Alcohol Use Disorder Treatment in Portland, OR
Drinking patterns exist on a spectrum, and many people who are struggling do not fit the picture they carry in their head of what alcohol use disorder is supposed to look like. You do not need to have lost a job, ended a relationship, or hit a visible low point for your drinking to be a clinical concern worth taking seriously. Caroline Thiongo PMHNP-BC at Thrive Psychological Wellness provides honest evaluation and evidence-based medication management for alcohol use disorder, alongside treatment for any co-occurring mental health conditions, at our Portland and Multnomah Village offices and through telehealth for patients anywhere in Oregon.
What We Address
What Alcohol Use Disorder Actually Looks Like
Alcohol use disorder is diagnosed on a spectrum from mild to severe based on a specific set of criteria, not on a single dramatic event. Drinking more than intended, wanting to cut back but being unable to, cravings, increasing tolerance, and continuing to drink despite knowing it is causing problems are all part of the diagnostic picture. Many people who meet the clinical criteria are still functioning at work and in their relationships, which makes it easy to dismiss the severity of what is happening and delay seeking help longer than they should.
Withdrawal from alcohol can be medically serious in a way that withdrawal from many other substances is not. If someone has been drinking heavily and regularly, stopping abruptly without medical guidance carries real risk. Caroline Thiongo PMHNP-BC includes withdrawal risk assessment as a standard part of the evaluation and coordinates medical support when needed before any outpatient treatment plan begins, because starting outpatient care without addressing withdrawal risk first can be genuinely dangerous.
Depression and anxiety are extremely common alongside alcohol use disorder, both as a cause of drinking patterns and as a consequence of them. The evaluation at Thrive Psychological Wellness looks at the full clinical picture rather than the drinking in isolation, and the treatment plan addresses both the substance use and any co-occurring conditions directly.
Severity Spectrum
- Drinking more than intended, some difficulty cutting back, occasional cravings. Often addressed effectively with outpatient support and, in some cases, medication.
- More established pattern with noticeable tolerance and some interference with daily responsibilities. Medication-assisted treatment is often beneficial at this stage.
- Significant tolerance, withdrawal symptoms, and substantial interference with daily life. May require medical detox before outpatient treatment and benefits strongly from medication-assisted treatment.
Evaluation and Medication Management for Alcohol Use Disorder
Thrive Psychological Wellness offers secure, HIPAA-compliant telehealth appointments for alcohol use disorder evaluation and medication management to patients anywhere in Oregon. Telehealth is appropriate for outpatient treatment when there is no acute withdrawal risk requiring in-person medical supervision. If withdrawal risk is identified during the evaluation, Caroline Thiongo PMHNP-BC will coordinate the appropriate level of medical support before outpatient telehealth treatment begins.
Step 1: Honest Evaluation
We assess drinking patterns, frequency, quantity, prior attempts to cut back, withdrawal history, and any co-occurring mental health conditions. No judgment, just an honest clinical picture.
Step 2: Withdrawal Risk Assessment
If there is a history of heavy regular drinking, we assess withdrawal risk carefully. Severe cases may need medical detox before outpatient treatment begins, and we coordinate that referral.
Step 3: Medication-Assisted Treatment
Naltrexone, acamprosate, and disulfiram are all options depending on the clinical picture and patient preference. We discuss what fits your situation.
Step 4: Co-Occurring Condition Treatment and Follow-Up
We treat any co-occurring depression, anxiety, or other conditions alongside the alcohol use disorder and schedule regular follow-up to monitor progress and adjust medication.
Medications Reference Card
Reduces the rewarding effects of alcohol, which reduces cravings and heavy drinking days. Available as a daily pill or monthly injection (Vivitrol). One of the most commonly prescribed options.
Helps restore chemical balance disrupted by chronic alcohol use and reduces cravings during early sobriety. Taken three times daily, typically started after someone has stopped drinking.
Causes an unpleasant physical reaction if alcohol is consumed, functioning as a deterrent. Requires strong patient commitment and is not the right fit for everyone.
Used off-label for alcohol use disorder with good evidence for reducing heavy drinking days. An option when first-line medications are not well tolerated.
Alcohol Use Disorder Treatment by Telehealth Across Oregon
Thrive Psychological Wellness offers secure, HIPAA-compliant telehealth appointments for alcohol use disorder evaluation and medication management to patients anywhere in Oregon. Telehealth is appropriate for outpatient treatment when there is no acute withdrawal risk requiring in-person medical supervision. If withdrawal risk is identified during the evaluation, Caroline Thiongo PMHNP-BC will coordinate the appropriate level of medical support before outpatient telehealth treatment begins.
📍 Locations Served
In-Person Offices
Multnomah Village, OR (Primary)
Portland, OR (Secondary)
Regional Areas
SW Portland, Lake Oswego, Beaverton
Gresham, Milwaukie, Clackamas
How do I know if I have alcohol use disorder?
Alcohol use disorder is diagnosed using specific clinical criteria including drinking more than intended, difficulty cutting back despite wanting to, cravings, increasing tolerance, and continuing to drink despite negative consequences in relationships, health, or daily functioning. You do not need to have experienced a major life disruption for your drinking to be clinically significant. A psychiatric evaluation with Caroline Thiongo PMHNP-BC can determine where you fall on the spectrum and what level of support makes sense.
Is it dangerous to stop drinking on my own?
It can be, particularly if you have been drinking heavily and regularly over a sustained period. Alcohol withdrawal can produce serious symptoms including seizures in severe cases, which sets it apart from withdrawal from most other substances. Caroline Thiongo PMHNP-BC assesses withdrawal risk as part of the initial evaluation and will refer for medical detox when that is the clinically safer route before outpatient treatment begins. If you are concerned about withdrawal symptoms you are already experiencing, seek medical care before contacting our office.
What medications help with alcohol use disorder?
Naltrexone and acamprosate are the most commonly used first-line medications. Naltrexone reduces the rewarding effects of alcohol and cravings and is available as a daily tablet or a monthly injection. Acamprosate helps restore neurochemical balance and reduce cravings during early sobriety and is most effective once drinking has stopped. Disulfiram creates an unpleasant physical reaction to alcohol and works best for patients who are committed to abstinence. Topiramate is an off-label option that has evidence for reducing heavy drinking in selected patients. Caroline Thiongo PMHNP-BC selects medications based on the individual clinical picture rather than a standard protocol.
Can alcohol use disorder treatment be done through telehealth in Oregon?
Yes for outpatient evaluation and medication management when withdrawal risk has been assessed and does not require in-person medical supervision. Thrive Psychological Wellness offers secure, HIPAA-compliant telehealth appointments for alcohol use disorder care to patients anywhere in Oregon. The initial evaluation includes a withdrawal risk assessment that determines whether telehealth is appropriate or whether in-person care is the safer starting point.
Does insurance cover alcohol use disorder treatment in Oregon?
Yes. Most major Oregon insurance plans cover psychiatric evaluation and medication management for alcohol use disorder, including Oregon Health Plan. Thrive Psychological Wellness verifies your coverage before your first appointment so you know what to expect before care begins.
Accepting New Patients for Alcohol Use Disorder Treatment in Portland
If your drinking has become a concern, whether it feels mild or significant, an honest evaluation is the right place to start. We approach this without judgment and focus on what will actually help. Book a time and we will work through it together.
Crisis note below buttons: If you are in crisis, call or text 988. Cascadia Crisis Line: (503) 988-4888.