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.
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:
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]
People who abuse alcohol may experience acute problems associated with problem drinking, but continuing to drink in spite of the negative effects puts them at risk of developing chronic health problems. Alcohol abuse damages most organs in the body, especially the liver, cardiovascular system, gastrointestinal system, and brain. Chemical changes to the brain that lead to addiction may also cause harm to memory and cognition.
Alcoholism and alcohol abuse can affect all aspects of your life. Long-term alcohol use can cause serious health complications, affecting virtually every organ in your body, including your brain. Problem drinking can also damage your emotional stability, finances, career, and your ability to build and sustain satisfying relationships. Alcoholism and alcohol abuse can also have an impact on your family, friends and the people you work with.
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As an addiction professional who has worked in the field for 21 years I would be negligent in my duties if I did not inform my clients about the availability of AA as a potential avenue for recovery. I also let them know of other options such as SMART, rational recovery, etc. They invariable return to me saying "all I can find around town is AA". I encourage them to use what is available if they choose to do so. I educate them about the program of AA, the fellowship (which is not the program) and what AA's official stance is on medications (there is none other than it's between the alcoholic and their doctor). I educate and encourage them on all of these things so they are not at the mercy of any uninformed alcoholic in AA.

Alcohol exerts a depressive effect on the brain. The blood-brain barrier does not prevent alcohol from entering the brain, so the brain alcohol level will quickly become equivalent to the blood alcohol level. In the brain, alcohol interacts with various neurotransmitters to alter nerve function. Alcohol's depressive effects result in difficulty walking, poor balance, slurring of speech, and generally poor coordination (accounting in part for the increased likelihood of injury). The affected person also may have impairment of peripheral vision. At higher alcohol levels, a person's breathing and heart rates may be slowed and vomiting may occur (with a high risk of the vomit being breathed into the lungs, potentially resulting in aspiration pneumonia.) Still higher alcohol levels may result in coma and death.


While the program is neither religious nor mystical, it is considered spiritual in that members realize they are not the center of the universe. A higher power is at work, but that higher power can be defined however one chooses. Love, God, nature, conscience, the positive energy in a group of caring people, or an unnamed sense of spirit are all examples of higher powers.
In the case of expectant mothers who drink, future healthcare costs double, now including both the mother and child. For example, a child born with fetal alcohol syndrome could require special schooling. Not only is this a personal and unnecessary family tragedy but also it stands to impact the social system financially in the form of healthcare and education for years.

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Alcoholics Anonymous is based on the 12 Steps, devised by its co-founder, Bill W., and based on the Christian beliefs he adopted as part of his sobriety. The 12 Steps are presented as a set of principles to guide former alcoholics on how to tackle the problems caused by their addiction, how to make amends, and how to continue in their new lives as recovering drinkers. The 12 Steps have proven iconic enough to be adapted by other self-help and addiction recovery groups, such as Gamblers Anonymous, Narcotics Anonymous, and Food Addicts in Recovery Anonymous, with the precise terms adapted to represent the focus of the particular group. Additionally, many groups have changed the explicitly Christian overtones of the original 12 Steps to reflect secular or agnostic philosophies.
Among older patients with alcoholism, from one third to one half develop alcoholism after age 60 years. This group is harder to recognize. A population-based study found that problem drinking (>3 drinks/d) was observed in 9% of older men and in 2% of older women. Alcohol levels are higher in elderly patients for a given amount of alcohol consumed than in younger patients.
The World Health Organization estimates that as of 2010 there are 208 million people with alcoholism worldwide (4.1% of the population over 15 years of age).[9][10] Substance use disorders are a major public health problem facing many countries. "The most common substance of abuse/dependence in patients presenting for treatment is alcohol."[125] In the United Kingdom, the number of 'dependent drinkers' was calculated as over 2.8 million in 2001.[148] About 12% of American adults have had an alcohol dependence problem at some time in their life.[149] In the United States and Western Europe, 10 to 20 percent of men and 5 to 10 percent of women at some point in their lives will meet criteria for alcoholism.[150] Estonia had the highest death rate from alcohol in Europe in 2015 at 8.8 per 100,000 population.[151] In the United States, 30% of people admitted to hospital have a problem related to alcohol.[152]
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.
Over time, the regular consumption of alcohol will alter brain chemicals, making the drinker crave alcohol not for a good time, but to avoid feeling poorly. Brain function becomes more and more impaired as your blood alcohol content increases. Each time you drink alcohol, several chemicals in the brain become imbalanced. Over time, the brain becomes used to this imbalance, and considers it the new balance, so to speak. This is a disease of the brain called alcoholism.
The alcoholic's continual craving for alcohol makes abstinence -- an important goal of treatment -- extremely difficult. The condition is also complicated by denial: Alcoholics might be reluctant to admit their excess drinking either because of denial or guilt. Another barrier to receiving care is that physicians screen only about 15% of their primary care patients for alcohol disorders.

