In some ways, the championing of anonymity has been AA’s blessing and curse. It not only protects the privacy of the people it seeks to help (and those who seek it for help), it also protects the organization at large from public relations and morale damage if a high-profile member were to relapse. In the more than 75 years since Alcoholics Anonymous formed, NPR notes that “no one knows how exactly it works.”

Withdrawal symptoms can range from mild to life threatening. Mild withdrawal symptoms include nausea, achiness, diarrhea, difficulty sleeping, sweatiness, anxiety, and trembling. This phase usually lasts no more than three to five days. More severe effects of withdrawal can include hallucinations in which a patient sees, hears, or feels something that is not actually present, seizures, an unbearable craving for more alcohol, confusion, fever, fast heart rate (tachycardia), high blood pressure (hypertension), and delirium (a fluctuating level of consciousness). Patients at highest risk for the most severe symptoms of withdrawal are those with other medical problems, including malnutrition, liver disease, or Wernicke's syndrome. Severe withdrawal symptoms usually begin about three days after the individual's last drink, and may last a variable number of days.
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.

Jump up ^ Sullivan, JT; Sykora, K; Schneiderman, J; Naranjo, CA; Sellers, EM (November 1989). "Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar)" (PDF). Br J Addict. 84 (11): 1353–7. CiteSeerX 10.1.1.489.341. doi:10.1111/j.1360-0443.1989.tb00737.x. PMID 2597811. Archived from the original (PDF) on 10 August 2013. Retrieved 25 October 2017.


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.
Addiction is a complex brain disease that impacts people emotionally, physically, socially, financially, behaviorally, and personally. Families and loved ones are negatively affected as well. Addiction recovery is aided by professional treatment programs and by engaging in support groups that can offer encouragement, hope, and healthy peer interactions. These self-help groups aid in facilitating the formation of groups of people who have similar goals for sobriety and long-term abstinence from drugs and alcohol. The idea of a 12-Step program began with Alcoholics Anonymous, or AA, a program designed to support individuals struggling with addiction to alcohol in their recovery efforts.
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Non-12-step support groups provide a secular alternative to the 12-step programs and may be more comfortable for those not wanting to place such an emphasis on a higher power for recovery. Non-12-step groups sometimes involve fewer group sharing scenarios—which can provide some relief for those individuals who aren't as comfortable sharing sensitive personal information in group settings. Below are a few examples of non-12-step programs:
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.
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.
Withdrawal symptoms can range from mild to life threatening. Mild withdrawal symptoms include nausea, achiness, diarrhea, difficulty sleeping, sweatiness, anxiety, and trembling. This phase usually lasts no more than three to five days. More severe effects of withdrawal can include hallucinations in which a patient sees, hears, or feels something that is not actually present, seizures, an unbearable craving for more alcohol, confusion, fever, fast heart rate (tachycardia), high blood pressure (hypertension), and delirium (a fluctuating level of consciousness). Patients at highest risk for the most severe symptoms of withdrawal are those with other medical problems, including malnutrition, liver disease, or Wernicke's syndrome. Severe withdrawal symptoms usually begin about three days after the individual's last drink, and may last a variable number of days.

Heart. Small amounts of alcohol cause a drop in blood pressure, but with increased consumption, alcohol raises blood pressure into a dangerous range (hypertension). High levels of fats circulating in the bloodstream increase the risk of heart disease. Heavy drinking results in an increase in heart size, weakening of the heart muscle, abnormal heart rhythms, a risk of blood clots forming within the chambers of the heart, and a greatly increased risk of stroke due to a blood clot entering the circulatory system and blocking a brain blood vessel.


