AA has remained mostly unchanged since it was founded. Obviously, the world is not the same as it was in 1935, as well as addiction, how we see it, and how we treat it. While newer sober support programs like SMART Recovery make it a point to keep up with the latest in the science of recovery treatment, AA and its 12 Steps have relied on the same “one-size-fits-all” techniques for almost 80 years, techniques that may no longer be as effective in today’s world.
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Smith and Wilson left the Oxford Group in 1937 to focus on developing Alcoholics Anonymous, and by 1938, they had successfully brought the message to almost a hundred alcoholics in the Ohio and New York areas. Looking to capitalize on their momentum, they decided to document the group in a book. Wilson took the lead on the project, naming the resulting publication, Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism. He included 12 guidelines that, if followed, would grow the individual’s spirit to the point of overcoming the temptation to drink, and help the person make reparations for all the damage done during the days of drinking. These became known as the 12 Steps, and the book’s popularity led to Wilson’s group adopting the name of the book itself.
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Are you ready for some alarming information? A study published by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in 2006 included the analysis of 43,000 people. The researchers determined that waiting until age 21 to drink places the average person at a 9% chance of developing alcoholism. However, start drinking at age 14 or sooner, (which plenty of kids do), and that shoots up to a 47% chance. “In general, each additional year earlier than 21 that a respondent began to drink, the greater the odds that he or she would develop alcohol dependence at some point in life,” says the study.
Depending on the addiction type and intensity, you or someone you care about may require anything from a thirty day in-patient drug or alcohol treatment program all the way up to a 4-month or longer one. Certain drugs may allow for outpatient services while severe cases may need longer-term treatment services. However, you can find a Cheyenne treatment facility to fit just about any personal need.
Most Twelve Step participants view addiction as a lifelong disease and see the Twelve Steps as their new design for living. When people whose lives have been affected by addiction work the Twelve Steps, they can better sort out the things which they have no control over, and the things for which they are responsible. Group meetings offer a safe place to share one's experience, strength and hope, and to receive support and fellowship.
Young antisocial subtype: This group represents about 21 percent of people struggling with AUD, according to the NIAAA study. On average, this group is about 26 years old – so still young, but not as young as the young adult group. They are defined by having antisocial personality disorder; this mental health condition leads them to begin drinking in adolescence, around age 15 on average, and they display symptoms of AUD by age 18. They are also more likely to struggle with polydrug abuse, especially abuse of tobacco and marijuana. There is no overlap between the young adult and young antisocial subtypes.
Women develop long-term complications of alcohol dependence more rapidly than do men. Additionally, women have a higher mortality rate from alcoholism than men.[35] Examples of long-term complications include brain, heart, and liver damage[36] and an increased risk of breast cancer. Additionally, heavy drinking over time has been found to have a negative effect on reproductive functioning in women. This results in reproductive dysfunction such as anovulation, decreased ovarian mass, problems or irregularity of the menstrual cycle, and early menopause.[35] Alcoholic ketoacidosis can occur in individuals who chronically abuse alcohol and have a recent history of binge drinking.[37][38] The amount of alcohol that can be biologically processed and its effects differ between sexes. Equal dosages of alcohol consumed by men and women generally result in women having higher blood alcohol concentrations (BACs), since women generally have a higher percentage of body fat and therefore a lower volume of distribution for alcohol than men, and because the stomachs of men tend to metabolize alcohol more quickly.[39]
The World Health Organization examined mental disorders in primary care offices and found that alcohol dependence or harmful use was present in 6% of patients. In Britain, 1 in 3 patients in community-based primary care practices had at-risk drinking behavior. Alcoholism is more common in France than it is in Italy, despite virtually identical per capita alcohol consumption.
Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Doctor On Demand
Received income in an amount equal to or greater than $250 from: Blue Cross Blue Shield Federal Employee Program
Received royalty from Lippincott Williams & Wilkins for book editor; Received grant/research funds from National Alliance for Research in Schizophrenia and Depression for independent contractor; Received consulting fee from Blue Cross Blue Shield Association for consulting. for: Received book royalty from American Psychiatric Publishing Inc.

