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An initial step in detecting liver damage is a simple blood test to determine the presence of certain liver enzymes in the blood. Under normal circumstances, these enzymes reside within the cells of the liver. But when the liver is injured, these enzymes are spilled into the blood stream, and can lead to diseases like fatty liver, type 2 diabetes, obesity, and hepatitis. Several medications also can increase liver enzyme test results.
Set in beautiful Calistoga, California, Duffy's Napa Valley Rehab is a comprehensive treatment center where men and women can come to heal from addictions of all kinds. At Duffy's, residents are empowered to break free from chemical dependency and gain the skills they need to live the healthy, vibrant lives they deserve. For more information please call (866) 869-3318

Alcohol inhibits the receptor for glutamate. Long-term ingestion results in the synthesis of more glutamate receptors. When alcohol is withdrawn, the central nervous system experiences increased excitability. Persons who abuse alcohol over the long term are more prone to alcohol withdrawal syndrome than persons who have been drinking for only short periods. Brain excitability caused by long-term alcohol ingestion can lead to cell death and cerebellar degeneration, Wernicke-Korsakoff syndrome, tremors, alcoholic hallucinosis, delirium tremens, and withdrawal seizures. Opiate receptors are increased in the brains of recently abstinent alcoholic patients, and the number of receptors correlates with cravings for alcohol.
Drinking enough to cause a blood alcohol concentration (BAC) of 0.03–0.12% typically causes an overall improvement in mood and possible euphoria (a "happy" feeling), increased self-confidence and sociability, decreased anxiety, a flushed, red appearance in the face and impaired judgment and fine muscle coordination. A BAC of 0.09% to 0.25% causes lethargy, sedation, balance problems and blurred vision. A BAC of 0.18% to 0.30% causes profound confusion, impaired speech (e.g. slurred speech), staggering, dizziness and vomiting. A BAC from 0.25% to 0.40% causes stupor, unconsciousness, anterograde amnesia, vomiting (death may occur due to inhalation of vomit (pulmonary aspiration) while unconscious) and respiratory depression (potentially life-threatening). A BAC from 0.35% to 0.80% causes a coma (unconsciousness), life-threatening respiratory depression and possibly fatal alcohol poisoning. With all alcoholic beverages, drinking while driving, operating an aircraft or heavy machinery increases the risk of an accident; many countries have penalties for drunk driving.
I agree with many of the earlier comments highlighting the drawbacks of 12-Step for many folks seeking recovery.  Although the program claims to be "spiritual" and "not religious," it's roots are in the Oxford Group, an early evangelical Protestant organization, and the 12 Steps (12, because there were 12 apostles) are taken directly from Oxford Group, which maintained that people were "powerless over sin."  Bill W. simply replaced "sin" with "alcohol" and kept the rest unchanged.

The 12 Steps are designed to not only be read – but to be applied in our daily lives. The 12 Step approach to recovery is embraced throughout the world, so it’s always easy to find support where you are or wherever you go. Accordingly, we advise patients to keep in contact with ‘sober supports’ they make during treatment at one of our locations. We also encourage them to continue attending 12 Step groups on a regular basis after discharge. Being able to discuss mistakes or relapses, as needed, in a supportive environment helps to keep patients accountable for their actions.


Although all forms of problem drinking are getting worse in the US, not everyone who drinks too much meets the criteria for AUD. The CDC found, in 2014, that 90 percent of those who drink too much alcohol, even frequently, are not physically dependent on the substance to feel normal. Although one in three adults drink to excess, meeting the criteria for heavy or binge drinking, nine out of 10 do not meet the criteria for AUD from the DSM-5.
Friends and family members are interconnected—suspended in delicate balance. When a loved one begins the arduous journey of recovery, the balance shifts. With work and understanding, relationships can be reshaped into something better and a healthier balance can be achieved. Recovery and support for the recovering person are reciprocal gifts that keep on giving.
Of the over 16 million people in the country who have a potential AUD, 9.8 million men and 5.3 million women respectively have a diagnosable AUD. About 10 percent of children in the US have at least one parent who struggles with problem drinking, and about 31 percent of driving fatalities in the US involve a drunk driver. Unfortunately, very few people every year seek treatment for AUD despite physical, mental, social, financial, and legal ramifications.
...more and more, Bill discovered that new adherents could get sober by believing in each other and in the strength of this group. Men [no women were members yet] who had proven over and over again, by extremely painful experience, that they could not get sober on their own had somehow become more powerful when two or three of them worked on their common problem. This, then—whatever it was that occurred among them—was what they could accept as a power greater than themselves. They did not need the Oxford Group.

