Today, alcohol use disorder (AUD) affects around 7% of Americans, and there’s evidence that the global pandemic has increased consumption significantly. Alcohol abuse not only takes its toll on critical organs such as the liver, but also exacerbates mental health problems that can erode personal relationships or one’s ability to function at work in a vicious, downward spiral. Despite how widespread alcoholism is, finding effective treatment and support isn’t always easy — especially if you want an online alternative to AA or rehab.
Luckily, the rise of telemedicine in recent years has seen new options emerge for people seeking medical help online. One of the leaders in virtual alcohol abuse recovery is a company called Monument. Their platform offers therapist-moderated support groups, educational resources to help you better understand the severity of your drinking, and if necessary, personalized prescription treatments and specialized therapy. It’s a thoughtfully curated community of peers and medical professionals — all conveniently accessible online — that’s designed to help curb your drinking or get sober.
In this article, we’ll take a look at the services that Monument provides to help the 38 million problem drinkers in America, and help you determine if their service can help you and/or the ones you love.
Is it possible to treat alcoholism online?
Too many people have an unhealthy relationship with alcohol. While this may conjure an image of someone spending the whole day drinking to excess, the reality is far more complex. Alcoholism, which can be clinically diagnosed as Alcohol Use Disorder (AUD), exists on a spectrum. People who drink only a few times a month may meet the criteria for a mild, moderate, or severe alcohol use disorder, while others with more frequent drinking habits may not.
While the severity of alcohol use disorder varies, so do the classifications of unhealthy alcohol use. For example, binge drinking is defined as consuming five drinks (for men) or four (for women) in a 2 hour period. According to the CDC, one in six adults binge drink around four times a month. ‘Heavy drinking,’ another drinking pattern, is typically defined as consuming 15 drinks or more per week for men, and 8 drinks or more per week for women.
Traditionally, alcoholism was treated with either 12-step style recovery programs or in rehab, or a mix of both. However, telemedicine is now a viable option for providing alcohol treatment thanks to advancements in communications technology such as streaming video. Doctors and therapists can remotely connect with patients, where they can diagnose alcoholism, provide treatment or therapy, and in some cases prescribe medication to help reduce cravings. Even as little as 5 years ago, virtual alcohol abuse support may have been tricky, but today– owing in large part to the global pandemic — thousands of people are staying sober without having ever met their support group, sponsor, or healthcare provider in person.
In fact, there are some who believe a modern (i.e. virtual) approach to alcohol treatment outweighs those of traditional care. A few of the biggest benefits of remote alcohol treatments include:
- Time-effectiveness & convenience
A large amount of the time treating alcoholism is spent traveling to meetings, doctor’s appointments, and finding the right specialists. Telemedicine offers a way for patients to access care far more conveniently. For anyone living in more rural towns or with demanding schedules, this means they can find treatment and support in ways that were previously unimaginable. By reducing the amount of time spent accessing treatment, patients can fit programs around work and family life, and thus are more likely to stick with their treatment. Companies like Monument are able to connect you to professional help within 48 hours. Previously this was unfathomable.
By reducing the amount of traveling required, patients save money on transport, parking, and copays. In addition, doctors can pass on the savings made by not requiring the overhead of a physical clinic or office.
Rehab is the most expensive solution for alcoholism. Staying at a facility can cost tens of thousands of dollars per month, plus it means taking time out of your life. Of course, some very severe cases of alcoholism may require in-person care because of the risk of withdrawal, which is why it is important to consult with a physician when considering the appropriate treatment, but generally, being able to avoid rehab by reducing the friction of accessing proactive care is a huge hidden benefit.
- Greater efficacy
Telemedicine is very effective for treating addiction. A 2016 paper found that when compared to face-to-face counseling, telemedicine was not only cheaper but more effective (57% abstinence vs 47% for traditional methods). We realize this is only one study, but as someone who participates in lots of online communities of all kinds, this resonates.
Review: How does Monument treat alcoholism?
Monument was founded when its CEO, Mike Russell, realized he had an issue with alcohol. As a successful entrepreneur and promoter, Russell seemed to function perfectly well to outsiders. But, he knew that his relationship with alcohol was unhealthy.
When he tried to find help, he was left unsatisfied. He reached out to a few clinics, and it took three weeks to get a reply from one. They told him that they had a two-month waiting list. The frustration with the status quo led him to start exploring alternatives. When he didn’t find any, he decided to build the future himself. Fast forward a couple years, and Monument has become a clear leader in online alcohol treatment.