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Most Twelve Step participants view addiction as a lifelong disease and see the Twelve Steps as their new design for living. When people whose lives have been affected by addiction work the Twelve Steps, they can better sort out the things which they have no control over, and the things for which they are responsible. Group meetings offer a safe place to share one's experience, strength and hope, and to receive support and fellowship.
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.
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I am surprised that along with the detailed description of the utility of CBT in aiding recovery from addictions that no mention was made of the SMART Recovery Self-Help Network. The SMART Recovery Program (Self-Management And Recovery Training) which is grounded in CBT along with several other evidence-based tools. There are about 1,500 free SMART Recovery meetings available in communities & prisons around the world. smartrecovery.org is an interactive website which receives about 120,000 unique visitors per month and has over 135,000 registrants. 30 online SMART Recovery meetings per week are available online. 160 SMART facilitators per month are being trained via an interactive online program; many are professionals. About 1/3 of regular SMART Recovery participants also attend 12-Step meetings, at least occasionally, There have been >25,000 SMART meetings in MA where 2/3 of participants are professionally referred and the majority of meetings occur in hospitals. SMART Recovery has no objection to appropriate, medically-prescribed pharmaceuticals being used in the course of recovery from an addiction.
Though it can feel as if you are hiding a unique or embarrassing problem, the fact is that families across the country are experiencing the exact same thing you are. You are not alone with the disease, and you will not be alone as you seek the treatment necessary to begin to heal and start a new life in recovery. Alcohol.org is available to provide education and support all along the way.
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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.

I disagree. The underlying premise of "recovery" is not hope, but wellness. Becoming well. Staying well. By AA's own statistics, only 10.4% of participants continue with the program after the first year. What about the 89.6% that don't continue? According to AA, they failed. It's their fault. They weren't "working" the program. Or, they're "constitutionally incapable of being honest." If one defines normality as what the vast majority of people do in a given situation, then it is "normal" for people to fail in AA.


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.
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.
People have been brewing and fermenting alcoholic drinks since the dawn of civilization. Consumed in moderate amounts, alcoholic beverages are relaxing and in some cases may even have beneficial effects on heart health. Consumed in excess, alcohol is poisonous and is considered a drug. It is estimated that between 18 million -- or one in 12 adults -- in the U.S. abuse alcohol or are chronic alcoholics. Nearly 100,000 Americans die each year as a result of alcohol abuse, and alcohol is a factor in more than half of the country's homicides, suicides, and traffic accidents. Alcohol abuse also plays a role in many social and domestic problems, from job absenteeism and crimes against property to spousal and child abuse.
The twelve steps of alcoholics anonymous do not come from the Oxford Groups because there were twelve apostles the  Oxford Groups practised six steps all of which AA adopted but also added six which had to do specifically with a non denominational or religious numinous power and the specific effects of alcohol addiction on the character on the afflicted.  As many addicts -- probably many more -- have been harmed by the ignorant prescription or pharmaceuticals to people in recovery for AA as have been harmed by a lay AA sponsor telling a member that all prescriptions are bad. .   

The co-occurrence of major depressive disorder and alcoholism is well documented.[47][48][49] Among those with comorbid occurrences, a distinction is commonly made between depressive episodes that remit with alcohol abstinence ("substance-induced"), and depressive episodes that are primary and do not remit with abstinence ("independent" episodes).[50][51][52] Additional use of other drugs may increase the risk of depression.[53] Psychiatric disorders differ depending on gender. Women who have alcohol-use disorders often have a co-occurring psychiatric diagnosis such as major depression, anxiety, panic disorder, bulimia, post-traumatic stress disorder (PTSD), or borderline personality disorder. Men with alcohol-use disorders more often have a co-occurring diagnosis of narcissistic or antisocial personality disorder, bipolar disorder, schizophrenia, impulse disorders or attention deficit/hyperactivity disorder (ADHD).[54] Women with alcoholism are more likely to experience physical or sexual assault, abuse and domestic violence than women in the general population,[54] which can lead to higher instances of psychiatric disorders and greater dependence on alcohol.


