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.
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There are few medications that are considered effective in treating moderate to severe alcohol use disorder. Naltrexone (Trexan, Revia, or Vivitrol) has been found effective in managing this illness. It is the most frequently used medication in treating alcohol use disorder . It decreases the alcoholic's cravings for alcohol by blocking the body's euphoric ("high") response to it. Naltrexone is either taken by mouth on a daily basis or through monthly injections. Disulfiram (Antabuse) is prescribed for about 9% of alcoholics. It decreases the alcoholic's craving for the substance by producing a negative reaction to drinking. Acamprosate (Campral) works by decreasing cravings for alcohol in those who have stopped drinking. Ondansetron (Zofran) has been found to be effective in treating alcohol use disorder in people whose problem drinking began before they were 25 years old. None of these medications have been specifically approved to treat alcoholism in people less than 18 years of age. Baclofen (Lioresal) has been found to be a potentially effective treatment to decrease alcohol cravings and withdrawal symptoms. Some research indicates that psychiatric medications like lithium (Eskalith, Lithobid) and sertraline (Zoloft) may be useful in decreasing alcohol use in people who have another mental health disorder in addition to alcohol use disorder.
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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.
Alcoholics Anonymous publishes several books, reports, pamphlets, and other media, including a periodical known as the AA Grapevine. 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.
Prior to entering any inpatient or outpatient rehabilitation program for alcohol use disorder, the possibility that the person with this disorder could suffer from physical symptoms of alcohol withdrawal needs to be addressed. People who have a pattern of extensive alcohol abuse are at risk for developing a potentially fatal set of withdrawal symptoms (delirium tremens or DTs) that may include irregular heartbeat, sweating, high fever, shaking/tremors, hallucinations, and even fatal seizures, three days after withdrawal symptoms begin. Those individuals will need to enter a detoxification (detox) program that includes the use of close medical support, monitoring, and prescription of medications like chlordiazepoxide (Librium) or clonazepam (Klonopin) to help prevent and ease the symptoms of alcohol withdrawal.
The 12-step approach to rehabilitation treatment is embraced throughout the world, so it’s always easy to find support where you are or wherever you go. Accordingly, we advise patients to keep in contact with ‘sober supports’ they make during treatment at one of our locations. We also encourage them to continue attending 12-step groups on a regular basis after discharge. Being able to discuss mistakes or relapses, as needed, in a supportive environment helps to keep patients accountable for their actions.
Twelve-Step Recovery addresses the psychology of the person with addiction as well as the individual’s spirituality--his/her values, his/her connectedness to others, and his/her willingness to engage with others and humbly ask for help. The process of change in Twelve-Step Recovery starts with an acceptance that when friends or loved ones point out that things are amiss in one’s life, they are likely correct, and things have likely become unmanageable. And while taking personal responsibility and accepting accountability for one’s actions are considered key steps, Twelve-Step Recovery outlines that excessive self-reliance and the firm stance that “I can get myself out of this,” and “I know what to do about this,” will be roadblocks to recovery from addiction. “Getting out of oneself” and recognizing that one doesn’t have all the answers, and humbly asking for help from another human being—from a health professional or from a lay person—are behaviors and behavioral styles that are promoted by Alcoholics Anonymous and related “Twelve-Step” programs of peer support.
No conversation about alcoholism or substance abuse recovery is complete without mentioning Alcoholics Anonymous. The group has become synonymous with the concept of addiction rehabilitation in general, and it was instrumental in changing the conversation in how people with drinking problems came to be understood and regarded. As the science and psychology of addiction evolves, the role of Alcoholics Anonymous is also changing, but it remains a cornerstone of the aftercare experience.
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.
I agree with many of the earlier comments highlighting the drawbacks of 12-Step for many folks seeking recovery. Although the program claims to be "spiritual" and "not religious," it's roots are in the Oxford Group, an early evangelical Protestant organization, and the 12 Steps (12, because there were 12 apostles) are taken directly from Oxford Group, which maintained that people were "powerless over sin." Bill W. simply replaced "sin" with "alcohol" and kept the rest unchanged.
