AA meetings do not exclude other alcoholics, though some meetings cater to specific demographics such as gender, profession, age, sexual orientation,[44][45] or culture.[46][47] Meetings in the United States are held in a variety of languages including Armenian, English, Farsi, Finnish, French, Japanese, Korean, Russian, and Spanish.[48][45] While AA has pamphlets that suggest meeting formats,[49][50] groups have the autonomy to hold and conduct meetings as they wish "except in matters affecting other groups or AA as a whole".[4] Different cultures affect ritual aspects of meetings, but around the world "many particularities of the AA meeting format can be observed at almost any AA gathering".[51]
Sponsors share their experience, strength, and hope with their sponsees... A sponsor's role is not that of a legal adviser, a banker, a parent, a marriage counselor, or a social worker. Nor is a sponsor a therapist offering some sort of professional advice. A sponsor is simply another addict in recovery who is willing to share his or her journey through the Twelve Steps.[29]

Blood. Alcohol may cause changes to all the types of blood cells. Red blood cells become abnormally large. White blood cells (important for fighting infections) decrease in number, resulting in a weakened immune system. This places alcohol-dependent individuals at increased risk for infections and may account in part for the increased risk of cancer faced by people with alcoholism. Platelets and blood clotting factors are affected, causing an increased risk of bleeding.
Over time, the regular consumption of alcohol will alter brain chemicals, making the drinker crave alcohol not for a good time, but to avoid feeling poorly. Brain function becomes more and more impaired as your blood alcohol content increases. Each time you drink alcohol, several chemicals in the brain become imbalanced. Over time, the brain becomes used to this imbalance, and considers it the new balance, so to speak. This is a disease of the brain called alcoholism.
Women develop long-term complications of alcohol dependence more rapidly than do men. Additionally, women have a higher mortality rate from alcoholism than men.[35] Examples of long-term complications include brain, heart, and liver damage[36] and an increased risk of breast cancer. Additionally, heavy drinking over time has been found to have a negative effect on reproductive functioning in women. This results in reproductive dysfunction such as anovulation, decreased ovarian mass, problems or irregularity of the menstrual cycle, and early menopause.[35] Alcoholic ketoacidosis can occur in individuals who chronically abuse alcohol and have a recent history of binge drinking.[37][38] The amount of alcohol that can be biologically processed and its effects differ between sexes. Equal dosages of alcohol consumed by men and women generally result in women having higher blood alcohol concentrations (BACs), since women generally have a higher percentage of body fat and therefore a lower volume of distribution for alcohol than men, and because the stomachs of men tend to metabolize alcohol more quickly.[39]
If you have said to yourself: “Yes, I'm one of those people who are powerless over alcohol. My life has become unmanageable. I can't stop drinking and I want help”, you have made a good start on Step One and discovered, as it says in the Big Book, “We are unable, at certain times, to bring into our consciousness with sufficient force the memory of the suffering and humiliation of even a week or a month ago. We are without defense against the first drink.”
Other tests are sometimes used for the detection of alcohol dependence, such as the Alcohol Dependence Data Questionnaire, which is a more sensitive diagnostic test than the CAGE questionnaire. It helps distinguish a diagnosis of alcohol dependence from one of heavy alcohol use.[116] The Michigan Alcohol Screening Test (MAST) is a screening tool for alcoholism widely used by courts to determine the appropriate sentencing for people convicted of alcohol-related offenses,[117] driving under the influence being the most common. The Alcohol Use Disorders Identification Test (AUDIT), a screening questionnaire developed by the World Health Organization, is unique in that it has been validated in six countries and is used internationally. Like the CAGE questionnaire, it uses a simple set of questions – a high score earning a deeper investigation.[118] The Paddington Alcohol Test (PAT) was designed to screen for alcohol-related problems amongst those attending Accident and Emergency departments. It concords well with the AUDIT questionnaire but is administered in a fifth of the time.[119] Certain blood tests may also indicate possible alcoholism.[3]

