observations The most frequent medical consequences of alcoholism are central nervous system depression and cirrhosis. The severity of each may be greater in the absence of food intake. Alcoholic patients also may suffer from alcoholic gastritis, peripheral neuropathies, auditory hallucinations, and cardiac problems. Abrupt withdrawal of alcohol in addiction causes weakness, sweating, and hyperreflexia. The severe form of alcohol withdrawal is delirium tremens.

Alcoholism, also known as alcohol use disorder (AUD), is a broad term for any drinking of alcohol that results in mental or physical health problems.[12] The disorder was previously divided into two types: alcohol abuse and alcohol dependence.[1][13] In a medical context, alcoholism is said to exist when two or more of the following conditions are present: a person drinks large amounts over a long time period, has difficulty cutting down, acquiring and drinking alcohol takes up a great deal of time, alcohol is strongly desired, usage results in not fulfilling responsibilities, usage results in social problems, usage results in health problems, usage results in risky situations, withdrawal occurs when stopping, and alcohol tolerance has occurred with use.[1] Risky situations include drinking and driving or having unsafe sex, among other things.[1] Alcohol use can affect all parts of the body, but it particularly affects the brain, heart, liver, pancreas and immune system.[3][4] This can result in mental illness, Wernicke–Korsakoff syndrome, irregular heartbeat, liver cirrhosis and increased cancer risk, among other diseases.[3][4] Drinking during pregnancy can cause damage to the baby resulting in fetal alcohol spectrum disorders.[2] Women are generally more sensitive than men to the harmful physical and mental effects of alcohol.[9]

While group therapy can help teens stay sober, groups that include a number of teens who also engage in disordered behaviors can actually tend to increased alcohol use in this age group. Family interventions for alcoholism that tend to be effective for teens include multidimensional family therapy (MDFT), group therapy, and multifamily educational intervention (MFE). MDFT has been found to be quite effective. Longer-term residential treatment, often called rehab, of three to five months that addresses peer relationships, educational problems, and family issues is often used in treating alcohol use disorder in teens.


