In one section, Dr. Miller discusses the importance of pharmacological therapy for the treatment of addiction. In another section he discusses the importance of AA in recovery, knowing full well that AA, with their definition of  "abstinence" does not welcome those receiving medication into their program. This is not only disingenuous, it is hypocritical. And AA's definition of abstinence, it is killing people. Those who have an addiction to opioids, when they relapse, too many of them, they die. They need to be on medication, and they need to stay on medication. Medication to treat this brain disorder of structure and function that we call addiction. They need to get their life back. And keep it. And if those still wedded to the ideology of AA, to the beliefs of the 1930's, when there were no medications for the treatment of addiction, don't like it, then oh well. Too bad.
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We offer flexible programming and a curriculum focused on fully integrated behavioral and mental health that also treats substance use. Through our program, your child will develop new coping skills and learn to address triggers and stressors as they continue their normal routine at home and school. Every aspect of your child’s treatment is designed to meet their specific needs and all substance abuse treatment is individualized to meet the needs of each patient.
My Treatment Lender is the only recovery-based lending company in the country. We provide loans to people who are in need of behavioral health, substance abuse and/or eating disorder treatment. We can help clients cover the cost of co-pays, high deductibles, or their entire stay. We believe that people don't have to suffer from mental health issues, alcoholism, drug addiction or eating disorders. There is a solution. By providing loans for treatment, we hope to be able to give people who want to recover the best chance possible.
Diagnosis is aided by administering specific psychological assessments that help to indicate what aspects of a person's life may be affected by alcohol use. Determining the exact quantity of alcohol that a person drinks is less important than determining how drinking affects relationships, jobs, educational goals, and family life. Because the metabolism (how the body breaks down and processes) of alcohol varies among individuals, the quantity of alcohol consumed is not part of the criteria list for diagnosing either alcohol dependence or alcohol abuse.
Recovery from alcoholism is a life-long process. The potential for relapse remains present and must be acknowledged and respected. Many individuals stop drinking and then relapse multiple times before attaining extended periods of sobriety. Statistics suggest that, among middle-class alcohol-dependent individuals in stable financial and family situations who have undergone treatment, 60% or more successfully stop drinking for at least one year.
In the United States and Canada, AA meetings are held in hundreds of correctional facilities. The AA General Service Office has published a workbook with detailed recommendations for methods of approaching correctional-facility officials with the intent of developing an in-prison AA program.[79] In addition, AA publishes a variety of pamphlets specifically for the incarcerated alcoholic.[80] Additionally, the AA General Service Office provides a pamphlet with guidelines for members working with incarcerated alcoholics.[81]
My Treatment Lender is the only recovery-based lending company in the country. We provide loans to people who are in need of behavioral health, substance abuse and/or eating disorder treatment. We can help clients cover the cost of co-pays, high deductibles, or their entire stay. We believe that people don't have to suffer from mental health issues, alcoholism, drug addiction or eating disorders. There is a solution. By providing loans for treatment, we hope to be able to give people who want to recover the best chance possible.
AA sprang from The Oxford Group, a non-denominational movement modeled after first-century Christianity.[13] Some members founded the Group to help in maintaining sobriety. "Grouper" Ebby Thacher was Wilson's former drinking buddy who approached Wilson saying that he had "got religion", was sober, and that Wilson could do the same if he set aside objections to religion and instead formed a personal idea of God, "another power" or "higher power".[14][15]
Q. Alcoholism Steve 26 yr old suffered with bi-polar and the related drugs that eventually lead to his over dose. He died in where he felt a connection to the intellectual environment. After suffering with Steve for so many years, I am convinced that this disease is genetic; his grandmother also suffered with drug addiction and a mental disorder, but had that gene that must have been inherited by Steve. Any one in the area of mental health and genetic engineering Research? We want to set up or get involved with public awareness on the devastation of this disease which kills 100+ thousands in this country each year; yet society treats it as a social problem -- The advancement of mental research has been slow almost medieval -- Please help. No one, no family should have to suffer the way my beautiful son suffered and who had so much to give to humanity.
According to the National Survey on Drug Use and Health, approximately 15 million American adults misuse alcohol or are alcohol dependent. In the United States, nearly 20% of patients treated in general medical practices report drinking at levels considered "risky" or "hazardous." According to NIAAA, less than 10% of patients with alcohol use disorder receive treatment.
AA's program is an inheritor of Counter-Enlightenment philosophy. AA shares the view that acceptance of one's inherent limitations is critical to finding one's proper place among other humans and God. Such ideas are described as "Counter-Enlightenment" because they are contrary to the Enlightenment's ideal that humans have the capacity to make their lives and societies a heaven on earth using their own power and reason.[33] After evaluating AA's literature and observing AA meetings for sixteen months, sociologists David R. Rudy and Arthur L. Greil found that for an AA member to remain sober a high level of commitment is necessary. This commitment is facilitated by a change in the member's worldview. To help members stay sober AA must, they argue, provide an all-encompassing worldview while creating and sustaining an atmosphere of transcendence in the organization. To be all-encompassing AA's ideology places an emphasis on tolerance rather than on a narrow religious worldview that could make the organization unpalatable to potential members and thereby limit its effectiveness. AA's emphasis on the spiritual nature of its program, however, is necessary to institutionalize a feeling of transcendence. A tension results from the risk that the necessity of transcendence, if taken too literally, would compromise AA's efforts to maintain a broad appeal. As this tension is an integral part of AA, Rudy and Greil argue that AA is best described as a quasi-religious organization.[40]
As is true with virtually any mental health diagnosis, there is no one test that definitively indicates that someone has an alcohol-use disorder. Screening tools, including online or other tests may help identify individuals who are at risk for having a drinking problem. Therefore, health care professionals diagnose alcohol abuse or dependence by gathering comprehensive medical, family, and mental health information. The practitioner will also either perform a physical examination or request that the individual's primary care doctor perform one. The medical examination will usually include lab tests to evaluate the person's general health and to explore whether or not the individual has a medical condition that might have mental health symptoms.
Alcoholism is appropriately considered a disease rather than a weakness of character or chosen pattern of bad behavior. It is the third most common mental illness, affecting more than 14 million people in the United States. Other facts and statistics about alcohol dependence include its pattern of afflicting about 4% of women and 10% of men. It costs more than $200 billion per year in lower productivity, early death, and costs for treatment. Worldwide, alcohol is thought to contribute to more than 200 illnesses and injuries, like liver disease, heart disease, and neurological problems. Alcohol-related deaths number more than 3 million per year, nearly 6% of all deaths worldwide. For adults between 20-40 years of age, that percentage rises to about 25% of deaths due to alcohol.
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I am still surprised and disappointed by professionals who focus on the all or nothing, right vs wrong approach to treatment.  I think we owe to all our lie RS and the treatment community to learn about the different options our clients may encounter and professionally guide them to the best match for them on the present.  Why do some addicts have years of solid recovery with one approach over another probably won't have definitive explanation other than every addict is unique. We support them. We I still response single hope and help them explore options.  We do not decide or judge.  They have family friends and society doing enough.   I regret how judgmental I've been trying to push a client and may have created more resistance and fear. 
Most of the warning signs and symptoms of alcoholism are not difficult to pinpoint. However, there are some that are obvious. Often, an alcoholic will not admit that there is a problem. This could be due to denial, or a true belief no problem exists. Generally speaking, the last person to realize that there is a problem is the alcoholic. He or she will likely deny the existence of a problem until irreparable damage is done. This is why the symptoms of alcoholism are important to recognize.
The DSM-IV diagnosis of alcohol dependence represents one approach to the definition of alcoholism. In part, this is to assist in the development of research protocols in which findings can be compared to one another. According to the DSM-IV, an alcohol dependence diagnosis is: "maladaptive alcohol use with clinically significant impairment as manifested by at least three of the following within any one-year period: tolerance; withdrawal; taken in greater amounts or over longer time course than intended; desire or unsuccessful attempts to cut down or control use; great deal of time spent obtaining, using, or recovering from use; social, occupational, or recreational activities given up or reduced; continued use despite knowledge of physical or psychological sequelae."[104] Despite the imprecision inherent in the term, there have been attempts to define how the word alcoholism should be interpreted when encountered. In 1992, it was defined by the National Council on Alcoholism and Drug Dependence (NCADD) and ASAM as "a primary, chronic disease characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking."[105] MeSH has had an entry for "alcoholism" since 1999, and references the 1992 definition.[106]