Hazard duly joined a Christian evangelical movement, known as the Oxford Group. In addition to the basic tenets of the Christian faith (such as honesty and personal change), “personal evangelism” was stressed, or one member of the group sharing his story with someone outside of the group, especially if the other person was undergoing a personal crisis.
"Learning basic Twelve Step philosophy and language can open the lines of communication," continued Cathy. "Once you understand some Twelve Step principles, concepts such as powerlessness, spiritual awakening, higher power and making amends, they will seem less like cult mantras and more like the simple guides they are intended to be." A Twelve Step program is one that adapts the Twelve Steps of AA to fit the particular needs of a mutual-help group. Narcotics Anonymous, Al-Anon, Alateen, Gamblers Anonymous, Nicotine Anonymous, and Adult Children of Alcoholics are examples of groups with a Twelve Step foundation.
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"Thirteenth-stepping" is a pejorative term for AA members approaching new members for dates. A study in the Journal of Addiction Nursing sampled 55 women in AA and found that 35% of these women had experienced a "pass" and 29% had felt seduced at least once in AA settings. This has also happened with new male members who received guidance from older female AA members, in pursuit of sexual company. The authors suggest that both men and women need to be prepared for this behavior or find Male only or female-only groups.[88] However, this is a small survey compared to the estimated 2 million members (2016) and many women have reported feeling safe in AA. AA's pamphlet on sponsorship suggests that men be sponsored by men and women be sponsored by women.[89]
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]

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Severe childhood trauma is also associated with a general increase in the risk of drug dependency.[69] Lack of peer and family support is associated with an increased risk of alcoholism developing.[69] Genetics and adolescence are associated with an increased sensitivity to the neurotoxic effects of chronic alcohol abuse. Cortical degeneration due to the neurotoxic effects increases impulsive behaviour, which may contribute to the development, persistence and severity of alcohol use disorders. There is evidence that with abstinence, there is a reversal of at least some of the alcohol induced central nervous system damage.[74] The use of cannabis was associated with later problems with alcohol use.[75] Alcohol use was associated with an increased probability of later use of tobacco, cannabis, and other illegal drugs.[76]

In order to effectively recover from an addiction, professional help in the field of substance abuse is only part of the equation. Often times, recovering individuals additionally need the support of others who are also recovering from addiction. This is where support groups can provide a critical element needed to bring success to an individual's recovery process.


Jump up ^ Agrawal, A; Sartor, CE; Lynskey, MT; Grant, JD; Pergadia, ML; Grucza, R; Bucholz, KK; Nelson, EC; Madden, PA; Martin, NG; Heath, AC (2009). "Evidence for an Interaction Between Age at 1st Drink and Genetic Influences on DSM-IV Alcohol Dependence Symptoms". Alcoholism: Clinical and Experimental Research. 33 (12): 2047–56. doi:10.1111/j.1530-0277.2009.01044.x. PMC 2883563. PMID 19764935.
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.
Genetic differences that exist between different racial groups affect the risk of developing alcohol dependence. For example, there are differences between African, East Asian and Indo-racial groups in how they metabolize alcohol. These genetic factors partially explain the differing rates of alcohol dependence among racial groups.[84][85] The alcohol dehydrogenase allele ADH1 B*3 causes a more rapid metabolism of alcohol. The allele ADH1 B*3 is only found in those of African descent and certain Native American tribes. African Americans and Native Americans with this allele have a reduced risk of developing alcoholism.[86] Native Americans, however, have a significantly higher rate of alcoholism than average; it is unclear why this is the case.[87] Other risk factors such as cultural environmental effects e.g. trauma have been proposed to explain the higher rates of alcoholism among Native Americans compared to alcoholism levels in caucasians.[88][89]
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.
Michael M. Miller, MD, FASAM, FAPA, is the medical director of the Herrington Recovery Center at Rogers Memorial Hospital-Oconomowoc. He is a board-certified general psychiatrist and addiction psychiatrist. Dr. Miller has practiced addiction medicine for more than 30 years and is certified in addiction medicine by the American Board of Addiction Medicine. Dr. Miller is also an at-large director of the American Board of Addiction Medicine and The ABAM Foundation. He is a past president of ASAM.

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.