Alcoholics Anonymous (AA) : Alabama • Alaska • American Samoa • Arizona • Arkansas • California • Colorado • Connecticut • Delaware • Federated States of Micronesia • Florida • Georgia • Guam • Hawaii • Idaho • Illinois • Indiana • Iowa • Kansas • Kentucky • Louisiana • Maine • Marshall Islands • Maryland • Massachusetts • Michigan • Minnesota • Mississippi • Missouri • Montana • Nebraska • Nevada • New Hampshire • New Jersey • New Mexico • New York • North Carolina • North Dakota • Northern Mariana Islands • Ohio • Oklahoma • Oregon • Pennsylvania • Rhode Island • South Carolina • South Dakota • Tennessee • Texas • Tribal Areas • Utah • Vermont • Virgin Islands • Virginia • Washington • Washington DC • West Virginia • Wisconsin • Wyoming
A genome-wide association study of more than 100,000 human individuals identified variants of the gene KLB, which encodes the transmembrane protein β-Klotho, as highly associated with alcohol consumption. The protein β-Klotho is an essential element in cell surface receptors for hormones involved in modulation of appetites for simple sugars and alcohol.
Whether you’re the loved one of someone struggling with alcohol addiction, or you yourself are struggling, it’s important to be aware of these signs and to know that you’re not alone. Thousands of people from all walks of life battle alcoholism every day, and thousands make the decision to seek help. The Recovery Village offers various programs at facilities throughout the country that are designed to treat alcoholism, among other disorders. All you have to do is call, and one of our intake coordinators will take care of the rest.
In a closed AA meeting, the only people who may attend are those who are recovering addicts (or those interested in learning more about overcoming their addiction). Open meetings allow the attendance of friends, spouses and family members. Whether you decide to go to a closed or open meeting depends exclusively on what you’re comfortable with. Some people would rather keep their recovery separate from the rest of their life. Others thrive on the support that loved ones can provide during meetings.
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.
A chronic, progressive behavioral disorder characterized by a strong urge to consume ethanol and an inability to limit the amount of drinking despite adverse consequences, which may include social or occupational impairment and deterioration of physical health. Both physical dependence (withdrawal symptoms such as nausea, sweating, tremors, and delirium resulting from abstinence) and tolerance (the need to increase alcohol intake to achieve the desired effect) occur.
Choosing to seek help for an alcohol addiction is one of the biggest decisions you will face. There are different forms of treatment available based on frequency and severity of alcohol abuse. Recovering from alcohol addiction is a process that continues long after rehab. It takes commitment to practice and apply the techniques you learn in rehab, counseling, support groups and other types of therapy.
Recently some researchers have suggested that there are two distinct types of alcoholism. According to these researchers, type 1 alcoholism develops in adulthood, often in the early twenties. It is most often associated with the desire to relieve stress and anxiety and is not associated with any criminal or antisocial behavior. Type 2 alcoholism develops earlier, usually during the teenage years. Drinking is done primarily to get high. Type 2 alcoholism is associated with violence, destructiveness, and other criminal and antisocial behavior. Those who study alcoholism do not universally accept the distinction between these two types of alcoholism. Research continues in this area.
The term “self-help” is often used to describe AA groups, but it is somewhat of a misnomer: it isn’t “professional help,” but it is more about listening and accepting guidance from a peer or mentor than it is about using “self” to move beyond active addiction. And while Twelve-Step approaches accept that addiction is a disease and isn’t simply a sign of “moral weakness,” there is a focus on values and morals in Twelve-Step Recovery, as the individual is encouraged to engage in a process of taking a “moral inventory” of one’s life and past actions in preparation for “making amends” to others, as indicated, possible, and appropriate.
Because the 12-step philosophy is proven to be one of the most successful approaches to managing the disease of addiction, many drug and alcohol rehab programs have integrated these steps into their treatment models. If you enter an inpatient or outpatient rehab program these days, you’re likely to have the opportunity to learn about 12-step recovery strategies or to participate in 12-step meetings.
While 12-Step facilitation programs don’t necessarily follow the steps, they promote the use of a 12-Step methodology, in the hope that clients will move to a 12-Step program after rehab to help maintain sobriety. In addition, certain treatment centers base their model for service around some of the ideas promoted through the 12-Step program. These centers can offer research-based services and promote a more scientific understanding of addiction treatment, but they incorporate some of the spiritual, psychological, and practical practices that the 12-Step program promotes. This results in an encompassing model of care designed to support clients through rehab and to give tools that they can use after treatment to maintain their recovery for the long-term.