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Alcoholism is a term used to describe someone with an alcohol use disorder. Someone with alcoholism has both a physical and psychological dependence on alcohol. They may have problems controlling their drinking habits or choose to keep drinking even though it causes problems. These problems may interfere with their professional and social relationships or even their own health.
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]
Severe acute withdrawal symptoms such as delirium tremens and seizures rarely occur after 1-week post cessation of alcohol. The acute withdrawal phase can be defined as lasting between one and three weeks. In the period of 3–6 weeks following cessation increased anxiety, depression, as well as sleep disturbance, is common;[65] fatigue and tension can persist for up to 5 weeks as part of the post-acute withdrawal syndrome; about a quarter of alcoholics experience anxiety and depression for up to 2 years. These post-acute withdrawal symptoms have also been demonstrated in animal models of alcohol dependence and withdrawal.[66] A kindling effect also occurs in alcoholics whereby each subsequent withdrawal syndrome is more severe than the previous withdrawal episode; this is due to neuroadaptations which occur as a result of periods of abstinence followed by re-exposure to alcohol. Individuals who have had multiple withdrawal episodes are more likely to develop seizures and experience more severe anxiety during withdrawal from alcohol than alcohol-dependent individuals without a history of past alcohol withdrawal episodes. The kindling effect leads to persistent functional changes in brain neural circuits as well as to gene expression.[67] Kindling also results in the intensification of psychological symptoms of alcohol withdrawal.[65] There are decision tools and questionnaires which help guide physicians in evaluating alcohol withdrawal. For example, the CIWA-Ar objectifies alcohol withdrawal symptoms in order to guide therapy decisions which allows for an efficient interview while at the same time retaining clinical usefulness, validity, and reliability, ensuring proper care for withdrawal patients, who can be in danger of death.[68]
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Alcohol dependency occurs on a continuum. Many Australians are only moderately or mildly dependent on alcohol (e.g. they may find it difficult to stop drinking once they start). They do not exhibit physical withdrawals like those with severe alcohol dependence, and do not consider their drinking patterns problematic. This may be because the major health and social consequences of alcohol dependence (with the exclusion of violence) do not begin when an individual first becomes alcohol dependent. For example, it may take years for an individual who is alcohol dependent to have financial or relationship problems as a result of drinking. In many cases chronic excessive drinking may have no immediate health and social consequences.