12-Step has also been criticized for putting vulnerable folks new to recovery into the hands of untrained "sponsors" who often give unsound advice and make unduly onerous demands.  Meetings have also recently been criticized for sometimes being unsafe; with no organizational supervision (every meeting is "autonomous"), there have been numerous reports in the news of sexual harassment, and even assault, occurring in the program.
After the individual is no longer drinking and has passed through withdrawal, the next steps involve helping the individual avoid relapsing and a return to drinking. This phase of treatment is referred to as rehabilitation. It can continue for a lifetime. Many programs incorporate the family into rehabilitation therapy, because the family has likely been severely affected by the patient's drinking. Some therapists believe that family members, in an effort to deal with their loved one's drinking problem, develop patterns of behavior that unintentionally support or enable the patient's drinking. This situation is referred to as co-dependence. These patterns should addressed in order to help successfully treat a person's alcoholism.
Since its origin with AA, the 12-Step model has been adopted and altered by many groups to fit other programs – for addiction treatment and otherwise. Many groups, like Narcotics Anonymous, use the steps exactly as they were conceived by AA. Others have modified the steps to fit their own needs and cultures. For example, a Native American group has combined the 12 Steps with the Native American concept of the Medicine Wheel to create a program designed specifically to help indigenous Americans who struggle with alcoholism and addiction, the Medicine Wheel and 12 Steps program. Others have come up with similar ideas to integrate the basic ideas of the 12 Steps into a cultural framework that makes sense for members of that culture.
Stanton Peele argued that some AA groups apply the disease model to all problem drinkers, whether or not they are "full-blown" alcoholics.[90] Along with Nancy Shute, Peele has advocated that besides AA, other options should be readily available to those problem drinkers who are able to manage their drinking with the right treatment.[91] The Big Book says "moderate drinkers" and "a certain type of hard drinker" are able to stop or moderate their drinking. The Big Book suggests no program for these drinkers, but instead seeks to help drinkers without "power of choice in drink."[92]

Within the medical and scientific communities, there is a broad consensus regarding alcoholism as a disease state. For example, the American Medical Association considers alcohol a drug and states that "drug addiction is a chronic, relapsing brain disease characterized by compulsive drug seeking and use despite often devastating consequences. It results from a complex interplay of biological vulnerability, environmental exposure, and developmental factors (e.g., stage of brain maturity)."[111] Alcoholism has a higher prevalence among men, though, in recent decades, the proportion of female alcoholics has increased.[36] Current evidence indicates that in both men and women, alcoholism is 50–60 percent genetically determined, leaving 40–50 percent for environmental influences.[153] Most alcoholics develop alcoholism during adolescence or young adulthood.[69] 31 percent of college students show signs of alcohol abuse, while six percent are dependent on alcohol. Under the DSM's new definition of alcoholics, that means about 37 percent of college students may meet the criteria.[154]
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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Asking Question About 12-Step: This introduces the steps to patients and allows them to voice any questions and concerns . For instance, 12-Step encourages reliance on a spiritual foundation. But many groups give individuals the freedom to choose their own version of a “Higher Power.” This choice often helps patients let go of any religious resentments or preconceived prejudices toward spiritual practices.

