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When it comes to maintaining long-term sobriety outside of a rehabilitation treatment program, the oldest and probably most well-known organization is Alcoholics Anonymous (AA). Founded in 1935, AA and its 12-Step Program has been the go-to for treating alcoholism for decades, with many addiction treatment centers incorporating at least some version of the 12 Steps in their own treatment therapies.
Prevention must begin at a young age since the first instance of intoxication usually occurs during the teenage years. It is particularly important that teenagers who are at high risk for alcoholism-those with a family history of alcoholism, early or frequent use of alcohol, a tendency to drink to drunkenness, alcohol use that interferes with school work, a poor family environment, or a history of domestic violence -receive education about alcohol and its long-term effects. How this is best achieved, without alienating these young people and thus losing their attention, is the subject of continuing debate and study.
Each person will have their own idea of who or what the higher power is to them, and in Step 3, individuals are asked to turn their lives over to this power for healing purposes. Steps 1 and 2 are all about reflection, learning that alcohol (or drugs) is a driving force in life and that a higher power is needed to recover and remain sober. With Step 3, individuals are called to action and to a willingness to change moving forward.
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.
Of men aged 18–25 years, 60% binge drink. (Binge drinking is defined as 5 alcoholic drinks for men [4 for women] in a row.) Binge drinking significantly increases the risk of injury and contracting sexually transmitted diseases. Women who binge drink at this age are at higher risk of becoming pregnant and potentially harming an unborn child. (Any amount of alcohol consumption during pregnancy is risky.) Cohort data from the Prospective Epidemiological Study of Myocardial Infarction (PRIME) investigated alcohol use patterns on ischemic heart disease in Northern Ireland and France. Regular and moderate alcohol use throughout the week, a typical pattern in middle-aged men in France, was associated with a lower risk of ischemic heart disease, whereas the binge drinking pattern more prevalent in Northern Ireland was associated with a higher risk of ischemic heart disease. [17]
More than a quarter (27%) of all 15- to 19-year-olds worldwide consume alcohol. Rates are highest in Europe (44%), followed by the Americas (38%) and the Western Pacific (38%). Total alcohol consumption per capita among those older than 15 years around the world rose from 5.5 liters of pure alcohol in 2005 to 6.4 liters in 2010 and remained at that level in 2016. [1, 2]
Moderate alcohol consumption (1–2 drinks/d) reduces the risk of cardiovascular disease in men and women by approximately 30%. [13, 14, 15] The effect of heavy alcohol consumption on the risk of cardiovascular disease varies in different studies. The person's drinking pattern appears to have an effect on cardiovascular disease. Drinking with meals may reduce the risk, while binge drinking increases risk (even in otherwise moderate drinkers).
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The immediate physical effects of drinking alcohol range from mild mood changes to complete loss of coordination, vision, balance, and speech -- any of which can be signals of acute alcohol intoxication, or drunkenness. These effects usually wear off in a matter of hours after a person stops drinking. Many law-enforcement agencies regard a .08 percentage of alcohol in the bloodstream as evidence of intoxication. Larger amounts of blood alcohol can impair brain function and eventually cause unconsciousness. An extreme overdose, alcohol poisoning, can be fatal.

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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Elderly people who drink excessively are at risk for having more serious illnesses, doctor visits, and symptoms of depression, with less life satisfaction and smaller social support networks compared to senior citizens who have never consumed alcohol. While binge drinking is often thought to be a symptom of young people, an often unknown fact is that a significant percentage of middle-aged and elderly individuals also engage in binge drinking. This behavior increases the risk for driving drunk, no matter what the age. That, in turn, puts the individual at risk for being arrested for driving under the influence (DUI) of alcohol.
In 1939, High Watch Farm in Kent, Connecticut was founded by Bill Wilson and Marty Mann. Sister Francis who owned the farm tried to gift the spiritual retreat for alcoholics to Alcoholics Anonymous, however citing the sixth tradition Bill W. turned down the gift but agreed to have a separate non-profit board run the facility composed of AA members. Bill Wilson and Marty Mann served on the High Watch board of directors for many years. High Watch was the first and therefore the oldest 12 step based treatment center in the world still operating today.

