According to information derived from the United States National Longitudinal Alcohol Epidemiologic Study released in 2006, about 8% of American adults are dependent on alcohol (estimates range from 5-10%). About 34% of adult Americans do not use alcohol at all. Another 44% are occasional or non-dependent users. Alcohol is the third leading cause of preventable death in the United States (smoking and obesity rank first and second) and is responsible for about 85,000 deaths annually, about half from injury and half from disease. Alcoholism is involved in about 30% of homicides and 22% of suicides. It is the cause of about 20% of fatal motor vehicle accidents and is a contributing factor in between one-third and one-half of all vehicular accidents. Alcoholism costs the United States about $185 billion annually in costs related to violence, traffic accidents, lost work productivity, and direct medical expenses. The National Institute on Alcohol Abuse and Alcoholism estimates that at least 6.6 million children under age 18 live in households with at least one alcoholic parent and that before age 18 about 25% of children are exposed to family alcohol dependency or alcohol abuse.
Treatment of alcoholism often is a combination of inpatient and outpatient therapy depending on the individual's alcohol history and physical condition. The person with alcoholism often resists the idea that he or she has an alcohol problem and needs to stop drinking. Treatment cannot be forced on adults unless it is a condition imposed by a court of law. However, if the person is a danger to him- or herself or to others, immediate hospitalization may be possible without the individual's consent.
Another variation comes from the fact that some people are uncomfortable with the specific, religious aspects of the 12-Step program. As stated above, and as evident by the steps themselves, the 12-Step model originated from a Christian point of view. Those who are not Christian have modified the steps to refer to their specific religious or spiritual practice as a way to connect more with the structure of the 12-Step program. In addition, a number of non-religious 12-Step groups have modified the steps to fit a secular model that can help those who are agnostic or atheist practice the program without feeling forced to adhere to a religion they don’t believe in.
Is Twelve-Step Recovery an antiquated concept or intervention? Many addiction specialist physicians contend that while the majority of continuing medical education in addiction, aimed at sharing novel breakthroughs and improving practice and outcomes, addresses pharmacotherapies, it is the psychosocial therapies which warrant at least equal attention. Some addiction medicine physicians are concerned that not only do biological interventions predominate in continuing education curriculums, but they dominate graduate medical education in addiction, and some of these physicians are concerned that fellowship training programs in addiction as well as residency programs in primary care, psychiatry, and other medical specialties should include training about and in Twelve Step Facilitation and on Twelve-Step Recovery in order for the physician to have an appropriately well-rounded educational experience and a full skill and knowledge base in the rapidly-growing specialty of addiction medicine.
For people in the first stage of alcohol use (having access but not having yet used alcohol), preventive measures are used. Therefore, limiting access to alcohol or other drugs, addressing any risk factors of the alcohol consumer or family, as well as optimal parental supervision for youth and expression regarding expectations are often recommended. The approach to those who have experimented with alcohol should not be minimized by mental health professionals, since infrequent use can progress to the more serious stages of alcohol use if not addressed. Therefore, professionals recommend that the alcohol-consuming individual be thoroughly educated about the effects and risks of alcohol, that fair but firm limits be set on the use of alcohol, and that the user be referred for brief counseling, a self-help group, and/or family support group. People who have progressed to the more advanced stages of alcoholism are typically treated intensively, using a combination of the medical, individual, and familial interventions already described.
Support groups provide people with understanding peers and ongoing support, in church basements, community centers, and public facilities scattered all across the country. Here, people can come together to discuss addiction’s difficulties, and they can meet with other addicted people to gain support and insight. Alumni groups are similar, in that they link peers together to discuss addiction, but these groups contain people who all worked within the same facility for help.
During addiction recovery, individuals in treatment may also undergo various types of therapy and participate in support groups as they work to address and heal the attitudes, thoughts, emotions and behaviors that led to substance abuse in the first place. Ongoing participation in therapy and support groups may continue long after the initial period of treatment as they may continue to provide lasting recovery benefit for many individuals.
