The Sinclair method is another approach to using naltrexone or other opioid antagonists to treat alcoholism by having the person take the medication about an hour before they drink alcohol and only then.[137][138] The medication blocks the positive reinforcement effects of ethanol and hypothetically allows the person to stop drinking or drink less.[138]
For some individuals whose circumstances or conditions don't require a full-time, residential recovery process, outpatient recovery may be a viable recovery option. In an outpatient recovery program, individuals undergo addiction rehabilitation while living at their own homes. They are able to schedule regular check-ins at a clinic or treatment center for medication and counseling on a regular basis.
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.
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]
The Steps start from a basic acceptance that we can control and change only ourselves and our own reactions to people and events. Twelve Step participants take ongoing inventory of themselves and honestly acknowledge the ways they have hurt themselves and others. When they are ready, they attempt to make amends to all persons they have harmed. Trust, acceptance, love, goodwill and forgiveness are key elements in a Twelve Step program just as they are important elements of any healthy relationship.
Women For Sobriety: Founded in 1975 for the purpose of creating a recovery program that was explicitly geared towards women, the goal of Women For Sobriety is not to be anti-male but to address the specific psychological needs that many women have during recovery. WFS operates under the belief that many women are already struggling with low self-esteem or shame that has been culturally instilled in them and don’t need more of it from their recovery program. Instead of the 12 Steps, WFS’s treatment program is based around the 13 Affirmations that point toward positive goals rather than admitting negative faults, such as “Happiness is a habit I am developing,” “Enthusiasm is my daily exercise,” and “I am responsible for myself and for my actions.”
Abstinence-based recovery, as the name suggests, focuses on complete abstinence from drug use, thereby breaking the cycle of addiction and dependency. To achieve remission from the disease of addiction, complete withdrawal of all mind-altering substances, including alcohol, is required. Abstinence-based recovery teaches us how to live a life of freedom that no longer requires us to turn to mood or mind-altering substances in order to help change the way we feel. The 12-Steps are an abstinence-based program that offers a lifeline of support to anyone hoping to recover from addiction.

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.
Based on this study, those who abstain altogether from substances – as advised in the 12-Step model – have better mental health outcomes than those who don’t abstain. The 12-Step model gives people a framework from which to surrender their addiction, process their experience, and move forward into new patterns. As described in an article on Psych Central called Recovery Using the 12 Steps, following the model assists an individual by helping build the following mental and emotional transformative practices and tools:
Traditional addiction treatment in America is derived from multidisciplinary treatment of chronic mental disease and the peer-support program of Alcoholics Anonymous, founded in 1935 by two middle-aged men who leaned on each other for hope, and described in the eponymous book published in 1939. Its subtitle indicates it is a how-to description of the path of recovery. It describes twelve steps in the process of recovery outlined by the authors. One of the evidence-based practices of modern addiction treatment, as outlined by the federal Substance Abuse and Mental Health Services Administration’s registry of Evidence Based Programs and Practices, is Twelve Step Facilitation Therapy.

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]
Jump up ^ Terra, Mauro Barbosa; Barros, Helena Maria Tannhauser; Stein, Airton Tetelbom; Figueira, Ivan; Palermo, Luiz Henrique; Athayde, Luciana Dias; Gonçalves, Marcelo de Souza; Da Silveira, Dartiu Xavier (2008). "Do Alcoholics Anonymous Groups Really Work? Factors of Adherence in a Brazilian Sample of Hospitalized Alcohol Dependents". American Journal on Addictions. 17 (1): 48–53. doi:10.1080/10550490701756393. PMID 18214722.
Relapse can be avoided by getting sufficient aftercare. Oftentimes, aftercare involves a peer support group, ongoing therapy, and even a maintenance medication like naltrexone, which reduces or eliminates cravings. Support from family and friends is also a very important part of sustained recovery, so finding a supportive home environment – through a sober home, moving to a new house, or clearing drugs and alcohol out of one’s existing home – is very important. Working with an evidence-based treatment program can help one gather resources about nearby or online support groups and therapists.
If you have said to yourself: “Yes, I'm one of those people who are powerless over alcohol. My life has become unmanageable. I can't stop drinking and I want help”, you have made a good start on Step One and discovered, as it says in the Big Book, “We are unable, at certain times, to bring into our consciousness with sufficient force the memory of the suffering and humiliation of even a week or a month ago. We are without defense against the first drink.”

In Step 4, individuals are asked to be thorough and honest in their personal inventory, writing down anything that comes to mind, and then to explore the effects and particulars of each incident. Self-reflection and introspection into how each event may have impacted family and loved ones as well as individual feelings are delved into during this step. People may wish to start a personal journal. This inventory during Step 4 can take some time to complete. Individuals may therefore spend a lot of time on Step 4, writing, praying, and receiving encouragement from others in their support group.


