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.

As AA chapters were increasing in number during the 1930s and 1940s, the guiding principles were gradually defined as the Twelve Traditions. A singleness of purpose emerged as Tradition Five: "Each group has but one primary purpose—to carry its message to the alcoholic who still suffers".[8] Consequently, drug addicts who do not suffer from the specifics of alcoholism involved in AA hoping for recovery technically are not welcome in "closed" meetings unless they have a desire to stop drinking alcohol.[9]


According to the National Institute on Drug Abuse’s Principles of Drug Addiction Treatment: A Research-Based Guide, short-term residential programs developed the idea of using a modified 12-Step approach to provide a shorter stay in treatment that included follow-up through a 12-Step fellowship. This is seen as a way to provide the important post-treatment structure that helps people maintain long-term recovery. Other programs have also incorporated the 12 Steps, both by encouraging clients to attend 12-Step fellowship meetings, and by incorporating 12-Step ideas into their practices.

Young adult subtype: These individuals account for, per the study, about 32 percent of people struggling with AUD. This group generally begins to experience compulsive behaviors around alcohol associated with addiction when they are around 20 years old. While they have fewer occasions during an average week in which they drink, they tend to binge drink on those occasions.
To start with, getting sober and drug-free requires the desire and determination to get clean, and having both of these is crucial. If you’re looking for help for a loved one or a friend, know that they’ll need to be “on board" with the idea of recovery if they are going to have a solid chance of getting clean. If they have not yet recognized their own problem, an addiction intervention may be necessary. During the beginning phases of recovery, an alcohol and drug detox is always necessary to remove any unwanted chemicals from the body, followed by intensive addiction recovery therapy. The latter may take 28-90 days (sometimes more), but completing the program provides all the tools needed to stay substance-free. It is highly beneficial for those leaving rehab to join a recovery support group and even consider spending time in a recovery home.
Risk factors for developing problems with alcohol arise from many interconnected factors, including your genetics, how you were raised, your social environment, and your emotional health. Some racial groups, such as American Indians and Native Alaskans, are more at risk than others of developing drinking problems or alcohol addiction. People who have a family history of alcoholism or who associate closely with heavy drinkers are more likely to develop drinking problems. Finally, those who suffer from a mental health problem such as anxiety, depression, or bipolar disorder are also particularly at risk, because alcohol is often used to self-medicate.

AA describes alcoholism as an illness that involves a physical allergy[107]:28 (where "allergy" has a different meaning than that used in modern medicine.[108]) and a mental obsession.[107]:23[109] The doctor and addiction specialist Dr. William D. Silkworth M.D. writes on behalf of AA that "Alcoholics suffer from a "(physical) craving beyond mental control".[107]:XXVI A 1960 study by E. Morton Jellinek is considered the foundation of the modern disease theory of alcoholism.[110] Jellinek's definition restricted the use of the word alcoholism to those showing a particular natural history. The modern medical definition of alcoholism has been revised numerous times since then. The American Medical Association uses the word alcoholism to refer to a particular chronic primary disease.[111]
Alcoholism formerly called alcohol dependence or alcohol addiction, is the more severe end of the alcohol use disorder spectrum. It is a destructive pattern of alcohol use that includes tolerance to or withdrawal from the substance, using more alcohol or using it for longer than planned, and trouble reducing its use or inability to use it in moderation. Other potential symptoms include spending an inordinate amount of time getting, using, or recovering from the use of alcohol, compromised functioning, and/or continuing to use alcohol despite an awareness of the detrimental effects it is having on one's life.
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Alcoholics Anonymous (AA). Alcoholics Anonymous is a self-help recovery organization that is made up of support groups for people who are committed to beating alcoholism. AA first introduced, and still uses, the 12 steps of recovery, which have been in use in the United States and Canada for the last 60 years. This alcohol recovery program encourages its members to reach out to a higher power to help people overcome their addictions. With more than 56,500 AA support groups and alcohol addiction recovery programs throughout the United States, most communities have at least one AA support group. Support group meetings may be open or closed. Open meetings allow the attendance of both the substance abuser and his or her family members. Closed meetings only allow the attendance of the substance abuser. Members are expected to attend meetings regularly and encouraged to seek out a sponsor who has managed to successfully maintain sobriety.
As an addiction professional who has worked in the field for 21 years I would be negligent in my duties if I did not inform my clients about the availability of AA as a potential avenue for recovery. I also let them know of other options such as SMART, rational recovery, etc. They invariable return to me saying "all I can find around town is AA". I encourage them to use what is available if they choose to do so. I educate them about the program of AA, the fellowship (which is not the program) and what AA's official stance is on medications (there is none other than it's between the alcoholic and their doctor). I educate and encourage them on all of these things so they are not at the mercy of any uninformed alcoholic in AA.
The basic premise of the 12-Step model is that people can help one another achieve and maintain abstinence from the substances or behaviors to which they are addicted. They can do this through meetings in which they share their experiences with one another and support each other in the ongoing effort of maintaining abstinence. In research, as seen in a recent article from the journal Addiction Research and Theory, abstinence practices (as supported by 12-Step programs) can account for high levels of what experts call flourishing, which is positive mental health and can contribute to longer-term recovery. In the study, those who maintained abstinence were more likely to flourish in the long-term, with 40.7 percent flourishing after three months (as compared to 9.3 percent languishing) and nearly 40 percent flourishing after 12 months (compared to 12.4 percent languishing).
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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