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Like individual groups, the GSO is self-supporting. AA receives proceeds from books and literature that constitute more than 50% of the income for its General Service Office.[30] In keeping with AA's Seventh Tradition, the Central Office is fully self-supporting through the sale of literature and related products, and through the voluntary donations of AA members and groups. It does not accept donations from people or organizations outside of AA.
At secular meetings there is generally much more acceptance of medication-assisted recovery, much less emphasis on deficits in "moral character," and no prayer.  The focus is present-centered, avoiding "war stories," and pragmatic:  "how am I staying sober today?  What tools am I using?" Participants are also generally not required to label themselves as addicts or alcoholics, which can be refreshing for many people new to recovery.  In LifeRing, "crosstalk" is a key element of meetings, so folks in recovery are sharing their strategies for success.
Various forms of group therapy or psychotherapy can be used to deal with underlying psychological issues that are related to alcohol addiction, as well as provide relapse prevention skills. The mutual-help group-counseling approach is one of the most common ways of helping alcoholics maintain sobriety.[6] Alcoholics Anonymous was one of the first organizations formed to provide mutual, nonprofessional counseling, and it is still the largest. Others include LifeRing Secular Recovery, SMART Recovery, Women For Sobriety, and Secular Organizations for Sobriety.[127] Rationing and moderation programs such as Moderation Management and DrinkWise do not mandate complete abstinence. While most alcoholics are unable to limit their drinking in this way, some return to moderate drinking. A 2002 US study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) showed that 17.7 percent of individuals diagnosed as alcohol dependent more than one year prior returned to low-risk drinking. This group, however, showed fewer initial symptoms of dependency.[128] A follow-up study, using the same subjects that were judged to be in remission in 2001–2002, examined the rates of return to problem drinking in 2004–2005. The study found abstinence from alcohol was the most stable form of remission for recovering alcoholics.[129] A long-term (60 year) follow-up of two groups of alcoholic men concluded that "return to controlled drinking rarely persisted for much more than a decade without relapse or evolution into abstinence."[130]
Dr.Miller, if it were that simple, we wouldn't be discussing the issue at all. I have experienced both sides of the fence so to speak. I've been the guy in the back of the room who couldn't put 24 hours of sobriety together, life in shambles, family gone, and without the ability to function in society.   On the other hand I have worked in the treatment field, worked the program in every aspect of my life, as well as sponsored countless people.  The sponsorship is where I have the "BEGINNING" of difficulty, not that it's all bad. Especially when it comes to forth step.  A person who has resentments should be made to see their part in their resentment. All to often though the addict is made to blame.  A sponsee of mine was raped in jail and he had put it on his forth step.  So he had sexual issues, self worth issues, ECT.  I deferred to my sponsor on how to deal with such a resentment. He and his sponsor both told me to tell the kid, yea, it was bad, but you put yourself In jail, so it your fault. I've taken enough psychology to know you never under any circumstances  tell a rape victim it's their fault that they were raped. I told him to defer to a mental health professional, and for a time he improved. Later after being forced back into AA by the legal system he was again told on a fourth step that it was his fault for being raped. But this crazy "tough love", "it's your fault"  "now learn some humility and fix it", kind of thinking permeates AA to it's core.  The kid did stay sober, his determination was so strong the police found him with both barrels of a shotgun in his mouth and the back of his head splattered against the wall. Next to him they found and unopened bottle of wiskey and a note saying "this is how bad I don't want to drink". You see, he had floundered in AA and so of course the finger was pointed  at him for failure, by his family, by the program, and most people he knew. This is just one of countless horror stories. If you look at the founder. I realize that most believe AA  was co founded by Dr. Robert Smith M.D.  In reality, Dr. Bob was the first person to have tried the program and had any success. Everyone Bill Wilson tried his program on previously failed miserably. But looking at the heart of the origins of the program, and I dont mean the Oxford groups of whom Bill Wilson would derive his 12 steps from their 6 step program, I mean at the thinking of Bill Wilson himself. He says in his biography that he had a literal disease that left him virtually powerless over every vice and compulsion he indulged in.  AND I don't say this to degrade In anyway the hardworking and caring people of AA. Heaven knows, the vast overwhelming majority of AA's have their hearts in the right place, but the whole thing is based on an excuse. The idea of having a disease took the heat off of Bill.  The program  slowly built up around that notion that there's a disease to blame. After 20 years of life experience, and a lot of academia,  I believe the problem lies in unintentional conditioning. Really a learning disorder to put it in other terms. Susceptible individuals, usually because of one form of trauma or another seek out relief. By repeated chemical administration the brain slowly starts to think that chemical is necessary for survival. Probably because the instinctual systems become involved. When a compulsion is more powerful than a individuals desire for oxygen, and food ECT.  Words are useless, consequences will have no effect. Mostly because a person can't directly access the sub conscience.  But you can unlearn something. Email me for the real solution
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?