Treatment on Monument begins with a quick eleven question self-assessment after you sign up for a free account. It’s conducted online and designed to help diagnose the contours and severity of alcohol use disorder, and also let you know about your withdrawal risk given potential alcohol dependency. Regardless of your results, users get unlimited access to themed support groups related to sobriety or moderation — 100% free of charge. These virtual meetings are therapist-moderated with like-minded participants also looking to cut back on their alcohol consumption. For some, the support groups alone are enough to help better understand their drinking habits and stave off unwanted benders. For others, the free support groups are a helpful first step, but additional intervention is recommended to achieve their goals for sobriety or moderation.
Thus Monument offers subscription plans that offer one-on-one access to professional clinicians. Paying users can speak with a physician via video call, and from there, decide together if medication to stop drinking is appropriate. It’s worth noting that prescription medication is very much an optional aspect of the Monument’s treatment plans, not the only offering. It’s also worth noting that for those at risk of acute alcohol withdrawal, Monument will recommend in-person supervision for safety, recognizing that virtual care alone may be insufficient.
What medications does Monument prescribe for alcohol abuse?
If Monument’s doctors approve medication as part of a patient’s alcohol treatment plan, a prescription will be sent via Monument’s pharmacy partner to the patient’s home or preferred pharmacy. From there, patients can continue to consult the physician as needed to adjust dosage, understand results, get refills, or get any questions answered.
The two medicines that Monument most often prescribes include:
Naltrexone is recommended for those who either want to cut back on drinking or stop altogether. It can help prevent alcohol cravings by disrupting the reward centers involved in alcohol consumption. More specifically, Naltrexone prevents endorphins from binding to the receptors in the brain, so instead of the short-term buzz you might typically feel from alcohol-stimulated endorphins and dopamine, you will feel less reward or pleasure after drinking alcohol with naltrexone. This solution has been shown to make alcohol less appealing over time. At Monument, naltrexone is prescribed in adherence with the FDA recommended daily dose. Alternatively, you may have heard about the Sinclair method, which is not based on daily dosing.
The most common side effects from taking Naltrexone to curb alcohol consumption include: difficulty sleeping, anxiety, nervousness, abdominal pain/cramps, nausea and/or vomiting, low energy, joint and muscle pain, headache, dizziness and somnolence. There’s also the risk of Naltrexone causing liver failure if taken in large doses. Thus it’s always important to consult a trusted medical professional to make sure it’s safe for you and properly administered.
Disulfiram (also known by the brand name, Antabuse) is only prescribed to those who want to go cold turkey. This prescription medication heightens sensitivity to alcoholism and even causes some of the effects of a hangover to be felt immediately after drinking. This solution works by inhibiting acetaldehyde dehydrogenase. Disulfiram can be an effective tool in giving up drinking.
The most common adverse effects from Disulfiram include: drowsiness, tiredness, headache, acne, and metallic-like taste in the mouth. Certain drug interactions make these more likely. Drinking on disulfiram can range from unpleasant to dangerous, which is why it’s only appropriate for people practicing abstinence from alcohol.
How much do Monument treatment plans cost?
Monument offers four different treatment plans, ranging from free to $259 per month. Here we’ll review each.
- Community membership — free!
One of the best features of Monument is that they understand that not everyone can afford treatment or medication. This plan allows users access to the Monument community, where they can forge connections with other people who are struggling with alcoholism.
Users can access this care in two different ways: via the forum or through virtual meetings that are hosted by therapists.
All of this is available for free, meaning it is an excellent resource for anyone trying to reduce their alcohol intake or stop drinking altogether. Curious to check it out? Go to joinmonument.com to sign up!
- Physician care — $45 initial fee + $9.99 per month
The physician care plan is great for anyone looking for medication that can help them solve their issues with alcohol (with expert oversight).
This plan includes one introductory appointment with a physician who will provide a medical intake assessment. After the first appointment, further physician appointments are $45. Monument recommends a follow-up appointment every three months.
Another aspect of this plan is medication management. If the physician considers it safe and appropriate, they will prescribe medication that is proven to help with alcoholism. The two options that Monument provides are naltrexone and disulfiram. Users can manage their subscriptions online and get them sent to their pharmacy or their home. You can use insurance to cover the cost of medication.