Before you do anything, it’s important to know whether your friend or loved one has an alcohol addiction. Alcohol use disorder, or alcoholism, is more than just drinking too much from time to time. Sometimes alcohol as coping mechanism or social habit may look like alcoholism, but it’s not the same. People with alcohol use disorder don’t drink in moderation, even if they say they’re only having one drink. To learn more, read about alcoholism and its symptoms.


The 12-Step philosophy pioneered by Alcoholics Anonymous is used by about 74 percent of treatment centers. The basic premise of this model is that people can help one another achieve and maintain abstinence from substances of abuse, but that healing cannot come about unless people with addictions surrender to a higher power. The 12-Step movement can be a force for good for many people, but some struggle with what they interpret as a strong religious element of the program. Many addiction treatment programs offer alternatives to 12-Step methodology for those who prefer a more secular foundation for treatment.

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]


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.
Clear communication by parents about the negative effects of alcohol, as well as about their expectations regarding drug use, has been found to significantly decrease alcohol use in teens. Adequate parental supervision has also been found to be a deterrent to underage alcohol abuse. Alcohol, and other drug use, has been found to occur most often between the hours of 3 p.m. and 6 p.m., immediately after school and prior to parents' arrival at home from work. Teen participation in extracurricular activities has therefore been revealed to be an important prevention measure for the use of alcohol in this age group. Parents can also help educate teens about appropriate coping and stress-management strategies. For example, 15- to 16-year-olds who use religion to cope with stress tend to use drugs significantly less often and have fewer problems as a result of drinking than their peers who do not use religion to cope.
The effects of alcoholism are far reaching. Alcohol affects every body system, causing a wide range of health problems. Problems include poor nutrition, memory disorders, difficulty with balance and walking, liver disease (including cirrhosis and hepatitis), high blood pressure, muscle weakness (including the heart), heart rhythm disturbances, anemia, clotting disorders, decreased immunity to infections, gastrointestinal inflammation and irritation, acute and chronic problems with the pancreas, low blood sugar, high blood fat content, interference with reproductive fertility, increased risk of cancer of the liver, esophagus, and breast, weakened bones, sleep disturbances, anxiety, and depression. About 20% of adults admitted to the hospital (for any reason) are alcohol dependent. Men are more than twice as likely to be alcohol dependent than women, and smokers who are alcohol dependent are much more likely to develop serious or fatal health problems associated with alcoholism.
Thank you. Twelve Steps and AA culture is a great bridge to extended self help. It works great when most of those working together come from diverse backgrounds. In my humble opinion, it gets difficult when the professional treatment world extends so deep into self help that they begin to set the standards for CBT in terms of acceptable attitudes. I am disheartened by the almost organized labor or mob influence on the traditional meetings.
Alcoholism is characterised by an increased tolerance to alcohol–which means that an individual can consume more alcohol–and physical dependence on alcohol, which makes it hard for an individual to control their consumption. The physical dependency caused by alcohol can lead to an affected individual having a very strong urge to drink alcohol. These characteristics play a role decreasing an alcoholic's ability to stop drinking.[25] Alcoholism can have adverse effects on mental health, causing psychiatric disorders and increasing the risk of suicide. A depressed mood is a common symptom of heavy alcohol drinkers.[26][27]
Problem drinking in women is much less common than it is in men, and the typical onset of problem drinking in females occurs later than in males. However, progression is more rapid, and females usually enter treatment earlier than males. Women more commonly combine alcohol with prescription drugs of abuse than do males. Women living with substance-abusing men are at high risk.

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.


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Wilson took this to heart, coming up with additional points to safeguard the integrity and future of his group. To that effect, he wrote that every individual AA group should decline outside contributions and ought to be able to fully support itself. Alcoholics Anonymous was never to be a professional organization; “the only requirement for AA membership,” he wrote, “is a desire to stop drinking.” Above all, groups had to prize anonymity; Wilson wrote that it is “the spiritual foundation of all our traditions,” and that the sacrifice of identity would help members “place principles before personalities.”

