Please encourage Spanish-speaking women members in your area to write their personal stories for possible inclusion in this new pamphlet. Submissions can be emailed to Literature@aa.org with "Spanish-speaking women in A.A." in the subject line of the message. Alternatively, submissions can be mailed to: Literature Coordinator, General Service Office, Box 459, Grand Central Station, New York, NY 10163.
Added fat and scar tissue on the liver due to excessive alcohol consumption can lead to all sorts of problems, but most often either cirrhosis or alcohol-induced hepatitis. Liver failure among those who drink heavily for many years is likely. Pancreatitis, or the consistent inflammation of the pancreas, can also cause damage to the body, including high blood sugar leading to diabetes.
Alcohol Use Disorder is a pattern of disordered drinking that can involve interference in daily tasks, withdrawal symptoms, discord in relationships, and risky decisions that place oneself or others in harm's way. More than 15 million American adults struggle with this condition, according to the National Institute on Alcohol Abuse and Alcoholism. Like all addictions, alcohol use disorder is inextricably linked to a complex matrix of biological, social, and psychological factors. Research highlights a genetic component to the disease, as about half of one's predisposition to alcoholism can be attributed to his or her genetic makeup. As a psychological malady, people may turn to alcohol to cope with trauma or other co-occurring mental disorders. Socially, alcoholism may be tied to familial dysfunction or a culture embedded with binge drinking. The brain's reward pathways also play an essential role: Alcohol consumption is associated with increased dopamine activity, which corresponds with pleasure, craving, and habit formation.
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Steps one through three deal with the individual’s acceptance of their inability to control their addiction alone and the need of support to remain abstinent. Steps four through nine teach the individual to take responsibility for their own actions and characteristics in order to create change in their life. Steps four, six and eight require self-reflection while steps five, seven and nine are the application of those reflections. The focus in steps 10 through 12 is on maintaining recovery. Each step builds upon the previous step in a progressive course of action.
"When I first told my family I was going into treatment, they were stunned," said Cathy, a recovering alcoholic. "I wanted to talk, needed to talk, but none of us had the right words yet. Now, five years later, I realize that it doesn't really matter how perfectly you say something. You have to risk saying the wrong thing and just start communicating.
During Step 8, people commonly resort to writing lists again, and this step is about forgiveness. Often, two lists are formed during this step: The first is a list of those who the person needs to forgive and the second is a list of those from whom they need to seek forgiveness. There will likely be crossover people on both lists. Individuals are encouraged to be honest and write down names of anyone who elicits strong emotions like resentment, shame, guilt, anger, fear, etc.
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]
Is Twelve-Step Recovery an antiquated concept or intervention? Many addiction specialist physicians contend that while the majority of continuing medical education in addiction, aimed at sharing novel breakthroughs and improving practice and outcomes, addresses pharmacotherapies, it is the psychosocial therapies which warrant at least equal attention. Some addiction medicine physicians are concerned that not only do biological interventions predominate in continuing education curriculums, but they dominate graduate medical education in addiction, and some of these physicians are concerned that fellowship training programs in addiction as well as residency programs in primary care, psychiatry, and other medical specialties should include training about and in Twelve Step Facilitation and on Twelve-Step Recovery in order for the physician to have an appropriately well-rounded educational experience and a full skill and knowledge base in the rapidly-growing specialty of addiction medicine.

Alcohol detoxification or 'detox' for alcoholics is an abrupt stop of alcohol drinking coupled with the substitution of drugs, such as benzodiazepines, that have similar effects to prevent alcohol withdrawal. Individuals who are only at risk of mild to moderate withdrawal symptoms can be detoxified as outpatients. Individuals at risk of a severe withdrawal syndrome as well as those who have significant or acute comorbid conditions are generally treated as inpatients. Detoxification does not actually treat alcoholism, and it is necessary to follow up detoxification with an appropriate treatment program for alcohol dependence or abuse to reduce the risk of relapse.[7] Some symptoms of alcohol withdrawal such as depressed mood and anxiety typically take weeks or months to abate while other symptoms persist longer due to persisting neuroadaptations.[65] Alcoholism has serious adverse effects on brain function; on average it takes one year of abstinence to recover from the cognitive deficits incurred by chronic alcohol abuse.[126]


Up to 30% of children are offered drugs before graduating high school, and for alcohol, it’s three out of every four kids who are offered. Peer pressure is a beast. Fitting-in is extremely important in high school, and unfortunately drinking alcohol is a common marker of ‘being cool.’ Peer pressure does not end after 12th grade, though. Oftentimes adults are pressured into drinking at social events when they don’t want to. Over time, this can be habit-forming.

