Misuse, problem use, abuse, and heavy use of alcohol refer to improper use of alcohol, which may cause physical, social, or moral harm to the drinker.[91] The Dietary Guidelines for Americans defines "moderate use" as no more than two alcoholic beverages a day for men and no more than one alcoholic beverage a day for women.[92] Some drinkers may drink more than 600 ml of alcohol per day during a heavy drinking period.[93] The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as the amount of alcohol leading to a blood alcohol content (BAC) of 0.08, which, for most adults, would be reached by consuming five drinks for men or four for women over a two-hour period. According to the NIAAA, men may be at risk for alcohol-related problems if their alcohol consumption exceeds 14 standard drinks per week or 4 drinks per day, and women may be at risk if they have more than 7 standard drinks per week or 3 drinks per day. It defines a standard drink as one 12-ounce bottle of beer, one 5-ounce glass of wine, or 1.5 ounces of distilled spirits.[94] Despite this risk, a 2014 report in the National Survey on Drug Use and Health found that only 10% of either "heavy drinkers" or "binge drinkers" defined according to the above criteria also met the criteria for alcohol dependence, while only 1.3% of non-binge drinkers met the criteria. An inference drawn from this study is that evidence-based policy strategies and clinical preventive services may effectively reduce binge drinking without requiring addiction treatment in most cases.[95]
The endpoint of “recovery” from addiction, if there is an endpoint, is to change one’s life for the better, to gain stability in one’s life, and to become more functional in one’s family and in one’s community. Being responsible, being reliable, being interested in others and not just in oneself, and being a loving being who cares about and is helpful to others, are all part of recovery.
Alcoholics Anonymous publishes several books, reports, pamphlets, and other media, including a periodical known as the AA Grapevine.[97] Two books are used primarily: Alcoholics Anonymous (the "Big Book") and Twelve Steps and Twelve Traditions, the latter explaining AA's fundamental principles in depth. The full text of each of these two books is available on the AA website at no charge.

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]
Five stages of alcohol and substance abuse disorders have been identified. The first stage is described as having access to alcohol rather than use of alcohol. In that stage, minimizing the risk factors that make a person more vulnerable to using alcohol are an issue. The second stage of alcohol use ranges from experimentation or occasional use to regular weekly use of alcohol. This or any of the more severe stages of alcoholism may involve binge drinking. The third stage is characterized by individuals further increasing the frequency of alcohol use and/or using the substance on a regular basis. This stage may also include either buying or stealing to get alcohol. In the fourth stage of alcohol use, users have established regular alcohol consumption, have become preoccupied with getting intoxicated ("high") and have developed problems in their social, educational, vocational, or family life as a result of using the substance. The final and most serious fifth stage of alcohol use is defined by the person only feeling normal when they are using alcohol. During this stage, risk-taking behaviors like stealing, engaging in physical fights, or driving while intoxicated increase, and they become most vulnerable to having suicidal thoughts.
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AA describes alcoholism as an illness that involves a physical allergy[107]:28 (where "allergy" has a different meaning than that used in modern medicine.[108]) and a mental obsession.[107]:23[109] The doctor and addiction specialist Dr. William D. Silkworth M.D. writes on behalf of AA that "Alcoholics suffer from a "(physical) craving beyond mental control".[107]:XXVI A 1960 study by E. Morton Jellinek is considered the foundation of the modern disease theory of alcoholism.[110] Jellinek's definition restricted the use of the word alcoholism to those showing a particular natural history. The modern medical definition of alcoholism has been revised numerous times since then. The American Medical Association uses the word alcoholism to refer to a particular chronic primary disease.[111]


 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.

