AddictionCenter.com is a referral service that provides information about addiction treatment practitioners and facilities. AddictionCenter.com is not a medical provider or treatment facility and does not provide medical advice. AddictionCenter.com does not endorse any treatment facility or guarantee the quality of care provided, or the results to be achieved, by any treatment facility. The information provided by AddictionCenter.com is not a substitute for professional treatment advice.

With a U.S. economy inching laboriously back from recession with a flagging job market in tow, we should be sensitive to hidden costs of this “lifestyle choice.” In a perfect world, we would weigh the right to drink excessively against the $94.2 billion in tax dollars that we spend every year to pay the costs of alcoholism. We should weigh the collective choice against the 1.9 million public school teachers we could hire with that $94.2 billion — or the million public parks that money could build for communities across the country, or the million students we could put through school. And we’d think hard about what cultural shift could moderate this “lifestyle choice” before it becomes disease.


The Twelve Traditions encourage members to practice the spiritual principle of anonymity in the public media and members are also asked to respect each other's confidentiality.[39] This is a group norm,[39] however, and not legally mandated; there are no legal consequences to discourage those attending twelve-step groups from revealing information disclosed during meetings.[40] Statutes on group therapy do not encompass those associations that lack a professional therapist or clergyman to whom confidentiality and privilege might apply. Professionals and paraprofessionals who refer patients to these groups, to avoid both civil liability and licensure problems, have been advised that they should alert their patients that, at any time, their statements made in meetings may be disclosed.[40]
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.

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The term is also used by outlets like Salon and New York Magazine, which suggest that the time has come for Alcoholics Anonymous to be decoupled from mainstream alcoholism recovery. The point is made by Mia Szalavitz, a recovering addict and now an addiction researcher and author, who wrote a book about how developments in neuroscience and psychology might render AA obsolete. Szalavitz takes issue with the AA concept of “hitting rock bottom,” the moment when a person experiences a personal loss (e.g., a DUI, eviction, divorce, firing, etc.) as a sign that the addiction has become too damaging to ignore. This expectation, writes Szalavitz, is “harsh and humiliating,” in the sense that help is withheld until the person crosses a tragic Rubicon. But so deeply does it run in the DNA of Alcoholics Anonymous that it has influenced how any 12-Step methodology treats addiction therapy. This, says Szalavitz, has made the treatment community on the whole “embrace a totally false, harmful view of what addiction is.”

Non-12-step support groups provide a secular alternative to the 12-step programs and may be more comfortable for those not wanting to place such an emphasis on a higher power for recovery. Non-12-step groups sometimes involve fewer group sharing scenarios—which can provide some relief for those individuals who aren't as comfortable sharing sensitive personal information in group settings. Below are a few examples of non-12-step programs:


When alcoholism affects a spouse or partner, it’s possible to become too wrapped up in their well-being. This is called codependency. You may get to the point where you feel compelled to help your person get well. However, family members and friends often have deep emotional ties that prevent them from having the objective viewpoint necessary for treatment.
Thank you dr Miller, very important part of recovery of addiction and important tool for our patients that should not be "a dying art". I have heard international lecturer and professional in addiction treatment, state that "Minnesota Model" is one treatment that has been shown ineffective (evidence based medicine... Many correlate that with Twelve step facilitation. Can you help with references to support or counteract that?
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.
During alcoholism treatment, therapy teams provide lessons on relapse prevention. These lessons are designed to help people spot the people, places, and things that can drive them to return to drinking. With the help of these lessons, people can learn to both avoid and/or handle their triggers so they won’t pick up an alcoholic beverage when they’re under stress.