Feeling a "kinship of common suffering" and, though drunk, Wilson attended his first Group gathering. Within days, Wilson admitted himself to the Charles B. Towns Hospital after drinking four beers on the way—the last alcohol he ever drank. Under the care of William Duncan Silkworth (an early benefactor of AA), Wilson's detox included the deliriant belladonna.[16] At the hospital a despairing Wilson experienced a bright flash of light, which he felt to be God revealing himself.[17] Following his hospital discharge Wilson joined the Oxford Group and recruited other alcoholics to the Group. Wilson's early efforts to help others become sober were ineffective, prompting Silkworth to suggest that Wilson place less stress on religion and more on "the science" of treating alcoholism. Wilson's first success came during a business trip to Akron, Ohio, where he was introduced to Robert Smith, a surgeon and Oxford Group member who was unable to stay sober. After thirty days of working with Wilson, Smith drank his last drink on 10 June 1935, the date marked by AA for its anniversaries.[18]
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As dependence increases, individuals are more likely to experience health and social consequences. The consumption of alcohol in moderation has health benefits for some (e.g. it reduces the risk of cardiovascular disease in older people). On the other hand, excessive alcohol consumption, especially when it is caused by alcohol dependence, is associated with an increased risk of numerous health problems. These include:
The program’s emphasis on negative feelings of powerlessness and guilt. Continuing in that train of thought, while the idea behind the 12 Steps may have been revolutionary at the time, for many they can feel outdated and even counterproductive. The 12-Step program demands that those in it break themselves down to be built back up, focusing on the notion that you are incapable of taking responsibility not just for your alcoholism but for yourself as well, that there is something wrong with you, and instilling what can feel more like shame than motivation.

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Alcohol misuse and dependence are primarily diagnosed through the use of clinical screening surveys. Several hundred such surveys exist, and they vary in the number and nature of questions they ask. Some of the more common scientifically-validated questionnaires include the Michigan Alcohol Screening Test (MAST), a shorter version called the Brief MAST, the Alcohol Use Disorders Identification Test (AUDIT), and a commonly employed, quick survey called the CAGE questionnaire. These surveys ask a range of questions about frequency of drinking, problems that result, and ability to stop.
The path to getting sober and drug-free is never exactly the same for any two people. However, anyone looking to find out more about rehab and recovery - either for themselves or their loved ones - will recognize some common steps, particularly when it comes to inpatient residential treatment programs. These steps are usually similar whether you’re looking for private alcoholism treatment or a drug addiction recovery center.
A member who accepts a service position or an organizing role is a "trusted servant" with terms rotating and limited, typically lasting three months to two years and determined by group vote and the nature of the position. Each group is a self-governing entity with AA World Services acting only in an advisory capacity. AA is served entirely by alcoholics, except for seven "nonalcoholic friends of the fellowship" of the 21-member AA Board of Trustees.[25]
Alcohol affects virtually every organ system in the body and, in high doses, can cause coma and death. It affects several neurotransmitter systems in the brain, including opiates, GABA, glutamate, serotonin, and dopamine. Increased opiate levels help explain the euphoric effect of alcohol, while its effects on GABA cause anxiolytic and sedative effects.
Young antisocial subtype: This group represents about 21 percent of people struggling with AUD, according to the NIAAA study. On average, this group is about 26 years old – so still young, but not as young as the young adult group. They are defined by having antisocial personality disorder; this mental health condition leads them to begin drinking in adolescence, around age 15 on average, and they display symptoms of AUD by age 18. They are also more likely to struggle with polydrug abuse, especially abuse of tobacco and marijuana. There is no overlap between the young adult and young antisocial subtypes.
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]
In a closed AA meeting, the only people who may attend are those who are recovering addicts (or those interested in learning more about overcoming their addiction). Open meetings allow the attendance of friends, spouses and family members. Whether you decide to go to a closed or open meeting depends exclusively on what you’re comfortable with. Some people would rather keep their recovery separate from the rest of their life. Others thrive on the support that loved ones can provide during meetings.
Fact: Alcoholism is NOT defined by what you drink, when you drink it, or even how much you drink. It’s the EFFECTS of your drinking that define a problem. If your drinking is causing problems in your home or work life, you have a drinking problem—whether you drink daily or only on the weekends, down shots of tequila or stick to wine, drink three bottles of beers a day or three bottles of whiskey.
FAS is the leading cause of mental retardation in the United States. One to two of every 1,000 infants born in the United States are afflicted with FAS. The incidence of FAS in children whose mothers drink heavily is 4% much higher than the rate in the general population. Research studies that have followed infants with FAS and FAEs across time have found that many of these children continue to have cognitive difficulties (e.g., lower IQ scores, more learning problems, poorer short-term memory functioning) and behavioral problems (e.g., high impulsivity, high activity level) into childhood and adolescence.
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Not all alcohol abusers become full-blown alcoholics, but it is a big risk factor. Sometimes alcoholism develops suddenly in response to a stressful change, such as a breakup, retirement, or another loss. Other times, it gradually creeps up on you as your tolerance to alcohol increases. If you’re a binge drinker or you drink every day, the risks of developing alcoholism are greater.
The personal nature of the behavioral issues that lead to seeking help in twelve-step fellowships results in a strong relationship between sponsee and sponsor. As the relationship is based on spiritual principles, it is unique and not generally characterized as "friendship". Fundamentally, the sponsor has the single purpose of helping the sponsee recover from the behavioral problem that brought the sufferer into twelve-step work, which reflexively helps the sponsor recover.[25]
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