A lot of people get wrapped up in abusing psychoactive substances that make them feel good.  Physical and psychological dependence ensue.  Both states of withdrawal may ensue.  There are people who just need motivation and life change to get away from their addiction.  There is another class of people who cannot stop.  The 12-steps are being attacked because they can't do anything for you.  You have to use the 12-steps for them to help you.  I have the disease, nothing else could help me. 

Attitudes and social stereotypes can create barriers to the detection and treatment of alcohol abuse. This is more of a barrier for women than men. Fear of stigmatization may lead women to deny that they are suffering from a medical condition, to hide their drinking, and to drink alone. This pattern, in turn, leads family, physicians, and others to be less likely to suspect that a woman they know is an alcoholic.[35] In contrast, reduced fear of stigma may lead men to admit that they are suffering from a medical condition, to display their drinking publicly, and to drink in groups. This pattern, in turn, leads family, physicians, and others to be more likely to suspect that a man they know is an alcoholic.[54]
The immediate physical effects of drinking alcohol range from mild mood changes to complete loss of coordination, vision, balance, and speech -- any of which can be signals of acute alcohol intoxication, or drunkenness. These effects usually wear off in a matter of hours after a person stops drinking. Many law-enforcement agencies regard a .08 percentage of alcohol in the bloodstream as evidence of intoxication. Larger amounts of blood alcohol can impair brain function and eventually cause unconsciousness. An extreme overdose, alcohol poisoning, can be fatal.
Because denial is common, you may not feel like you have a problem with drinking. You might not recognize how much you drink or how many problems in your life are related to alcohol use. Listen to relatives, friends or co-workers when they ask you to examine your drinking habits or to seek help. Consider talking with someone who has had a problem drinking, but has stopped.
Other tests are sometimes used for the detection of alcohol dependence, such as the Alcohol Dependence Data Questionnaire, which is a more sensitive diagnostic test than the CAGE questionnaire. It helps distinguish a diagnosis of alcohol dependence from one of heavy alcohol use.[116] The Michigan Alcohol Screening Test (MAST) is a screening tool for alcoholism widely used by courts to determine the appropriate sentencing for people convicted of alcohol-related offenses,[117] driving under the influence being the most common. The Alcohol Use Disorders Identification Test (AUDIT), a screening questionnaire developed by the World Health Organization, is unique in that it has been validated in six countries and is used internationally. Like the CAGE questionnaire, it uses a simple set of questions – a high score earning a deeper investigation.[118] The Paddington Alcohol Test (PAT) was designed to screen for alcohol-related problems amongst those attending Accident and Emergency departments. It concords well with the AUDIT questionnaire but is administered in a fifth of the time.[119] Certain blood tests may also indicate possible alcoholism.[3]
Functional subtype: Representing about 19 percent of those struggling with AUD in the study, this group is typically middle aged and, on the surface, appears to have their lives together. They have higher income, more education, and stable relationships compared to other adults struggling with AUD. They drink, on average, every other day, and tend to binge drink on those days.
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Topiramate, a derivative of the naturally occurring sugar monosaccharide D-fructose, has been found effective in helping alcoholics quit or cut back on the amount they drink. Evidence suggests that topiramate antagonizes excitatory glutamate receptors, inhibits dopamine release, and enhances inhibitory gamma-aminobutyric acid function. A 2008 review of the effectiveness of topiramate concluded that the results of published trials are promising, however, as of 2008, data was insufficient to support using topiramate in conjunction with brief weekly compliance counseling as a first-line agent for alcohol dependence.[177] A 2010 review found that topiramate may be superior to existing alcohol pharmacotherapeutic options. Topiramate effectively reduces craving and alcohol withdrawal severity as well as improving quality-of-life-ratings.[178]
Jump up ^ Terra, Mauro Barbosa; Barros, Helena Maria Tannhauser; Stein, Airton Tetelbom; Figueira, Ivan; Palermo, Luiz Henrique; Athayde, Luciana Dias; Gonçalves, Marcelo de Souza; Da Silveira, Dartiu Xavier (2008). "Do Alcoholics Anonymous Groups Really Work? Factors of Adherence in a Brazilian Sample of Hospitalized Alcohol Dependents". American Journal on Addictions. 17 (1): 48–53. doi:10.1080/10550490701756393. PMID 18214722.
The illness of the spiritual dimension, or "spiritual malady," is considered in all twelve-step groups to be self-centeredness.[17][18] The process of working the steps is intended to replace self-centeredness with a growing moral consciousness and a willingness for self-sacrifice and unselfish constructive action.[18] In twelve-step groups, this is known as a spiritual awakening not a religious experience.[21] This should not be confused with abreaction, which produces dramatic, but ephemeral, changes.[22] In twelve-step fellowships, "spiritual awakening" is believed to develop, most frequently, slowly over a period of time.[23]
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