Alcohol, especially when consumed in excess, can affect teens, women, men, and the elderly quite differently. Women and the elderly tend to have higher blood concentrations of alcohol compared to men and younger individuals who drink the same amount. Alcoholic women are more at risk for developing physical health problems like cirrhosis of the liver and heart and nerve damage at a faster rate than alcohol-dependent men. Interestingly, men and women seem to have similar learning and memory problems as the result of excessive alcohol intake, but again, women tend to develop those problems twice as fast as men.


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There is a group of physicians within ASAM who are concerned that twelve-step recovery is not being taught to new physicians entering this field (most physicians currently enter addiction practice in mid-career, rather than straight out of residency training). Referring to themselves as “Like Minded Docs,” they communicate regularly among each other, leaning on each other via email for support and guidance, and occasionally reaching out to ASAM regarding policies of the Society. One of their stated concerns is that continuing education programs for physicians newly involved with addiction or considering a mid-career switch into addiction medicine have more content on pharmacotherapies and less content on psychosocial therapies, and that Twelve-Step Facilitation therapy and twelve-step recovery overall are at risk of becoming ‘dying arts.’

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.[171] Studies by social psychologists Stivers and Greeley attempt to document the perceived prevalence of high alcohol consumption amongst the Irish in America.[172] 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.[173] 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.[174]
During Step 9, individuals will attempt to make amends for wrongdoings done to specific individuals. People are encouraged to reach out to these individuals and let them know that they would like to approach them to make amends. It can be very humbling to do so. In some cases, it is not possible to have these conversations directly, or doing so would be more harmful, so indirect methods may be ideal. Individuals can write a letter to the person (even if it will never actually be delivered), or they may choose to donate to a charity in their honor or help someone else in need.
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.
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The Traditions recommend that members remain anonymous in public media, altruistically help other alcoholics, and that AA groups avoid official affiliations with other organizations. They also advise against dogma and coercive hierarchies. Subsequent fellowships such as Narcotics Anonymous have adopted and adapted the Twelve Steps and the Twelve Traditions to their respective primary purposes.[4][5]
Elderly people who drink excessively are at risk for having more serious illnesses, doctor visits, and symptoms of depression, with less life satisfaction and smaller social support networks compared to senior citizens who have never consumed alcohol. While binge drinking is often thought to be a symptom of young people, an often unknown fact is that a significant percentage of middle-aged and elderly individuals also engage in binge drinking. This behavior increases the risk for driving drunk, no matter what the age. That, in turn, puts the individual at risk for being arrested for driving under the influence (DUI) of alcohol.