Various forms of group therapy or psychotherapy can be used to deal with underlying psychological issues that are related to alcohol addiction, as well as provide relapse prevention skills. The mutual-help group-counseling approach is one of the most common ways of helping alcoholics maintain sobriety.[6] Alcoholics Anonymous was one of the first organizations formed to provide mutual, nonprofessional counseling, and it is still the largest. Others include LifeRing Secular Recovery, SMART Recovery, Women For Sobriety, and Secular Organizations for Sobriety.[127] Rationing and moderation programs such as Moderation Management and DrinkWise do not mandate complete abstinence. While most alcoholics are unable to limit their drinking in this way, some return to moderate drinking. A 2002 US study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) showed that 17.7 percent of individuals diagnosed as alcohol dependent more than one year prior returned to low-risk drinking. This group, however, showed fewer initial symptoms of dependency.[128] A follow-up study, using the same subjects that were judged to be in remission in 2001–2002, examined the rates of return to problem drinking in 2004–2005. The study found abstinence from alcohol was the most stable form of remission for recovering alcoholics.[129] A long-term (60 year) follow-up of two groups of alcoholic men concluded that "return to controlled drinking rarely persisted for much more than a decade without relapse or evolution into abstinence."[130]
A complex mixture of genetic and environmental factors influences the risk of the development of alcoholism.[69] Genes that influence the metabolism of alcohol also influence the risk of alcoholism, and may be indicated by a family history of alcoholism.[70] One paper has found that alcohol use at an early age may influence the expression of genes which increase the risk of alcohol dependence.[71] Individuals who have a genetic disposition to alcoholism are also more likely to begin drinking at an earlier age than average.[72] Also, a younger age of onset of drinking is associated with an increased risk of the development of alcoholism,[72] and about 40 percent of alcoholics will drink excessively by their late adolescence. It is not entirely clear whether this association is causal, and some researchers have been known to disagree with this view.[73]
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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Alcohol abuse, now included in the diagnosis of alcohol use disorder, is a disease. While many have described this disorder as dipsomania, the latter term more accurately describes the intense craving that can be a symptom of alcohol use disorder. A maladaptive pattern of drinking alcohol that results in negative work, medical, legal, educational, and/or social effects on a person's life characterizes the disorder. The individual who abuses this substance tends to continue to use it despite such consequences. Effects of alcohol use disorder on families can include increased domestic abuse/domestic violence. The effects that parental alcoholism can have on children can be significantly detrimental in other ways as well. For example, the sons and daughters of alcoholics seem to be at higher risk for experiencing feelings that are more negative, stress, and alienation as well as aggression. There are a multitude of negative psychological effects of alcohol use disorder, including depression and antisocial behaviors.
Fact: You don’t have to be homeless and drinking out of a brown paper bag to be an alcoholic. Many alcoholics are able to hold down jobs, get through school, and provide for their families. Some are even able to excel. But just because you’re a high-functioning alcoholic doesn’t mean you’re not putting yourself or others in danger. Over time, the effects will catch up with you.
Risk factors for developing problems with alcohol arise from many interconnected factors, including your genetics, how you were raised, your social environment, and your emotional health. Some racial groups, such as American Indians and Native Alaskans, are more at risk than others of developing drinking problems or alcohol addiction. People who have a family history of alcoholism or who associate closely with heavy drinkers are more likely to develop drinking problems. Finally, those who suffer from a mental health problem such as anxiety, depression, or bipolar disorder are also particularly at risk, because alcohol is often used to self-medicate.
Fact: You don’t have to be homeless and drinking out of a brown paper bag to be an alcoholic. Many alcoholics are able to hold down jobs, get through school, and provide for their families. Some are even able to excel. But just because you’re a high-functioning alcoholic doesn’t mean you’re not putting yourself or others in danger. Over time, the effects will catch up with you.
Many start their addiction recovery process with a period of detoxification (detox), where the body rids itself of the toxic influence of drugs and/or alcohol. Detox allows the body to restore itself to a stable starting point from which substance abuse treatment efforts may more effectively begin. While detox programs vary, medical detox programs may utilize certain medications to manage withdrawal, when applicable, and otherwise facilitate this early recovery step.1
This inventory of self is meant to be comprehensive, searching, and fearless. This does not mean that it is without fear, but that individuals are encouraged to push past their fears and be honest with listing their shortcomings. Writing lists is often an important part of Step 4 as individuals are called to cite incidents, thoughts, feelings, and past experiences that may be difficult to think about.
When a health care professional is caught or suspected of diversion, the nursing board, board of pharmacy, attorney general, or another regulatory agency may require admission into IPRP. This may also result in local, State or Federal investigations and charges. IPRP is required to be transparent with all participating agencies if admission is mandated, thus potentially having a much greater negative effect on the professional's career. 
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Moderate alcohol consumption appears to increase the risk of breast cancer in women. Total mortality is reduced with moderate alcohol consumption but not with heavy alcohol consumption; the cardiovascular benefit is offset by cirrhosis, cancer, and injuries. The amount of alcohol associated with the lowest mortality appears to be 2 drinks per day in men and 1 drink or fewer per day in women. Moderate alcohol consumption reduces the risk of developing diabetes, but heavy alcohol consumption may increase the risk. The cardiovascular benefit becomes important in men older than 40 years and in women older than 50 years. The risk of hypertension is increased with 3 or more drinks daily.

Since the 1950s, alcohol addiction has been treated as a separate addiction from that of other illicit drugs under the AA program, meaning that drug abuse disorders are considered to be a different struggle, so a separate 12-step program is recommended. Chemical dependency is considered the most life-threatening addiction disorder and addicts are advised to address this addiction first and prior to other addictions such as gambling or sexual addiction, until abstinence is established and recovery has begun. Drug dependency is sometimes considered the root addiction, causing the individual to develop other addictive tendencies and therefore should be addressed first.
Monitor your teen’s activity: Know where your teen goes and who they hang out with. Remove or lock away alcohol from your home and routinely check potential hiding places for alcohol—in backpacks, under the bed, between clothes in a drawer, for example. Explain to your teen that this lack of privacy is a consequence of having been caught using alcohol.
Thank you for letting Los Angles Central Office serve and support you. LACO maintains this website and publishes both the online and print meeting directories, and it is the information hub for AA in the Los Angeles area. At Central Office volunteers are of service 365 days a year answering the phones and sharing experience, strength and hope. Let us know how we can help your group carry the message.

