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.
Alcohol withdrawal can occur when alcohol use has been heavy and prolonged and is then stopped or greatly reduced. It can occur within several hours to four or five days later. Signs and symptoms include sweating, rapid heartbeat, hand tremors, problems sleeping, nausea and vomiting, hallucinations, restlessness and agitation, anxiety, and occasionally seizures. Symptoms can be severe enough to impair your ability to function at work or in social situations.
The mental obsession is described as the cognitive processes that causes the individual to repeat the compulsive behavior after some period of abstinence, either knowing that the result will be an inability to stop or operating under the delusion that the result will be different. The description in the First Step of the life of the alcoholic or addict as "unmanageable" refers to the lack of choice that the mind of the addict or alcoholic affords concerning whether to drink or use again.
Alcoholics may also require treatment for other psychotropic drug addictions and drug dependences. The most common dual dependence syndrome with alcohol dependence is benzodiazepine dependence, with studies showing 10–20 percent of alcohol-dependent individuals had problems of dependence and/or misuse problems of benzodiazepine drugs such as valium or clonazopam. These drugs are, like alcohol, depressants. Benzodiazepines may be used legally, if they are prescribed by doctors for anxiety problems or other mood disorders, or they may be purchased as illegal drugs. Benzodiazepine use increases cravings for alcohol and the volume of alcohol consumed by problem drinkers. Benzodiazepine dependency requires careful reduction in dosage to avoid benzodiazepine withdrawal syndrome and other health consequences. Dependence on other sedative-hypnotics such as zolpidem and zopiclone as well as opiates and illegal drugs is common in alcoholics. Alcohol itself is a sedative-hypnotic and is cross-tolerant with other sedative-hypnotics such as barbiturates, benzodiazepines and nonbenzodiazepines. Dependence upon and withdrawal from sedative-hypnotics can be medically severe and, as with alcohol withdrawal, there is a risk of psychosis or seizures if not properly managed.
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.
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)
Michael, while one of the above posters felt that the anti-medication bias of many AA members (as well as its entire leadership) is receding, I have not seen that at all. Patients on methadone, buprenorphine and even (very recently) Vivitrol, are told that they are not "clean," cannot speak at the meeting, cannot receive sobriety tokens, cannot join in on committments and in fact are still using. They are urged routinely to stop their medications. While it has perhaps receded with some psychiatric medications, it has NOT with many other medications, including Disulfiram, Campral and Naltrexone.
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