Once a person is addicted to alcohol, to stop it may take hospitalizations, rehabilitations, and re-rehabilitations all of which hemorrhage expenses — not to mention destroy relationships and property. The estimated cost to the system of this specialized addiction care is $24.6 billion. Since addiction is a disease that rewires the brain, the individual is unlikely to quit through “willpower” alone, and it often takes something dramatic (or “hitting rock bottom”) before they will make changes. There are costs associated with these dramatic scenarios. In the case of car accidents caused by driving drunk, costs include not just hospitalization, but the cost to insurance companies, car owners, municipal employees responding to the accident, and a continued chain reaction of costs that could ultimately include vehicular homicides and funeral expenses.
Chuck Lorre's Mom (2013-), follows dysfunctional daughter/mother duo Christy and Bonnie Plunkett, who are estranged for years while simultaneously struggling with addiction. They attempt to pull their lives and relationships together by trying to stay sober and visiting Alcoholics Anonymous. The show also explores themes of alcoholism, drug addiction and relapse.

The World Health Organization examined mental disorders in primary care offices and found that alcohol dependence or harmful use was present in 6% of patients. In Britain, 1 in 3 patients in community-based primary care practices had at-risk drinking behavior. Alcoholism is more common in France than it is in Italy, despite virtually identical per capita alcohol consumption.

Alcoholism is appropriately considered a disease rather than a weakness of character or chosen pattern of bad behavior. It is the third most common mental illness, affecting more than 14 million people in the United States. Other facts and statistics about alcohol dependence include its pattern of afflicting about 4% of women and 10% of men. It costs more than $200 billion per year in lower productivity, early death, and costs for treatment. Worldwide, alcohol is thought to contribute to more than 200 illnesses and injuries, like liver disease, heart disease, and neurological problems. Alcohol-related deaths number more than 3 million per year, nearly 6% of all deaths worldwide. For adults between 20-40 years of age, that percentage rises to about 25% of deaths due to alcohol.
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A medical professional can work with a person attempting to detox from alcohol to help them manage cravings and other withdrawal symptoms. A doctor can also refer their patient to addiction treatment programs and therapists, so the individual can get help overcoming their alcohol abuse issues. If there are no serious withdrawal symptoms, a doctor can recommend over-the-counter remedies to manage pain or nausea. The support of friends and family can help keep the individual focused on sobriety.

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alcohol dependence = alcohol abuse combined with tolerance, withdrawal, and an uncontrollable drive to drink.[99] The term "alcoholism" was split into "alcohol abuse" and "alcohol dependence" in 1980's DSM-III, and in 1987's DSM-III-R behavioral symptoms were moved from "abuse" to "dependence".[100] It has been suggested that DSM-V merge alcohol abuse and alcohol dependence into a single new entry,[101] named "alcohol-use disorder".[102]
Al-Anon and Alateen. Al-Anon is an organization comprised of support groups targeted towards friends and family of individuals suffering from alcoholism. In these groups, family members and friends are able to share their personal experiences, discuss difficulties and find effective ways to deal with problems—regardless of whether the alcohol abusing individual in their lives have completed an addiction recovery program. Alateen is a fellowship that is specifically targeted towards younger Al-Anon members, particularly teenagers.

Within the medical and scientific communities, there is a broad consensus regarding alcoholism as a disease state. For example, the American Medical Association considers alcohol a drug and states that "drug addiction is a chronic, relapsing brain disease characterized by compulsive drug seeking and use despite often devastating consequences. It results from a complex interplay of biological vulnerability, environmental exposure, and developmental factors (e.g., stage of brain maturity)."[111] Alcoholism has a higher prevalence among men, though, in recent decades, the proportion of female alcoholics has increased.[36] Current evidence indicates that in both men and women, alcoholism is 50–60 percent genetically determined, leaving 40–50 percent for environmental influences.[153] Most alcoholics develop alcoholism during adolescence or young adulthood.[69] 31 percent of college students show signs of alcohol abuse, while six percent are dependent on alcohol. Under the DSM's new definition of alcoholics, that means about 37 percent of college students may meet the criteria.[154]