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]

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AA meetings are "quasi-ritualized therapeutic sessions run by and for, alcoholics".[41] They are usually informal and often feature discussions. Local AA directories list a variety of weekly meetings. Those listed as "closed" are available to those with a self professed "desire to stop drinking," which cannot be challenged by another member on any grounds.[4] "Open" meetings are available to anyone (nonalcoholics can attend as observers).[42] At speaker meetings, one or two members tell their stories, while discussion meetings allocate the most time for general discussion. Some meetings are devoted to studying and discussing the AA literature.[43]

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]
Like many chronic diseases, alcoholism cannot be cured; however, effective treatment is available to help individuals who suffer from alcoholism remain sober. Treatment usually consists primarily of group therapy, one or more types of counseling, and alcohol education. Participants must acknowledge that they have a drinking problem and have a strong desire to stop drinking. Once the decision has been made, they may check into a treatment center for a brief period of time to rehabilitate as they stop drinking. The treatment center (and/or doctor) counsels patients, gives them support, and helps them get through their initial symptoms and safely withdraw from the alcohol. In some cases, short-term medications such as benzodiazepines (Valium or similar drugs) are used to help alleviate some of the symptoms of alcohol dependence.
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.
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.
During 2018, Celebrate your "Sobriety Birthday" by contributing a $ amount to Central Office equal to the number of years of sobriety you're celebrating. Click Here for the latest listing of the Buck-a-year program participants. On your AA Birthday, make your contribution at Central Office by cash, check, or credit card, or by check in the mail. (Note: include with your contribution your 1st name, last initial, home group & sobriety date.) Or you can contribute online using PAYPAL or a credit or debit card - enter your 1st name, last initial, home group & sobriety date in the boxes below, then click Pay Now, enter the amount, and choose your method of payment
The various health problems associated with long-term alcohol consumption are generally perceived as detrimental to society, for example, money due to lost labor-hours, medical costs due to injuries due to drunkenness and organ damage from long-term use, and secondary treatment costs, such as the costs of rehabilitation facilities and detoxification centers. Alcohol use is a major contributing factor for head injuries, motor vehicle accidents (due to drunk driving), domestic violence, and assaults. Beyond the financial costs that alcohol consumption imposes, there are also significant social costs to both the alcoholic and their family and friends.[55] For instance, alcohol consumption by a pregnant woman can lead to fetal alcohol syndrome,[165] an incurable and damaging condition.[166] Estimates of the economic costs of alcohol abuse, collected by the World Health Organization, vary from one to six percent of a country's GDP.[167] One Australian estimate pegged alcohol's social costs at 24% of all drug abuse costs; a similar Canadian study concluded alcohol's share was 41%.[168] One study quantified the cost to the UK of all forms of alcohol misuse in 2001 as £18.5–20 billion.[148][169] All economic costs in the United States in 2006 have been estimated at $223.5 billion.[170]
More than 7 percent of all American adults have an alcohol use disorder. These adults drink too much, too often, and in ways that harm their health, their happiness, and their relationships. An intervention, in which the family outlines alcohol’s consequences, can push these people to enter treatment programs. Once there, counseling sessions, relapse prevention coaching, and support group work can help to support recovery. Relapse rates for alcohol fall within the 40-60 percent range, so people often need to stick with aftercare for the rest of life.
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Though cautious regarding the medical nature of alcoholism, AA has let others voice opinions. The Big Book states that alcoholism "is an illness which only a spiritual experience will conquer." Ernest Kurtz says this is "The closest the book Alcoholics Anonymous comes to a definition of alcoholism."[60] In his introduction to The Big Book, non-member William Silkworth said those unable to moderate their drinking have an allergy. Addressing the allergy concept, AA said "The doctor’s theory that we have an allergy to alcohol interests us. As laymen, our opinion as to its soundness may, of course, mean little. But as ex-problem drinkers, we can say that his explanation makes good sense. It explains many things for which we cannot otherwise account."[61] AA later acknowledged that "alcoholism is not a true allergy, the experts now inform us."[62] Wilson explained in 1960 why AA had refrained from using the term "disease":