Alcohol, especially when consumed in excess, can affect teens, women, men, and the elderly quite differently. Women and the elderly tend to have higher blood concentrations of alcohol compared to men and younger individuals who drink the same amount. Alcoholic women are more at risk for developing physical health problems like cirrhosis of the liver and heart and nerve damage at a faster rate than alcohol-dependent men. Interestingly, men and women seem to have similar learning and memory problems as the result of excessive alcohol intake, but again, women tend to develop those problems twice as fast as men.
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.
Given the malnutrition that many alcoholics suffer from, gradual correction of that condition is also important, both to prevent or correct the consequences of malnutrition (like low thiamine level) and to prevent the potential results of correcting nutrition problems too rapidly. One example of the latter is that people with chronic alcohol-induced low sodium levels in the bloodstream (hyponatremia) are at risk for severe neurological problems due to a loss of the outer, insulating covering of nerve cells in parts of the brain (central pontine myelinolysis) if low sodium levels are corrected too rapidly.
Steps 1-9 set up a strong spiritual foundation and a new way of life without drugs and alcohol. With Step 10, individuals are seeking daily accountability for their actions. Recovery is ongoing, and individuals continue to examine how their thoughts, words, behaviors, and actions impact daily life and how to keep themselves in line with their faith and God’s will. Individuals are asked to take inventory every day and immediately correct any wrongs that are apparent. This may be accomplished by keeping a journal or devising another method of self-examination each evening, for instance. By understanding how certain things may make a person feel and therefore act, individuals can become more aware of themselves and their behaviors. Step 10 involves personal reflections and a kind of spot-checking to keep oneself balanced emotionally.
At SOBA College Recovery we provide evidence-based, academically-focused treatment modalities. Our staff consists exclusively of American Society of Addiction Medicine (ASAM) certified psychiatrists working with mental health professionals. Upon admission, all clients will be re-assessed for co-occurring mental health conditions and our psychiatrists will develop a subsequent treatment plan. At SOBA College Recovery, life is just starting. We don’t feel recovery should be a punishment. Students and young adults will meet like-minded peers and counselors dedicated to enjoying life. Our core philosophy is based on role-modeling, openness, hard work, and trust. CALL TODAY 732-204-8325 ! College Recovery Helps Students and Young Adults Get Back On Track!
Statistics (US) Alcohol causes half a million hospital admissions/year, 17,000 psychiatric admissions, 80% of all fire-related deaths, 65% of serious head injuries, 50% of homicides, 40% of RTAs/MVAs, 33% of divorces, 33% child abuse cases, 30% of fatal accidents, 30% of domestic accidents, 8 million working days lost, £1.6 billion annual cost to society.
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Recovery is an interesting concept. It implies not only improvement, but potentially remission. The term describes a process as well as a destination. And the underlying premise of recovery is that of hope--hope that a person with a potentially fatal illness can avoid a catastrophic outcome. “Recovery activities” are not professional treatment, but can promote recovery just as professional treatment can. One of the most familiar “recovery activities” engaged in by persons with addiction is participation in the activities of Alcoholics Anonymous (AA).
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.
Topiramate, a derivative of the naturally occurring sugar monosaccharide D-fructose, has been found effective in helping alcoholics quit or cut back on the amount they drink. Evidence suggests that topiramate antagonizes excitatory glutamate receptors, inhibits dopamine release, and enhances inhibitory gamma-aminobutyric acid function. A 2008 review of the effectiveness of topiramate concluded that the results of published trials are promising, however, as of 2008, data was insufficient to support using topiramate in conjunction with brief weekly compliance counseling as a first-line agent for alcohol dependence.[177] A 2010 review found that topiramate may be superior to existing alcohol pharmacotherapeutic options. Topiramate effectively reduces craving and alcohol withdrawal severity as well as improving quality-of-life-ratings.[178]
Warning signs of alcoholism include the consumption of increasing amounts of alcohol and frequent intoxication, preoccupation with drinking to the exclusion of other activities, promises to quit drinking and failure to keep those promises, the inability to remember what was said or done while drinking (colloquially known as "blackouts"), personality changes associated with drinking, denial or the making of excuses for drinking, the refusal to admit excessive drinking, dysfunction or other problems at work or school, the loss of interest in personal appearance or hygiene, marital and economic problems, and the complaint of poor health, with loss of appetite, respiratory infections, or increased anxiety.[28]
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Jump up ^ Alcoholics Anonymous (2001-06-01). "Chapter 2: There Is a Solution". Alcoholics Anonymous (PDF) (4th ed.). Alcoholics Anonymous World Services. p. 21. ISBN 1893007162. OCLC 32014950. These observations would be academic and pointless if [he] never took the first drink, thereby setting the terrible cycle in motion. Therefore, the main problem...centers in his mind....The fact is that most alcoholics...have lost the power of choice in drink...unable, at certain times, to bring into [his] consciousness with sufficient force the memory of the suffering and humiliation of a month or even a week ago. [He] is without defense against the first drink.
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