The Hazelden Betty Ford Foundation is a force of healing and hope for individuals, families and communities affected by addiction to alcohol and other drugs. It is the nation's largest nonprofit treatment provider, with a legacy that began in 1949 and includes the 1982 founding of the Betty Ford Center. With 17 sites in California, Minnesota, Oregon, Illinois, New York, Florida, Massachusetts, Colorado and Texas, the Foundation offers prevention and recovery solutions nationwide and across the entire continuum of care for youth and adults.
Secular Organizations for Sobriety (SOS). SOS is presented as a secular alternative to the more spiritual 12-step addiction recovery programs (such as AA and NA) that encourage people to reach out to a higher power. The program targets substance abusers who would like to separate sobriety from spirituality and religion. The organization credits the individual for maintaining sobriety as opposed to crediting a higher power. SOS is comprised of a network of autonomous local groups that help individuals achieve and maintain sobriety. The organization has meetings in many cities across the United States. In SOS, sobriety is presented as the number one priority for individuals suffering from alcoholism or addiction. It emphasizes the use of clear communication and scientific knowledge in choosing the most rational approach to living a sober and rewarding life.
Jump up ^ Ståhlbrandt, Henriettæ; Johnsson, Kent O.; Berglund, Mats (2007). "Two-Year Outcome of Alcohol Interventions in Swedish University Halls of Residence: A Cluster Randomized Trial of a Brief Skills Training Program, Twelve-Step Influenced Intervention, and Controls" (PDF). Alcoholism: Clinical and Experimental Research. 31 (3): 458–66. doi:10.1111/j.1530-0277.2006.00327.x. PMID 17295731.
Dangerous behaviors common among alcoholics include impaired judgment and coordination, falling asleep at the wheel, falling asleep with lit cigarettes, aggressive outbursts, drinking to the point of vomiting, hangover, or alcohol poisoning — and these are just the ones most alcoholics experience in the course of their disease. All of these behaviors will eventually hit the system, in the form of health care costs, criminal justice costs, motor vehicle crash costs, and workplace productivity

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AA says it is "not organized in the formal or political sense",[25] and Bill Wilson called it a "benign anarchy".[26] In Ireland, Shane Butler said that AA “looks like it couldn’t survive as there’s no leadership or top-level telling local cumanns what to do, but it has worked and proved itself extremely robust.” Butler explained that "AA’s 'inverted pyramid' style of governance has helped it to avoid many of the pitfalls that political and religious institutions have encountered since it was established here in 1946."[27]
If you are still having issues with activation after trying the above mentioned items, please click on the “Gear” icon located on the lower left of the SRS window when it first opens. Next, click on “About” and then click on the check box to “Enable Log For Debugging”. This will turn on the logging feature for Customer Support to be able to further help you solve your issue. Once you have enabled logging, try to activate your license again, then call Customer Support and they will instruct you how to send the log files to them.
Another variation comes from the fact that some people are uncomfortable with the specific, religious aspects of the 12-Step program. As stated above, and as evident by the steps themselves, the 12-Step model originated from a Christian point of view. Those who are not Christian have modified the steps to refer to their specific religious or spiritual practice as a way to connect more with the structure of the 12-Step program. In addition, a number of non-religious 12-Step groups have modified the steps to fit a secular model that can help those who are agnostic or atheist practice the program without feeling forced to adhere to a religion they don’t believe in.
The Oxford Group’s creed was based on four principles: all people are sinners, all sinners can be changed, confession is required for that change, and the change must also change others. One of the people Hazard spread his word to was Bill Wilson, an old friend and former drinking partner. Through Hazard, Wilson (who was struggling with his alcoholism) learned of Carl Jung’s pantheistic musings on the importance of healthy spirituality; for Wilson, that healthy spirituality manifested in the form of a desperate conversion to Christianity in an attempt to quit drinking. When this happened in 1934, Wilson attributed the victory to his faith, and specifically Hazard’s intervention. He spoke to Dr. Bob Smith, a fellow Oxford Group member and recovering alcoholic who applied the same principles to his own battle with addiction. Smith had his last drink on June 10, 1935, one month after he and Wilson started working together; today, that date is celebrated as the birth of Alcoholics Anonymous, and its founders are remembered as “Bill W.” and “Dr. Bob.”

