Demographic preferences related to the addicts' drug of choice has led to the creation of Cocaine Anonymous, Crystal Meth Anonymous and Marijuana Anonymous. Behavioral issues such as compulsion for, and/or addiction to, gambling, crime, food, sex, hoarding, debting and work are addressed in fellowships such as Gamblers Anonymous, Overeaters Anonymous, Sexaholics Anonymous and Debtors Anonymous.

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.
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.

No laboratory tests exist that can screen for alcoholism with a high level of accuracy. Most alcoholism is diagnosed through patient and family history. However, alcoholism can be difficult to diagnose until late-stage physical symptoms become apparent because alcohol-dependent people often lie or about underestimate their alcohol use. In addition, many physicians do not routinely screen their patients using standardized questionnaires that may reveal alcohol problems.
In most parts of the world, alcohol is legal for adults to both purchase and consume. As a result, beverages that contain alcohol are available almost everywhere, and clearly, many adults partake. Since use is so common, it might seem hard to determine who is drinking alcohol in an appropriate manner and who is drinking in a manner that could lead to alcohol abuse or alcoholism. Experts suggest there are key signs to look for.
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 effects of alcoholism are far reaching. Alcohol affects every body system, causing a wide range of health problems. Problems include poor nutrition, memory disorders, difficulty with balance and walking, liver disease (including cirrhosis and hepatitis), high blood pressure, muscle weakness (including the heart), heart rhythm disturbances, anemia, clotting disorders, decreased immunity to infections, gastrointestinal inflammation and irritation, acute and chronic problems with the pancreas, low blood sugar, high blood fat content, interference with reproductive fertility, increased risk of cancer of the liver, esophagus, and breast, weakened bones, sleep disturbances, anxiety, and depression. About 20% of adults admitted to the hospital (for any reason) are alcohol dependent. Men are more than twice as likely to be alcohol dependent than women, and smokers who are alcohol dependent are much more likely to develop serious or fatal health problems associated with alcoholism.
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.
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]

Recovery is an interesting concept. It implies not only improvement, but potentially remission. The term describes a process as well as a destination. And the underlying premise of recovery is that of hope--hope that a person with a potentially fatal illness can avoid a catastrophic outcome. “Recovery activities” are not professional treatment, but can promote recovery just as professional treatment can. One of the most familiar “recovery activities” engaged in by persons with addiction is participation in the activities of Alcoholics Anonymous (AA).


In a closed AA meeting, the only people who may attend are those who are recovering addicts (or those interested in learning more about overcoming their addiction). Open meetings allow the attendance of friends, spouses and family members. Whether you decide to go to a closed or open meeting depends exclusively on what you’re comfortable with. Some people would rather keep their recovery separate from the rest of their life. Others thrive on the support that loved ones can provide during meetings.
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]
Alcoholism, also known as alcohol use disorder (AUD), is a broad term for any drinking of alcohol that results in mental or physical health problems.[12] The disorder was previously divided into two types: alcohol abuse and alcohol dependence.[1][13] In a medical context, alcoholism is said to exist when two or more of the following conditions are present: a person drinks large amounts over a long time period, has difficulty cutting down, acquiring and drinking alcohol takes up a great deal of time, alcohol is strongly desired, usage results in not fulfilling responsibilities, usage results in social problems, usage results in health problems, usage results in risky situations, withdrawal occurs when stopping, and alcohol tolerance has occurred with use.[1] Risky situations include drinking and driving or having unsafe sex, among other things.[1] Alcohol use can affect all parts of the body, but it particularly affects the brain, heart, liver, pancreas and immune system.[3][4] This can result in mental illness, Wernicke–Korsakoff syndrome, irregular heartbeat, liver cirrhosis and increased cancer risk, among other diseases.[3][4] Drinking during pregnancy can cause damage to the baby resulting in fetal alcohol spectrum disorders.[2] Women are generally more sensitive than men to the harmful physical and mental effects of alcohol.[9]
LifeRing Secular Recovery: For people who would prefer a recovery program without the spiritual aspects of the AA and the 12-Step program, LifeRing is not based on any ideas of a higher power. Instead, they focus on the belief that each person has the power within them to control their alcoholism, having its member visualize themselves as two people: the Addict Self and the Sober Self, and work on weakening the former and strengthening the latter. LifeRing does this by connected Sober Selves through in-person and online group meetings to create a strong network of support without any kind of structured stages, steps, or sponsors. Instead, they emphasize that the best person to design an effective sobriety program is you since you will know what does and doesn’t work for you personally.
Various forms of group therapy or psychotherapy can be used to deal with underlying psychological issues that are related to alcohol addiction, as well as provide relapse prevention skills. The mutual-help group-counseling approach is one of the most common ways of helping alcoholics maintain sobriety.[6] Alcoholics Anonymous was one of the first organizations formed to provide mutual, nonprofessional counseling, and it is still the largest. Others include LifeRing Secular Recovery, SMART Recovery, Women For Sobriety, and Secular Organizations for Sobriety.[127] Rationing and moderation programs such as Moderation Management and DrinkWise do not mandate complete abstinence. While most alcoholics are unable to limit their drinking in this way, some return to moderate drinking. A 2002 US study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) showed that 17.7 percent of individuals diagnosed as alcohol dependent more than one year prior returned to low-risk drinking. This group, however, showed fewer initial symptoms of dependency.[128] A follow-up study, using the same subjects that were judged to be in remission in 2001–2002, examined the rates of return to problem drinking in 2004–2005. The study found abstinence from alcohol was the most stable form of remission for recovering alcoholics.[129] A long-term (60 year) follow-up of two groups of alcoholic men concluded that "return to controlled drinking rarely persisted for much more than a decade without relapse or evolution into abstinence."[130]

A long-term study conducted by the National Institute on Alcohol Abuse and Alcoholism found that, after eight years, people with alcoholism who were part of both inpatient treatment and an AA group had a better chance of staying sober for the first three years of study. By the end of the eight years, those who received both had a much higher rate of abstinence. The researchers at NIAAA concluded that regular attendance at AA meetings had a notable impact on the viability and longevity of recovery.


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. 
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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