A complex mixture of genetic and environmental factors influences the risk of the development of alcoholism. Genes that influence the metabolism of alcohol also influence the risk of alcoholism, and may be indicated by a family history of alcoholism. One paper has found that alcohol use at an early age may influence the expression of genes which increase the risk of alcohol dependence. Individuals who have a genetic disposition to alcoholism are also more likely to begin drinking at an earlier age than average. Also, a younger age of onset of drinking is associated with an increased risk of the development of alcoholism, and about 40 percent of alcoholics will drink excessively by their late adolescence. It is not entirely clear whether this association is causal, and some researchers have been known to disagree with this view.
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.
Among older patients with alcoholism, from one third to one half develop alcoholism after age 60 years. This group is harder to recognize. A population-based study found that problem drinking (>3 drinks/d) was observed in 9% of older men and in 2% of older women. Alcohol levels are higher in elderly patients for a given amount of alcohol consumed than in younger patients.
This may be due to the fact that the data stored on the device has been corrupted, either a segment of the binary data is gone or the data has been overwritten by another file. Most file recovery software will find the remnants of theses corrupted files. However, because they are incomplete it is very unlikely the file will open. When it comes to the Seagate file recovery suite, there are some cases where a file was found by the software and is labeled as “Good” integrity, but may be a corrupt file.
More informally than not, AA's membership has helped popularize the disease concept of alcoholism, though AA officially has had no part in the development of such postulates which had appeared as early as the late eighteenth century. Though AA initially avoided the term "disease", in 1973 conference-approved literature categorically stated that "we had the disease of alcoholism."[better source needed] Regardless of official positions, from AA's inception most members have believed alcoholism to be a disease.
While Wilson and Smith credited their sobriety to working with alcoholics under the auspices of the Oxford Group, a Group associate pastor sermonized against Wilson and his alcoholic Groupers for forming a "secret, ashamed sub-group" engaged in "divergent works". By 1937, Wilson separated from the Oxford Group. AA Historian Ernest Kurtz described the split:
There are numerous individual psychotherapeutic treatments for alcohol addiction. Relapse prevention uses methods for recognizing and amending problem behaviors. Individualized drug counseling specifically emphasizes short-term behavioral goals in an attempt to help the individual reduce or stop the use of alcohol altogether. Cognitive-behavioral therapy techniques, like helping the individual with alcohol use disorder recognize what tends to precede and follow their episodes of alcohol use, are often used to address alcohol abuse. Some treatment programs include drug testing. Twelve-step recovery programs like Alcoholics Anonymous are individualized drug-counseling methods. Motivational enhancement therapy encourages the person suffering from alcohol use disorder to increase their desire to participate in therapy. Stimulus control refers to an intervention that teaches the alcohol-use disordered person to stay away from situations that are associated with alcohol use and to replace those situations with activities that are alcohol-free and otherwise contrary to using alcohol. Urge control is an approach to changing patterns that lead to drug or alcohol use.
The personal nature of the behavioral issues that lead to seeking help in twelve-step fellowships results in a strong relationship between sponsee and sponsor. As the relationship is based on spiritual principles, it is unique and not generally characterized as "friendship". Fundamentally, the sponsor has the single purpose of helping the sponsee recover from the behavioral problem that brought the sufferer into twelve-step work, which reflexively helps the sponsor recover.
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.
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. 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.
Sponsors and sponsees participate in activities that lead to spiritual growth. Experiences in the program are often shared by outgoing members with incoming members. This rotation of experience is often considered to have a great spiritual reward. These may include practices such as literature discussion and study, meditation, and writing. Completing the program usually implies competency to guide newcomers which is often encouraged. Sponsees typically do their Fifth Step, review their moral inventory written as part of the Fourth Step, with their sponsor. The Fifth Step, as well as the Ninth Step, have been compared to confession and penitence. Michel Foucault, a French philosopher, noted such practices produce intrinsic modifications in the person—exonerating, redeeming and purifying them; relieves them of their burden of wrong, liberating them and promising salvation.