There is a group of physicians within ASAM who are concerned that twelve-step recovery is not being taught to new physicians entering this field (most physicians currently enter addiction practice in mid-career, rather than straight out of residency training). Referring to themselves as “Like Minded Docs,” they communicate regularly among each other, leaning on each other via email for support and guidance, and occasionally reaching out to ASAM regarding policies of the Society. One of their stated concerns is that continuing education programs for physicians newly involved with addiction or considering a mid-career switch into addiction medicine have more content on pharmacotherapies and less content on psychosocial therapies, and that Twelve-Step Facilitation therapy and twelve-step recovery overall are at risk of becoming ‘dying arts.’
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.
AA's program is an inheritor of Counter-Enlightenment philosophy. AA shares the view that acceptance of one's inherent limitations is critical to finding one's proper place among other humans and God. Such ideas are described as "Counter-Enlightenment" because they are contrary to the Enlightenment's ideal that humans have the capacity to make their lives and societies a heaven on earth using their own power and reason.[33] After evaluating AA's literature and observing AA meetings for sixteen months, sociologists David R. Rudy and Arthur L. Greil found that for an AA member to remain sober a high level of commitment is necessary. This commitment is facilitated by a change in the member's worldview. To help members stay sober AA must, they argue, provide an all-encompassing worldview while creating and sustaining an atmosphere of transcendence in the organization. To be all-encompassing AA's ideology places an emphasis on tolerance rather than on a narrow religious worldview that could make the organization unpalatable to potential members and thereby limit its effectiveness. AA's emphasis on the spiritual nature of its program, however, is necessary to institutionalize a feeling of transcendence. A tension results from the risk that the necessity of transcendence, if taken too literally, would compromise AA's efforts to maintain a broad appeal. As this tension is an integral part of AA, Rudy and Greil argue that AA is best described as a quasi-religious organization.[40]
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.

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Treating underlying problems: There may be problems with self-esteem, stress, anxiety, depression, or other aspects of mental health. It is important to treat these problems, too, as they can increase the risks posed by alcohol. Common alcohol-related issues, such as hypertension, liver diseases, and possibly heart diseases, will need to be treated too.

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Doctor On Demand
Received income in an amount equal to or greater than $250 from: Blue Cross Blue Shield Federal Employee Program
Received royalty from Lippincott Williams & Wilkins for book editor; Received grant/research funds from National Alliance for Research in Schizophrenia and Depression for independent contractor; Received consulting fee from Blue Cross Blue Shield Association for consulting. for: Received book royalty from American Psychiatric Publishing Inc.

In order to effectively recover from an addiction, professional help in the field of substance abuse is only part of the equation. Often times, recovering individuals additionally need the support of others who are also recovering from addiction. This is where support groups can provide a critical element needed to bring success to an individual's recovery process.
Around a third of individuals with alcohol dependence resolve their alcohol consumption problems without professional intervention. Others need the support of a health professional who can recommend a range of treatments. While there are many effective treatments, people who overcome alcohol dependence often relapse (i.e. develop alcohol dependency once again).

The diagnosis of an alcohol problem is best made by the history. Screening instruments for alcohol problems include the CAGE ([need to] cut down [on drinking], annoyance, guilt [about drinking], [need for] eye-opener) questionnaire and the AUDIT (alcohol use disorders identification test). The CAGE questions should be given face-to-face, whereas AUDIT can be given as a paper-and-pencil test.
To be diagnosed with AUD, individuals must meet certain criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Under DSM–5, the current version of the DSM, anyone meeting any two of the 11 criteria during the same 12-month period receives a diagnosis of AUD. The severity of AUD—mild, moderate, or severe—is based on the number of criteria met.
No laboratory tests exist that can screen for alcoholism with a high level of accuracy. Most alcoholism is diagnosed through patient and family history. However, alcoholism can be difficult to diagnose until late-stage physical symptoms become apparent because alcohol-dependent people often lie or about underestimate their alcohol use. In addition, many physicians do not routinely screen their patients using standardized questionnaires that may reveal alcohol problems.
Jump up ^ Sullivan, JT; Sykora, K; Schneiderman, J; Naranjo, CA; Sellers, EM (November 1989). "Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar)" (PDF). Br J Addict. 84 (11): 1353–7. CiteSeerX 10.1.1.489.341. doi:10.1111/j.1360-0443.1989.tb00737.x. PMID 2597811. Archived from the original (PDF) on 10 August 2013. Retrieved 25 October 2017.
The National Survey on Drug Use and Health (NSDUH) for 2015 found that 86.4 percent of the population ages 18 and older consumed alcohol at some point in their lives; about 56 percent reported that they drank in the past month, indicating a pattern of regular alcohol consumption. Alcohol is legal in the US for people ages 21 and older to consume, but as an intoxicating substance, it is dangerous and can lead to addiction. The NSDUH also found that 26.9 percent of the population engaged in binge drinking in the past month (more than four drinks within two hours), and 7 percent reported that they drank heavily in the past month (more than two drinks per day). These behaviors indicate higher risk for AUD.
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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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