The Hazelden Betty Ford Foundation is a force of healing and hope for individuals, families and communities affected by addiction to alcohol and other drugs. It is the nation's largest nonprofit treatment provider, with a legacy that began in 1949 and includes the 1982 founding of the Betty Ford Center. With 17 sites in California, Minnesota, Oregon, Illinois, New York, Florida, Massachusetts, Colorado and Texas, the Foundation offers prevention and recovery solutions nationwide and across the entire continuum of care for youth and adults.
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.[90]
SMART Recovery: (Self Management for Addiction Recovery): SMART Recovery is a 4-point program based on cognitive behavioral therapy and seeks to empower the individual through education and practical techniques. It is present-focused and does not use the term “disease” when referring to addiction. Attendees may use medications, which are not encouraged in AA.
Warning signs of alcoholism include the consumption of increasing amounts of alcohol and frequent intoxication, preoccupation with drinking to the exclusion of other activities, promises to quit drinking and failure to keep those promises, the inability to remember what was said or done while drinking (colloquially known as "blackouts"), personality changes associated with drinking, denial or the making of excuses for drinking, the refusal to admit excessive drinking, dysfunction or other problems at work or school, the loss of interest in personal appearance or hygiene, marital and economic problems, and the complaint of poor health, with loss of appetite, respiratory infections, or increased anxiety.[28]
If you feel as though your alcohol consumption is taking a toll on your life, it’s important to find treatment options that will help you kick you alcohol addiction to the curb. Your doctor will be able to offer professional medical assistance if you are concerned about your drinking. Seeking help for alcoholism sooner rather than later gets you back on track to living a healthy, fulfilling life.
Treatments are varied because there are multiple perspectives of alcoholism. Those who approach alcoholism as a medical condition or disease recommend differing treatments from, for instance, those who approach the condition as one of social choice. Most treatments focus on helping people discontinue their alcohol intake, followed up with life training and/or social support to help them resist a return to alcohol use. Since alcoholism involves multiple factors which encourage a person to continue drinking, they must all be addressed to successfully prevent a relapse. An example of this kind of treatment is detoxification followed by a combination of supportive therapy, attendance at self-help groups, and ongoing development of coping mechanisms. The treatment community for alcoholism typically supports an abstinence-based zero tolerance approach; however, some prefer a harm-reduction approach.[125]
Self Management and Recovery Training (SMART Recovery). SMART Recovery is a network of support groups that advocate the use of scientific research in addiction recovery. SMART Recovery supports the use of prescription medications and behavioral therapies in the treatment of substance abuse. Since scientific knowledge is constantly evolving, the SMART Recovery program is also constantly evolving. The organization has face-to-face meetings across the United States and daily online meetings.
Treating underlying problems: There may be problems with self-esteem, stress, anxiety, depression, or other aspects of mental health. It is important to treat these problems, too, as they can increase the risks posed by alcohol. Common alcohol-related issues, such as hypertension, liver diseases, and possibly heart diseases, will need to be treated too.
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Alcoholism is characterised by an increased tolerance to alcohol–which means that an individual can consume more alcohol–and physical dependence on alcohol, which makes it hard for an individual to control their consumption. The physical dependency caused by alcohol can lead to an affected individual having a very strong urge to drink alcohol. These characteristics play a role decreasing an alcoholic's ability to stop drinking.[25] Alcoholism can have adverse effects on mental health, causing psychiatric disorders and increasing the risk of suicide. A depressed mood is a common symptom of heavy alcohol drinkers.[26][27]
Jump up ^ Ståhlbrandt, Henriettæ; Johnsson, Kent O.; Berglund, Mats (2007). "Two-Year Outcome of Alcohol Interventions in Swedish University Halls of Residence: A Cluster Randomized Trial of a Brief Skills Training Program, Twelve-Step Influenced Intervention, and Controls" (PDF). Alcoholism: Clinical and Experimental Research. 31 (3): 458–66. doi:10.1111/j.1530-0277.2006.00327.x. PMID 17295731.

Situated at the foothills of the Great Smoky Mountains, Village Behavioral Health offers an ideal setting for adolescents to begin facing their difficulties free from distractions. Our programs's goal is to help teenagers make better choices by helping them understand how poor choices have affected them in the past. Village Behavioral Health provides a safe, secure, and serene setting to allow treatment to truly begin. Family involvement is essential to make a lasting change. For the adolescent to get the full benefit of our program, we believe the family must be active participants in the treatment process. Family Therapy occurs on a regular basis and is a critical part of our program, ensuring long-term success of the youth. Village Behavioral Health’s Alcohol & Drug Program follows the 12-step model. Each adolescent begins their treatment within the 12-step model and engages in on-campus groups. Adolescents are also introduced to a relapse prevention program and guided in gaining control over their substance abuse and addiction.
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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This inventory of self is meant to be comprehensive, searching, and fearless. This does not mean that it is without fear, but that individuals are encouraged to push past their fears and be honest with listing their shortcomings. Writing lists is often an important part of Step 4 as individuals are called to cite incidents, thoughts, feelings, and past experiences that may be difficult to think about.
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