Jump up ^ Littrell, Jill (2014). Understanding and Treating Alcoholism Volume I: An Empirically Based Clinician's Handbook for the Treatment of Alcoholism: Volume Ii: Biological, Psychological, and Social Aspects of Alcohol Consumption and Abuse. Hoboken: Taylor and Francis. p. 55. ISBN 9781317783145. Archived from the original on 20 July 2017. The World Health Organization defines alcoholism as any drinking which results in problems
When most people think about “alcoholism,” they assume the chronic severe group is the only group. However, adolescents and young adults, both with and without mental illnesses, can struggle with compulsive behaviors around alcohol, and many adults in the US are dependent on alcohol to stabilize their emotions. These conditions, too, indicate a potential AUD. If alcohol abuse remains unaddressed, it can lead to severe health consequences, both acute and chronic.
Fact: You don’t have to be homeless and drinking out of a brown paper bag to be an alcoholic. Many alcoholics are able to hold down jobs, get through school, and provide for their families. Some are even able to excel. But just because you’re a high-functioning alcoholic doesn’t mean you’re not putting yourself or others in danger. Over time, the effects will catch up with you.

Fact: You don’t have to be homeless and drinking out of a brown paper bag to be an alcoholic. Many alcoholics are able to hold down jobs, get through school, and provide for their families. Some are even able to excel. But just because you’re a high-functioning alcoholic doesn’t mean you’re not putting yourself or others in danger. Over time, the effects will catch up with you.
While Wilson and Smith credited their sobriety to working with alcoholics under the auspices of the Oxford Group, a Group associate pastor sermonized against Wilson and his alcoholic Groupers for forming a "secret, ashamed sub-group" engaged in "divergent works".[19] By 1937, Wilson separated from the Oxford Group. AA Historian Ernest Kurtz described the split:[19]

When most people think about “alcoholism,” they assume the chronic severe group is the only group. However, adolescents and young adults, both with and without mental illnesses, can struggle with compulsive behaviors around alcohol, and many adults in the US are dependent on alcohol to stabilize their emotions. These conditions, too, indicate a potential AUD. If alcohol abuse remains unaddressed, it can lead to severe health consequences, both acute and chronic.


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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.
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In 1955, Wilson acknowledged AA's debt, saying "The Oxford Groupers had clearly shown us what to do. And just as importantly, we learned from them what not to do." Among the Oxford Group practices that AA retained were informal gatherings, a "changed-life" developed through "stages", and working with others for no material gain, AA's analogs for these are meetings, "the steps", and sponsorship. AA's tradition of anonymity was a reaction to the publicity-seeking practices of the Oxford Group, as well as AA's wish to not promote, Wilson said, "erratic public characters who through broken anonymity might get drunk and destroy confidence in us."[20]

Based on this study, those who abstain altogether from substances – as advised in the 12-Step model – have better mental health outcomes than those who don’t abstain. The 12-Step model gives people a framework from which to surrender their addiction, process their experience, and move forward into new patterns. As described in an article on Psych Central called Recovery Using the 12 Steps, following the model assists an individual by helping build the following mental and emotional transformative practices and tools:
Over 6% of the Australian population meet the criteria for having alcohol consumption disorders, either alcohol dependence or intoxication disorder. Alcohol dependence is the most common disorder, occurring in about 4.1% of Australians. A greater proportion of men (6.1%) suffer from alcohol dependence than women (2.3%). 18–24 years olds (of whom 9.3% meet the criteria for alcohol dependence) are the age group most likely to be alcohol dependent in Australia. There is a higher rate of alcohol consumption disorders amongst Indigenous Australians, compared to non-Indigenous Australians.

While both alcohol abuse and alcoholism are included in the alcohol use disorder diagnosis and involve engaging in maladaptive behaviors in the use of alcohol, abuse of this substance does not include the person having withdrawal symptoms or needing more and more amounts to achieve intoxication (tolerance) unless the person has developed alcoholism.


Alcoholics Anonymous (AA) is a global organization that was created, and is designed, to help former alcoholics through the process of learning to live their lives without the crutch of alcohol abuse. People who attend AA groups have made the decision to stop drinking and stay sober. Some of them join voluntarily; some attend as a continuation of their therapy; some are required to be there because of a court order. Whatever brings them there, the other members of the group act as a support network, explains the American Journal of Public Health; they share success stories and honest accounts of setbacks, and use this emotional connectedness to inspire and encourage each other to keep going.
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