In figuring out the price of rehabilitation in Cheyenne, WY, you first have to look at the amenities the center delivers and its locale in comparison to your own preferences. You'll find quite a wide range in cost for rehabilitation facilities. Many take private insurance, so either check with your provider to see if the costs are partially covered through your PPO or HMO, or dial our helpline, toll-free for a discreet insurance check.
Alcohol use disorder (which includes a level that's sometimes called alcoholism) is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking.
Luckily, if the 12-Step program has proven itself ineffective for you and your recovery needs, there are many alternatives to choose from. Even if they are not physically available to you, the majority of them have a strong Internet presence and can provide support with online forums for members to share their experiences in, which for some who are uncomfortable sharing in person may even find to be a preferable option.
Al-Anon and Alateen. Al-Anon is an organization comprised of support groups targeted towards friends and family of individuals suffering from alcoholism. In these groups, family members and friends are able to share their personal experiences, discuss difficulties and find effective ways to deal with problems—regardless of whether the alcohol abusing individual in their lives have completed an addiction recovery program. Alateen is a fellowship that is specifically targeted towards younger Al-Anon members, particularly teenagers.
There are numerous individual psychotherapeutic treatments for alcohol addiction. Relapse prevention uses methods for recognizing and amending problem behaviors. Individualized drug counseling specifically emphasizes short-term behavioral goals in an attempt to help the individual reduce or stop the use of alcohol altogether. Cognitive-behavioral therapy techniques, like helping the individual with alcohol use disorder recognize what tends to precede and follow their episodes of alcohol use, are often used to address alcohol abuse. Some treatment programs include drug testing. Twelve-step recovery programs like Alcoholics Anonymous are individualized drug-counseling methods. Motivational enhancement therapy encourages the person suffering from alcohol use disorder to increase their desire to participate in therapy. Stimulus control refers to an intervention that teaches the alcohol-use disordered person to stay away from situations that are associated with alcohol use and to replace those situations with activities that are alcohol-free and otherwise contrary to using alcohol. Urge control is an approach to changing patterns that lead to drug or alcohol use.
Thank you dr Miller, very important part of recovery of addiction and important tool for our patients that should not be "a dying art". I have heard international lecturer and professional in addiction treatment, state that "Minnesota Model" is one treatment that has been shown ineffective (evidence based medicine... Many correlate that with Twelve step facilitation. Can you help with references to support or counteract that?
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Other options include inpatient and outpatient rehab centers, which offer professional addiction treatment and medical care. These programs can also offer a medically supervised detox, which is important in the early stages of alcohol withdrawal. People who have been drinking heavily for long periods of time and stop are at risk of symptoms such as insomnia, nausea, vomiting, tremors, fever, seizures, hallucinations, and severe confusion. Some of these symptoms can be dangerous or even fatal. A medical detox can reduce these symptoms and prevent complications.7
Stanton Peele argued that some AA groups apply the disease model to all problem drinkers, whether or not they are "full-blown" alcoholics.[90] Along with Nancy Shute, Peele has advocated that besides AA, other options should be readily available to those problem drinkers who are able to manage their drinking with the right treatment.[91] The Big Book says "moderate drinkers" and "a certain type of hard drinker" are able to stop or moderate their drinking. The Big Book suggests no program for these drinkers, but instead seeks to help drinkers without "power of choice in drink."[92]
Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

Another important point about 12 Step programs is their cost and accessibility.  What other chronic lifelong disease has an equally accessible and cost effective (free) intervention?    Like any disease, part of our job as physicians is to recommend effective treatment which our patients can both access and afford.  I'd like for my patients to be able to access and afford all useful modalities of addiction treatment, but here at least is one they can all use.   

The alcoholic's continual craving for alcohol makes abstinence -- an important goal of treatment -- extremely difficult. The condition is also complicated by denial: Alcoholics might be reluctant to admit their excess drinking either because of denial or guilt. Another barrier to receiving care is that physicians screen only about 15% of their primary care patients for alcohol disorders.
There are two types of rehabilitation that help treat alcoholism: inpatient rehab and outpatient rehab. Inpatient rehabs are intensive treatment programs that require you to check into a facility for a certain period of time, usually 30, 60 or 90 days. Outpatient rehab allows individuals to participate in a recovery program while continuing with their daily life. Talk with your doctor about treatment options to determine which form of recovery will best fit your needs.
Alcoholics Anonymous (AA), the first twelve-step fellowship, was founded in 1935 by Bill Wilson and Dr. Robert Holbrook Smith, known to AA members as "Bill W." and "Dr. Bob", in Akron, Ohio. In 1946 they formally established the twelve traditions to help deal with the issues of how various groups could relate and function as membership grew.[5][6] The practice of remaining anonymous (using only ones first names) when interacting with the general public was published in the first edition of the AA Big Book.[7]
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