- Total care (weekly) — $259 per month
Total Care (Weekly) is the most comprehensive plan that Monument offers. This plan includes four therapy appointments per month. These therapy sessions take place online and last for 45 minutes. Monument’s therapy offering is unique in that the therapists on the platform are all specialized in treating substance use disorders.
Additionally, it allows subscribers unlimited access to a physician. Because these programs are designed to be holistic and personalized based on the patient’s needs, other options available with this plan include moderated group therapy sessions and access to an anonymous group forum.
- Total care (biweekly) — $149 per month
Total Care (Biweekly) is essentially the same as Total Care (weekly) except that the therapy sessions are done on a biweekly basis. Again, unlimited access to a physician is available, plus group meetings and access to the anonymous forum.
How does Monument compare to AA and other alcohol recovery apps?
Of course, Monument isn’t the only alcohol recovery app to emerge over the last few years. Here we’ll take a look at some of the alternative apps available and compare them to Monument’s holistic approach.
Best Alcohol Recovery apps: Monument vs Tempest vs Ria vs Workit vs Sunnyside
|Personalized Treatment program?||✅||✅||✅||✅||❌|
|Monthly Cost||Free – $249 for either 2 or 4 therapy sessions per month||$41|
Accountability coaching available for an additional cost ($299 for 4 sessions)
|$300||Varies by state. Customers are asked to call to find out||As low as $6.58 per month|
|Available in||Online community + education: All 50 states|
Personalized treatment in 18 States:
|Online community + education: All 50 states||Online community + education: All 50 states
Personalized treatment in 26 states:|
|Online community + education: All 50 states
Personalized treatment in 6 States:|
|Online community + education: All 50 states|
|Able to start for free?||✅ Free moderated support groups||❌||❌||✅ Free online courses||❌|
|Offers 1-on-1 therapy?||✅||❌||❌||✅||❌|
|Offes scholarship / financial aid?||❌||✅||❌||✅||❌|
While Monument offers the most comprehensive online platform for alcohol abuse recovery, we hope this chart helps you quickly compare what other alcohol recovery apps offer as an alternative. Here’s a quick synopsis of the approach each of Monument’s competitors take to improve excessive and destructive drinking habits.
Review of Tempest
Tempest uses a holistic approach that allows each user to customize their own journey. It uses a modern, research-based approach to alcohol treatment, mixing video, workbooks, and live lessons, alongside accountability coaching. Membership can cost as little as $41 per month, and Tempest also offers an intense 4-week program for $399.
Tempest uses a mix of different systems based on each individual, such as Mindfulness-based practices and Integral Recovery.
Review of Ria Health
Ria Health takes a novel approach to alcohol treatment. Patients are given a digital breathalyzer and are required to take photos of their medication each day. Ria says this provides accountability that their program is being followed. They provide weekly sessions with a recovery coach and online groups, all accessible through their online platform or app.
Review of Workit Health
WorkIt Health is a startup that offers treatments for a wide range of addictions, including alcoholism. Users log in to the app, answer some questions, and are given a customized program based on their goals. From here, they can consult with a clinician, or a counselor, depending on what approach is best for them. While WorkIt is covered by insurance, its pricing structure is frustratingly opaque. All they say is that it is a fraction of traditional methods. Users are encouraged to call and find out.
Review of Sunnyside
(formerly Cutback Coach)
Sunnyside is a subscription-based service that uses psychology-backed tools to help users develop a more intuitive relationship with alcohol. The rebrand from “Cutback Coach” to Sunnyside in late 2021 was to focus on adding more good to the lives of our users, not taking away, to improve overall health and wellness including increased productivity, weight loss, reduced anxiety, achieve tangible benefits to overall health and wellness including increased productivity, weight loss, reduced anxiety, and better sleep.
Rather than the all-or-nothing, sobriety-first approach, Sunnyside focuses on building healthy habits to fit users’ lifestyle. To achieve this, they recommend a more mindful approach. The app is primarily focused on tracking your drinking and taking a proactive strategy to stop or reduce drinking.
Coaches are available through texting communications in the app, and memberships cost between $6.58 – $9.99 per month based on monthly, quarterly or annual payment.
Customer Reviews: What are people saying about Monument online?
In the short time since it was launched, Monument has helped tens of thousands find quality support. That said, because they are still a young company and the discreet nature of alcoholism as a disease, their presence around the web remains somewhat limited, and user generated reviews are somewhat scarce for now.
On their website, however, Monument shares dozens of testimonials from happy customers that rave about their physicians, therapists, and support group moderators.