This final step is the service aspect, and it asks individuals to give back to others who are also struggling with addiction. After coming to God or a higher power, individuals are then taught to share this spirituality with others and support them in recovery. During Step 12, individuals are often asked to share their stories, testimonies, and struggles with others in order to provide hope and encouragement.
Support groups provide people with understanding peers and ongoing support, in church basements, community centers, and public facilities scattered all across the country. Here, people can come together to discuss addiction’s difficulties, and they can meet with other addicted people to gain support and insight. Alumni groups are similar, in that they link peers together to discuss addiction, but these groups contain people who all worked within the same facility for help.
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". By 1937, Wilson separated from the Oxford Group. AA Historian Ernest Kurtz described the split:
Stereotypes of alcoholics are often found in fiction and popular culture. The "town drunk" is a stock character in Western popular culture. Stereotypes of drunkenness may be based on racism or xenophobia, as in the fictional depiction of the Irish as heavy drinkers. Studies by social psychologists Stivers and Greeley attempt to document the perceived prevalence of high alcohol consumption amongst the Irish in America. Alcohol consumption is relatively similar between many European cultures, the United States, and Australia. In Asian countries that have a high gross domestic product, there is heightened drinking compared to other Asian countries, but it is nowhere near as high as it is in other countries like the United States. It is also inversely seen, with countries that have very low gross domestic product showing high alcohol consumption. In a study done on Korean immigrants in Canada, they reported alcohol was even an integral part of their meal, and is the only time solo drinking should occur. They also believe alcohol is necessary at any social event as it helps conversations start.
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Many AA meetings take place in treatment facilities. Carrying the message of AA into hospitals was how the co-founders of AA first remained sober. They discovered great value of working with alcoholics who are still suffering, and that even if the alcoholic they were working with did not stay sober, they did. Bill Wilson wrote, "Practical experience shows that nothing will so much insure immunity from drinking as intensive work with other alcoholics". Bill Wilson visited Towns Hospital in New York City in an attempt to help the alcoholics who were patients there in 1934. At St. Thomas Hospital in Akron, Ohio, Smith worked with still more alcoholics. In 1939, a New York mental institution, Rockland State Hospital, was one of the first institutions to allow AA hospital groups. Service to corrections and treatment facilities used to be combined until the General Service Conference, in 1977, voted to dissolve its Institutions Committee and form two separate committees, one for treatment facilities, and one for correctional facilities.
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Programs like AA and other 12-Step groups provide a healthy community of support and solidarity filled with individuals who are all seeking to remain sober on a long-term basis. Individuals who regularly attend AA meetings are about twice as likely to remain abstinent over those who don’t, per the Journal of Addictive Disorders. The 12 Steps can go a long way in providing individuals in recovery with the support they need.
Medications also are available that may help a recovering alcoholic avoid returning to drinking. These have been used with variable success; different medications may be more or less successful for different individuals. Disulfiram (Antabuse) is a drug which, when mixed with alcohol, causes unpleasant reactions including nausea, vomiting, diarrhea, and trembling. It was estimated that in 2008, 200,000 recovering alcoholics in the United States were taking disulfiram. Naltrexone (Depade, ReVia) helps to reduce the brain's craving for alcohol. Acamprosate (Campral) works by reducing anxiety and insomnia that often occur when habitual drinkers become abstinent. Drugs alone will not prevent relapse. They are most effective when used in conjunction with a self-help program and/or psychotherapy aimed at changing behavior.
But not everyone in the treatment community is as skeptical toward Alcoholics Anonymous. Scientific American grants that it’s not a perfect solution, but claims that criticisms of the group are often unfair or based on false assumptions. For many alcoholics, AA’s wide availability of meetings and lack of expense make it a worthy consideration. The Recent Developments in Alcoholism journal said 12-Step programs are “an ideal recovery recourse,” and the Alcoholic Research & Health journal notes that the rise of other treatment methods have not displaced the model of mutual health groups, which are still the most widely sought-after source of help for alcoholism and other substance abuse problems.