Severe acute withdrawal symptoms such as delirium tremens and seizures rarely occur after 1-week post cessation of alcohol. The acute withdrawal phase can be defined as lasting between one and three weeks. In the period of 3–6 weeks following cessation increased anxiety, depression, as well as sleep disturbance, is common;[65] fatigue and tension can persist for up to 5 weeks as part of the post-acute withdrawal syndrome; about a quarter of alcoholics experience anxiety and depression for up to 2 years. These post-acute withdrawal symptoms have also been demonstrated in animal models of alcohol dependence and withdrawal.[66] A kindling effect also occurs in alcoholics whereby each subsequent withdrawal syndrome is more severe than the previous withdrawal episode; this is due to neuroadaptations which occur as a result of periods of abstinence followed by re-exposure to alcohol. Individuals who have had multiple withdrawal episodes are more likely to develop seizures and experience more severe anxiety during withdrawal from alcohol than alcohol-dependent individuals without a history of past alcohol withdrawal episodes. The kindling effect leads to persistent functional changes in brain neural circuits as well as to gene expression.[67] Kindling also results in the intensification of psychological symptoms of alcohol withdrawal.[65] There are decision tools and questionnaires which help guide physicians in evaluating alcohol withdrawal. For example, the CIWA-Ar objectifies alcohol withdrawal symptoms in order to guide therapy decisions which allows for an efficient interview while at the same time retaining clinical usefulness, validity, and reliability, ensuring proper care for withdrawal patients, who can be in danger of death.[68]
Alcohol withdrawal can occur when alcohol use has been heavy and prolonged and is then stopped or greatly reduced. It can occur within several hours to four or five days later. Signs and symptoms include sweating, rapid heartbeat, hand tremors, problems sleeping, nausea and vomiting, hallucinations, restlessness and agitation, anxiety, and occasionally seizures. Symptoms can be severe enough to impair your ability to function at work or in social situations.
The twelve steps of alcoholics anonymous do not come from the Oxford Groups because there were twelve apostles the  Oxford Groups practised six steps all of which AA adopted but also added six which had to do specifically with a non denominational or religious numinous power and the specific effects of alcohol addiction on the character on the afflicted.  As many addicts -- probably many more -- have been harmed by the ignorant prescription or pharmaceuticals to people in recovery for AA as have been harmed by a lay AA sponsor telling a member that all prescriptions are bad. .   
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.
Short-term effects of alcohol abuse can be just as dangerous as long-term effects. For instance, drinking can impact your reaction time, causing you to have slow reflexes and coordination. That’s why drinking and driving is extremely dangerous. Getting behind the wheel of a car can alter your perception of speed and distance, putting yourself and others at risk.
Stereotypes of alcoholics are often found in fiction and popular culture. The "town drunk" is a stock character in Western popular culture. Stereotypes of drunkenness may be based on racism or xenophobia, as in the fictional depiction of the Irish as heavy drinkers.[171] Studies by social psychologists Stivers and Greeley attempt to document the perceived prevalence of high alcohol consumption amongst the Irish in America.[172] Alcohol consumption is relatively similar between many European cultures, the United States, and Australia. In Asian countries that have a high gross domestic product, there is heightened drinking compared to other Asian countries, but it is nowhere near as high as it is in other countries like the United States. It is also inversely seen, with countries that have very low gross domestic product showing high alcohol consumption.[173] In a study done on Korean immigrants in Canada, they reported alcohol was even an integral part of their meal, and is the only time solo drinking should occur. They also believe alcohol is necessary at any social event as it helps conversations start.[174]
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.

People have been brewing and fermenting alcoholic drinks since the dawn of civilization. Consumed in moderate amounts, alcoholic beverages are relaxing and in some cases may even have beneficial effects on heart health. Consumed in excess, alcohol is poisonous and is considered a drug. It is estimated that between 18 million -- or one in 12 adults -- in the U.S. abuse alcohol or are chronic alcoholics. Nearly 100,000 Americans die each year as a result of alcohol abuse, and alcohol is a factor in more than half of the country's homicides, suicides, and traffic accidents. Alcohol abuse also plays a role in many social and domestic problems, from job absenteeism and crimes against property to spousal and child abuse.