Alcohol exerts a depressive effect on the brain. The blood-brain barrier does not prevent alcohol from entering the brain, so the brain alcohol level will quickly become equivalent to the blood alcohol level. In the brain, alcohol interacts with various neurotransmitters to alter nerve function. Alcohol's depressive effects result in difficulty walking, poor balance, slurring of speech, and generally poor coordination (accounting in part for the increased likelihood of injury). The affected person also may have impairment of peripheral vision. At higher alcohol levels, a person's breathing and heart rates may be slowed and vomiting may occur (with a high risk of the vomit being breathed into the lungs, potentially resulting in aspiration pneumonia.) Still higher alcohol levels may result in coma and death.
If you are still having issues with activation after trying the above mentioned items, please click on the “Gear” icon located on the lower left of the SRS window when it first opens. Next, click on “About” and then click on the check box to “Enable Log For Debugging”. This will turn on the logging feature for Customer Support to be able to further help you solve your issue. Once you have enabled logging, try to activate your license again, then call Customer Support and they will instruct you how to send the log files to them.
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.
Alcoholics Anonymous became so well-known that Wilson and other early members of the group were invited to a dinner hosted by John D. Rockefeller, Jr., the patriarch of one of the most powerful families in American history. Despite Wilson’s requests, Rockefeller refused to finance AA, believing that the money would only corrupt the noble ambitions of the group. Instead, Rockefeller felt that the organization’s own characteristics – the personal testimonies, the word-of-mouth, and the anonymity – were key to its success and longevity.
Jump up ^ "HEALTH AND ETHICS POLICIES OF THE AMA HOUSE OF DELEGATES" (PDF). June 2008. p. 33. Archived (PDF) from the original on 20 March 2015. Retrieved 10 May 2015. H-30.997 Dual Disease Classification of Alcoholism: The AMA reaffirms its policy endorsing the dual classification of alcoholism under both the psychiatric and medical sections of the International Classification of Diseases. (Res. 22, I-79; Reaffirmed: CLRPD Rep. B, I-89; Reaffirmed: CLRPD Rep. B, I-90; Reaffirmed by CSA Rep. 14, A-97; Reaffirmed: CSAPH Rep. 3, A-07)
Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism. The only requirement for membership is a desire to stop drinking. There are no dues or fees for AA membership; we are self-supporting through our own contributions. AA is not allied with any sect, denomination, politics, organization or institution; does not wish to engage in any controversy, neither endorses nor opposes any causes. Our primary purpose is to stay sober and help other alcoholics to achieve sobriety.

More informally than not, AA's membership has helped popularize the disease concept of alcoholism, though AA officially has had no part in the development of such postulates which had appeared as early as the late eighteenth century.[58] Though AA initially avoided the term "disease", in 1973 conference-approved literature categorically stated that "we had the disease of alcoholism."[59][better source needed] Regardless of official positions, from AA's inception most members have believed alcoholism to be a disease.[60]


Easy access: There appears to be a correlation between easy access to alcohol — such as cheap prices — and alcohol abuse and alcohol-related deaths. One study registered a significant drop in alcohol-related deaths after one state raised alcohol taxes. The effect was found to be nearly two to four times that of other prevention strategies, such as school programs or media campaigns.
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Alcoholics Anonymous (AA) was the first 12-step program established and many other support groups have branched off from AA using this model. AA is an organization that unites people who have struggled with alcohol dependency, providing strength and faith in one another to overcome addiction. Its mission is to “stay sober and help other alcoholics to achieve sobriety” without judgment or segregation. AA founders Bill Wilson and Dr. Bob Smith developed the 12 steps based on concepts from Carl Jung’s theories as influenced by Eastern philosophy, and from spiritual values such as those rooted in the principles of the Oxford Group.
The Big Book was originally written as a guide for people who couldn’t attend AA fellowship meetings, but it soon became a model for the program in general. It has since been adopted as a model for a wide range of addiction peer-support and self-help programs designed to help drive behavioral change. In addition to the original Alcoholics Anonymous (AA) group, various offshoots now exist, such as Narcotics Anonymous (NA), Heroin Anonymous (HA), and Gamblers Anonymous (GA).
AA says it is "not organized in the formal or political sense",[25] and Bill Wilson called it a "benign anarchy".[26] In Ireland, Shane Butler said that AA “looks like it couldn’t survive as there’s no leadership or top-level telling local cumanns what to do, but it has worked and proved itself extremely robust.” Butler explained that "AA’s 'inverted pyramid' style of governance has helped it to avoid many of the pitfalls that political and religious institutions have encountered since it was established here in 1946."[27]
Mental health is as important as physical health. It includes your emotional, psychological, and social well being. Mental illnesses are serious disorders that can affect your thinking, mood, and behavior. There are many factors in these disorders, such as genes, family history, and life experiences. These government services can help you find someone to talk to, treatment options, and information on a wide range of mental health issues.         
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