This is the rarest group, accounting for 9% of American alcoholics, and the most severe. Most people in this subtype are usually men, and are associated with a high rate of divorce, financial problems, clinical depression, and the use of other drugs. These are people whose lives have been all but completely taken over by booze. Alcoholism truly is a sad disease.
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If you think you have a problem with drinking, or know someone who does, we can help. The primary purpose of Alcoholics Anonymous is to help the alcoholic who is still suffering. If you are experiencing a medical emergency, please contact your local hospital or health care provider. To contact someone in Alcoholics Anonymous, please visit our Find A Meeting page, and click on the city or district nearest you. This will provide meeting locations, meeting times, and phone numbers to contact someone nearest you for help.

AA's program extends beyond abstaining from alcohol.[33] Its goal is to effect enough change in the alcoholic's thinking "to bring about recovery from alcoholism"[34] through "an entire psychic change," or spiritual awakening.[35] A spiritual awakening is meant to be achieved by taking the Twelve Steps,[36] and sobriety is furthered by volunteering for AA[37] and regular AA meeting attendance[38] or contact with AA members.[36] Members are encouraged to find an experienced fellow alcoholic, called a sponsor, to help them understand and follow the AA program. The sponsor should preferably have experience of all twelve of the steps, be the same sex as the sponsored person, and refrain from imposing personal views on the sponsored person.[37] Following the helper therapy principle, sponsors in AA may benefit from their relationship with their charges, as "helping behaviors" correlate with increased abstinence and lower probabilities of binge drinking.[39]


Research and population surveys have shown that persons under stress , particularly chronic stress, tend to exhibit more unhealthy behaviors than less-stressed persons. Stressed people drink more alcohol, smoke more, and eat less nutritious foods than non-stressed individuals. Many people report drinking alcohol in response to various types of stress, and the amount of drinking in response to stress is related to the severity of the life stressors and the individuals' lack of social support networks.
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]
Attitudes and social stereotypes can create barriers to the detection and treatment of alcohol abuse. This is more of a barrier for women than men. Fear of stigmatization may lead women to deny that they are suffering from a medical condition, to hide their drinking, and to drink alone. This pattern, in turn, leads family, physicians, and others to be less likely to suspect that a woman they know is an alcoholic.[35] In contrast, reduced fear of stigma may lead men to admit that they are suffering from a medical condition, to display their drinking publicly, and to drink in groups. This pattern, in turn, leads family, physicians, and others to be more likely to suspect that a man they know is an alcoholic.[54]
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.

The only requirement for membership is a desire to stop drinking. There are no dues or fees for A.A. membership; we are self-supporting through our own contributions. A.A. 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.
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alcohol dependence = alcohol abuse combined with tolerance, withdrawal, and an uncontrollable drive to drink.[99] The term "alcoholism" was split into "alcohol abuse" and "alcohol dependence" in 1980's DSM-III, and in 1987's DSM-III-R behavioral symptoms were moved from "abuse" to "dependence".[100] It has been suggested that DSM-V merge alcohol abuse and alcohol dependence into a single new entry,[101] named "alcohol-use disorder".[102]
At least two thirds of all alcohol consumed by Australians is consumed at levels which present either long or short term health risks. Some 10% of Australian men and women consume more than the average number of drinks recommended in the Australian guidelines. While a smaller proportion of Indigenous Australians drink than non-Indigenous Australians, a higher proportion of Indigenous Australians (20%) exceed the recommended average daily drinking limits than non-Indigenous Australians.
The first step in the treatment of alcoholism, called detoxification, involves helping the person stop drinking and ridding his or her body of the harmful (toxic) effects of alcohol. Because the person's brain and body has become accustomed to alcohol, the alcohol-dependent person will most likely develop withdrawal symptoms and need to be supported through them. Withdrawal will be different for different individuals, depending on the severity of the alcoholism as measured by the quantity of alcohol ingested daily and the length of time the patient has been alcohol dependent.

alcohol dependence = alcohol abuse combined with tolerance, withdrawal, and an uncontrollable drive to drink.[99] The term "alcoholism" was split into "alcohol abuse" and "alcohol dependence" in 1980's DSM-III, and in 1987's DSM-III-R behavioral symptoms were moved from "abuse" to "dependence".[100] It has been suggested that DSM-V merge alcohol abuse and alcohol dependence into a single new entry,[101] named "alcohol-use disorder".[102]
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This is the rarest group, accounting for 9% of American alcoholics, and the most severe. Most people in this subtype are usually men, and are associated with a high rate of divorce, financial problems, clinical depression, and the use of other drugs. These are people whose lives have been all but completely taken over by booze. Alcoholism truly is a sad disease.

More than 7 percent of all American adults have an alcohol use disorder. These adults drink too much, too often, and in ways that harm their health, their happiness, and their relationships. An intervention, in which the family outlines alcohol’s consequences, can push these people to enter treatment programs. Once there, counseling sessions, relapse prevention coaching, and support group work can help to support recovery. Relapse rates for alcohol fall within the 40-60 percent range, so people often need to stick with aftercare for the rest of life.
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Codependency is the tendency to interact with another person in an excessively passive or caretaking manner that negatively affects the quality of the codependent individual's life. The codependent person has a pattern of putting their own needs below those of others, likely has low self-esteem, and tends to engage in denial, excessive compliance, and control. Individuals who are codependent are at risk for engaging in addictive behaviors, including alcoholism, drug or sexual addiction, as well as eating disorders or self-destructive or other self-defeating behaviors. Psychotherapy and participation in support groups are the usual treatments for codependency.

Some of the divide between 12-Step recovery and academic addiction medicine came about because of resistance by some AA members to the use of any pharmaceuticals whatsoever. Newcomers were told to abandon any and all medications. While this attitude is receding, stories of members with advanced cancer refusing opiates are still told with admiration in meetings. 
Jump up ^ GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–71. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442.

There are many kinds of counseling and psychotherapy that can be helpful for the person with addiction, beyond non-specific “supportive psychotherapy” that can be offered in any setting, along with medication management or apart from such an approach. Cognitive Behavioral Therapy is arguably the most widespread ‘evidence based practice’ offered to persons with addiction. This approach challenges irrational thoughts, understands automatic thoughts and thought chains, understands the thoughts and feelings that can lead to relapse behaviors and seeks to minimize relapse by specifying unhealthy cognitions and providing practice in decoupling an unhealthy thought (“stinking thinking,” as some people say) from an unhealthy action. Dialectical Behavioral Therapy and Mindfulness Meditation are two approaches that have enjoyed increased popularity in addiction treatment in this century.
A sponsor is a more experienced person in recovery who guides the less-experienced aspirant ("sponsee") through the program's twelve steps. New members in twelve-step programs are encouraged to secure a relationship with at least one sponsor who both has a sponsor and has taken the twelves steps themselves.[25] Publications from twelve-step fellowships emphasize that sponsorship is a "one on one" nonhierarchical relationship of shared experiences focused on working the Twelve Steps.[26][27][28] According to Narcotics Anonymous:
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