with their employer, pay off their debts and learn to tell from their voice what state they will come home in. We call this pattern of family roles codependency. It does not disappear on the day the person who drinks starts treatment, and it needs its own therapy, separate from treatment of the addiction.
Relatives sign up for codependency therapy themselves and need neither the drinking person's consent nor their decision to start treatment. In this therapy we work on two things: the limits the family can actually hold to, and helping household members stop carrying the consequences of someone else's drinking. If the person who drinks refuses treatment, the family can file a notice with the municipal commission for solving alcohol problems (gminna komisja rozwiązywania problemów alkoholowych, GKRPA), and the commission then applies to the court for an order committing the person to addiction treatment.
How many patients have entered treatment under a court order is shown by the statistics of the regional addiction therapy facility operating in Zielona Góra, collected in the regional programme for the prevention and resolution of alcohol problems for 2022 to 2030. The facility registered 986 people in 2018, 934 in 2019 and 755 in 2020, including 304, 292 and 322 patients respectively referred by the court. The share of court referrals rose in 2020 mainly because the number of people seeking help on their own fell during the pandemic year. The facility admits patients from across the whole voivodeship, so these figures do not describe only residents of Zielona Góra or the years after 2020.
Why we ask about depression and anxiety disorders in alcoholism treatment
Some patients have been drinking for years to suppress the symptoms of another condition: depression, an anxiety disorder or post-traumatic stress disorder. Once alcohol is stopped, these symptoms return, often within the first weeks of abstinence. A patient who gets no treatment for them goes back to alcohol within a few weeks, because nothing else brings relief.
This is why we ask about mood, sleep, anxiety and any earlier psychiatric treatment at the very first consultation. When we suspect a second diagnosis, we treat both conditions in parallel: a psychiatrist manages treatment of the mental disorder, the addiction therapist works on the drinking, and the two exchange information about the patient as treatment continues.
We do not need to establish which came first at the initial visit, and doing so is not required to start treatment. We reassess mood, anxiety and sleep after four to six weeks without alcohol, because some symptoms clear up on their own by then, while those that remain call for psychiatric treatment.
How many residents of Zielona Góra end up at the sobering-up centre each year
The sobering-up centre on Racula-Rodła Street in Zielona Góra admitted 1,941 people in 2025, with 21 places in the facility. Two years earlier it took in 2,110 people: 1,847 men, 259 women and four minors. These are stays, not individual people, and the centre also serves neighbouring communes, so the figure does not describe residents of the city alone.
Social welfare services count families and show another side of the same problem. In 2024, alcohol addiction was the reason for granting benefits to 212 families in Zielona Góra, and to 197 the year before. Only homelessness was a more frequent reason; alcohol addiction that year overtook parenting and caregiving difficulties, for which 193 families received benefits. Free help from addiction therapists funded by the city was used by 164 people in the same year, though the city counts all addictions together here, not only alcohol. Both of these routes start with an institution that already knows about the drinking; at Nasz Gabinet Zielona Góra the patient books their own appointment, without a referral and without having reported anywhere beforehand.