Moderate alcohol consumption (1–2 drinks/d) reduces the risk of cardiovascular disease in men and women by approximately 30%. [13, 14, 15] The effect of heavy alcohol consumption on the risk of cardiovascular disease varies in different studies. The person's drinking pattern appears to have an effect on cardiovascular disease. Drinking with meals may reduce the risk, while binge drinking increases risk (even in otherwise moderate drinkers).
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.

Signs that indicate a person is intoxicated include the smell of alcohol on their breath or skin, glazed or bloodshot eyes, the person being unusually passive or argumentative, and/or a deterioration in the person's appearance, judgment, or hygiene. Other physical symptoms of the state of being drunk include flushed skin. Cognitively, the person may experience decreased ability to pay attention and a propensity toward memory loss.
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"We will comprehend the word serenity and we will know peace." (Alcoholics Anonymous, p. 84)          Just For Today          Life takes on new meaning in A.A. To watch people recover, to see them help others, to watch loneliness vanish, to see a fellowship grow up about you, to have a host of friends - this is an experience not to be missed. (from the 12&12 and Alcoholics Anonymous)          

 In addition, every federal court in the land that has examined the issue has held that 12-Step programs -- despite their claims to the contrary -- are sufficiently religious that coerced attendance (for example, when a court or probation officer orders mandatory attendance at AA meetings) violates the Establishment Clause of the First Amendment of the U.S. Constitution.  This is explicitly the law in the 2nd, 7th, and 9th federal circuits, as well as the states of New York and Tennessee.
Humility is the key of Step 7, as individuals are asked to seek God’s will in how their life is to be lived. Humility is defined as the state of being humble or thinking less of oneself than of others. Humility is an important concept in recovery. Meditation is often useful during Step 7 as a method of self-introspection and learning how to apply humility to one’s life. During Step 7, individuals work to remain humble.

Some people don’t like or are not interested in the 12-Step model, even with the variations above or through organizations that facilitate the 12-Step model. Some people don’t like basing their recovery on the idea that they cannot control their addiction, when there is evidence that there are ways of practicing internal control over the recovery process.
While 12-Step facilitation programs don’t necessarily follow the steps, they promote the use of a 12-Step methodology, in the hope that clients will move to a 12-Step program after rehab to help maintain sobriety. In addition, certain treatment centers base their model for service around some of the ideas promoted through the 12-Step program. These centers can offer research-based services and promote a more scientific understanding of addiction treatment, but they incorporate some of the spiritual, psychological, and practical practices that the 12-Step program promotes. This results in an encompassing model of care designed to support clients through rehab and to give tools that they can use after treatment to maintain their recovery for the long-term.

Narcotics Anonymous (NA). Narcotics Anonymous is an organization that adapted the same principles as Alcoholics Anonymous. Just like AA, NA emphasizes a spiritual connection to a higher power. The program is targeted towards men and women for whom drugs have become a major problem. These people come together regularly in support group meetings and help one another to maintain abstinence as they recover from their addictions.
These are all very different drinking patterns, but they have one thing in common. People who drink like this have lost some modicum of control over their consumption. The beverages drive their behaviors. It can seem like a subtle distinction, but it’s an important one to understand, as people who don’t amend troublesome drinking behaviors can become people who have symptoms of alcoholism.
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AA is the most widely available 12-Step program, and meeting times and locations are easily found on the Internet. Our Continuum of Care staff provides recommendations for solution-based meetings with a solid foundation of support. At Origins Behavioral HealthCare, we familiarize our patients with 12-Step meetings during their stay and connect them with 12-Step resources in their own communities.
The term is also used by outlets like Salon and New York Magazine, which suggest that the time has come for Alcoholics Anonymous to be decoupled from mainstream alcoholism recovery. The point is made by Mia Szalavitz, a recovering addict and now an addiction researcher and author, who wrote a book about how developments in neuroscience and psychology might render AA obsolete. Szalavitz takes issue with the AA concept of “hitting rock bottom,” the moment when a person experiences a personal loss (e.g., a DUI, eviction, divorce, firing, etc.) as a sign that the addiction has become too damaging to ignore. This expectation, writes Szalavitz, is “harsh and humiliating,” in the sense that help is withheld until the person crosses a tragic Rubicon. But so deeply does it run in the DNA of Alcoholics Anonymous that it has influenced how any 12-Step methodology treats addiction therapy. This, says Szalavitz, has made the treatment community on the whole “embrace a totally false, harmful view of what addiction is.”
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