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n the continued extreme dependence on excessive amounts of alcohol, accompanied by a cumulative pattern of deviant behaviors. The most frequent consequences are chronic gastritis, central nervous system depression, and cirrhosis of the liver, each of which can compromise the delivery of dental care. Oral cancer and increased levels of periodontal disease are also risks.
As defined by the American Society of Addiction Medicine (ASAM), addiction is a disease that disrupts brain chemistry and circuitry, which in turn impacts willpower, reward, memory, and motivation. The first step calls for individuals to accept that they are unable to control their drinking and/or drug use and that their willpower and motivation have been compromised. When someone struggles with addiction, they are no longer able to manage how much and how often drugs and/or alcohol are abused. Recognition of this loss of control and admission of being powerless over addiction is the first step toward recovery.
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The first book written to cover the 12 step program was titled "Alcoholics Anonymous", affectionately known as the Big Book by program members. Following the subsequent extensive growth of twelve step programs for other addictive and dysfunctional behaviors, many additional books were written and recordings and videos were produced. These cover the steps in greater detail and how people have specifically applied the steps in their lives. An extensive chronology and background about the history of A.A. has been put together at Dick B.'s website.
I am appalled that a book written by two extremely disturbed privileged white males who lived in 1930s Jim Crow era America is still the "treatment " standard for addiction. AA has been ruled a religious organization by several federal circuit courts, and it is impossible to work the program without a belief in a God who magically answers prayers for the addict who prays hard enough. It is not possible to turn one's will and life over to the care of Nature, or a Doorknob, or the Group of Drunks. One is guided through the steps by someone who is only qualified by the amount of sober time they claim to have. 12 step groups are especially dangerous for survivors of rape, abuse, and other trauma when they are tasked to examine "their part" in the crimes committed against them, not to mention having to defend themselves against the unethical yet joked about 13th Step.
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.
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.
Signs that indicate a person is intoxicated include the smell of alcohol on their breath or skin, glazed or bloodshot eyes, the person being unusually passive or argumentative, and/or a deterioration in the person's appearance, judgment, or hygiene. Other physical symptoms of the state of being drunk include flushed skin. Cognitively, the person may experience decreased ability to pay attention and a propensity toward memory loss.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has modified some of the criteria involved in the medical definition of an alcohol use disorder. There are 11 criteria listed to help clinicians determine if their patient has AUD and how serious the problem is. A mild AUD involves experiencing two or three of the 11 symptoms for one year; a moderate AUD involves four or five of the symptoms; and a severe AUD involves six or more of the listed criteria.

People who struggle with AUD may begin drinking because of social situations or anxiety about being around people; however, signs of a potential AUD include changes in friend groups, especially geared toward friends who drink versus those who don’t, and avoiding social situations to drink instead. Those who have a family member who struggles with AUD are more likely to suffer from high stress, emotional and physical abuse, and mental health or substance abuse problems later in life.


interventions Extreme caution should be used in administering drugs to alcoholic patients because of the possibility of additive central nervous system depression and toxicity caused by inability of the liver to metabolize the drugs. Treatment consists of psychotherapy (especially group therapy by organizations such as Alcoholics Anonymous), or administration of drugs such as disulfiram that cause an aversion to alcohol. See also acute alcoholism, chronic alcoholism.
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.
A condition characterised by a pathologic pattern of alcohol use causing a serious impairment in social or occupational functioning; also defined by the Joint Committee of the National Council on Alcoholism and Drug Dependence & the American Society of Addiction Medicine as a “primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterised by … distortions in thinking, most notably denial.” A simpler, operational definition is persistent drinking that interferes with the person’s health, legal position, interpersonal relationships, or means of livelihood. Alcoholism is characterised by the regular intake of ≥75 g/day of alcohol.

In the twelve-step program human structure is symbolically represented in three dimensions: physical, mental, and spiritual. The problems the groups deal with are understood to manifest themselves in each dimension. For addicts and alcoholics the physical dimension is best described by the allergy-like bodily reaction resulting in the compulsion to continue using substances after the initial use.[17][18] The statement in the First Step that the individual is "powerless" over the substance-abuse related behavior at issue refers to the lack of control over this compulsion, which persists despite any negative consequences that may be endured as a result.[19]
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