I agree with Jann B.'s earlier comments that the resistance of some AA members to pharmacological assistance has helped to create the divide between 12 Step recovery and academic addiction medicine. In fact, resistance by active alcoholics to psychological assisstance - mostly by withholding the true nature of their addiction -  was addressed in AA's original publication in 1939 of the text Alcoholilcs Anonymous. It acknowledged that the alcoholic him/herself was in part responsible for the skepticism many professionals felt when treating alcoholics. However, AA literature also is quite clear (in the text and via subsequent pamphlets) about the importance of seeking outside help and being open-minded to the advice of a helping professional.

That said, I believe the divide between 12 Step recovery and academic addiction medicine is largely a result of AA's non-scientific approach. The nature of addiction and subsequent recovery through 12 Step work is not easily measurable or definable. Academia can measure length of sobriety and certain facts, but is not able to tell us why this occurs...at least not in a quantitative way.  As a result, tends to avoid embracing 12 Step recovery because they cannot define it measurable scientific methods.

Fortunately to the suffering alchoholic who desires escape from the hell of alchoholism, 12 Step recovery doesn't necessitate understanding the process, it requires doing the process.

The transformation to permanent sobriety results from taking action, not from taking thought. Study and debate it all you want, but his pragmatic approach continues to save lives, as it did mine, 31 years ago.

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.

With Step 9, individuals are apologizing for their actions while under the influence of drugs or alcohol or for the damages their addiction has caused. Individuals may then attempt to offer restitution and seek forgiveness and reconciliation but need to be aware that they may not receive it. Working through Step 9 helps to set things right so everyone can move on.
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FAS is the leading cause of mental retardation in the United States. One to two of every 1,000 infants born in the United States are afflicted with FAS. The incidence of FAS in children whose mothers drink heavily is 4% much higher than the rate in the general population. Research studies that have followed infants with FAS and FAEs across time have found that many of these children continue to have cognitive difficulties (e.g., lower IQ scores, more learning problems, poorer short-term memory functioning) and behavioral problems (e.g., high impulsivity, high activity level) into childhood and adolescence.

Alcoholics Anonymous World Services, Inc. has not approved, endorsed, or reviewed this website, nor is it affiliated with it, and the ability to link to A.A.W.S.' site does not imply otherwise. No copyrighted material shall be purposefully posted herein without the express permission of those individuals or institutions possessing ownership of said copyrights. Alcoholics Anonymous®, AA®, and The Big Book® are registered trademarks of Alcoholics Anonymous World Services Inc. The Grapevine®, and AA Grapevine® are registered trademarks of The AA Grapevine, Inc.
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.
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]
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.
When a health care professional is caught or suspected of diversion, the nursing board, board of pharmacy, attorney general, or another regulatory agency may require admission into IPRP. This may also result in local, State or Federal investigations and charges. IPRP is required to be transparent with all participating agencies if admission is mandated, thus potentially having a much greater negative effect on the professional's career. 

When alcohol dependence is mild or moderate, health practitioners commonly provide counselling or support to change behaviour. They may recommend particular strategies for avoiding situations which involve a high risk of excessive alcohol consumption (e.g. nightclubs) or coping with stressful situations without drinking alcohol. Health professionals can help identify sources of support, and suggest strategies that will help people dependent on alcohol regulate their own consumption (e.g. by having one or two alcohol-free days per week).
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.

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Since 2014, Addiction Center has been an informational web guide for those who are struggling with substance use disorders and co-occurring behavioral and mental health disorders. All content included on Addiction Center is created by our team of researchers and journalists. of our articles are fact-based and sourced from relevant publications, government agencies and medical journals.
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