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.
Elderly people who drink excessively are at risk for having more serious illnesses, doctor visits, and symptoms of depression, with less life satisfaction and smaller social support networks compared to senior citizens who have never consumed alcohol. While binge drinking is often thought to be a symptom of young people, an often unknown fact is that a significant percentage of middle-aged and elderly individuals also engage in binge drinking. This behavior increases the risk for driving drunk, no matter what the age. That, in turn, puts the individual at risk for being arrested for driving under the influence (DUI) of alcohol.
Excessive alcohol consumption is correlated with increased risk of stroke, liver disease, and decreased life expectancy. In fact, binge drinking during only the weekends is still enough to damage the liver, studies show, and moderate drinking interferes with sleep quality by interrupting circadian rhythms and REM sleep. However, a number of different treatment options are available to address alcoholic dysfunction.
At Origins, our goal is seamlessly integrate cutting-edge, evidence-based medical and clinical services within the timeless 12-Step model. We understand that quality treatment addresses all aspects of the person, including the spiritual components of wellness. The 12-Steps are a spiritual program of action that can change our perceptions, and bring new purpose into our lives. By connecting with a deeper sense of meaning, those of us in recovery are able to positively impact the lives of those around us.
Prioritizing coping over healing. While AA obviously wants its members to avoid relapse and maintain sobriety, the means of doing so is heavily focused on using skills to cope with addictive behaviors rather than addressing the underlying issues that are causing them. Because of this, many people find the 12-Step program might help them stay sober, but leave them still struggling with the problems that led to becoming alcoholics in the first place.
In 1939, Alcoholics Anonymous published its original 12-step method of recovery from alcoholism in the book Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism. Many programs have started as offshoots of the original Alcoholics Anonymous program. Likewise, these problems include drug addiction, compulsion, and depression.
Denial is one of the biggest obstacles to getting help for alcohol abuse and alcoholism. The desire to drink is so strong that the mind finds many ways to rationalize drinking, even when the consequences are obvious. By keeping you from looking honestly at your behavior and its negative effects, denial also exacerbates alcohol-related problems with work, finances, and relationships.
The 12-Step philosophy pioneered by Alcoholics Anonymous is used by about 74 percent of treatment centers. The basic premise of this model is that people can help one another achieve and maintain abstinence from substances of abuse, but that healing cannot come about unless people with addictions surrender to a higher power. The 12-Step movement can be a force for good for many people, but some struggle with what they interpret as a strong religious element of the program. Many addiction treatment programs offer alternatives to 12-Step methodology for those who prefer a more secular foundation for treatment.
GENERAL DISCLAIMER: Rehabs.com is designed for educational purposes only and is not engaged in rendering medical advice. The information provided through Rehabs.com should not be used for diagnosing or treating a health problem or disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, you should consult your health care provider. The authors, editors, producers, and contributors shall have no liability, obligation, or responsibility to any person or entity for any loss, damage, or adverse consequences alleged to have happened directly or indirectly as a consequence of material on this website. If you believe you have a medical emergency, you should immediately call 911.
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.
Given the malnutrition that many alcoholics suffer from, gradual correction of that condition is also important, both to prevent or correct the consequences of malnutrition (like low thiamine level) and to prevent the potential results of correcting nutrition problems too rapidly. One example of the latter is that people with chronic alcohol-induced low sodium levels in the bloodstream (hyponatremia) are at risk for severe neurological problems due to a loss of the outer, insulating covering of nerve cells in parts of the brain (central pontine myelinolysis) if low sodium levels are corrected too rapidly.

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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]
The program’s emphasis on negative feelings of powerlessness and guilt. Continuing in that train of thought, while the idea behind the 12 Steps may have been revolutionary at the time, for many they can feel outdated and even counterproductive. The 12-Step program demands that those in it break themselves down to be built back up, focusing on the notion that you are incapable of taking responsibility not just for your alcoholism but for yourself as well, that there is something wrong with you, and instilling what can feel more like shame than motivation.

When a health care professional is caught or suspected of diversion, the nursing board, board of pharmacy, attorney general, or another regulatory agency may require admission into IPRP. This may also result in local, State or Federal investigations and charges. IPRP is required to be transparent with all participating agencies if admission is mandated, thus potentially having a much greater negative effect on the professional's career. 
Moderate alcohol consumption appears to increase the risk of breast cancer in women. Total mortality is reduced with moderate alcohol consumption but not with heavy alcohol consumption; the cardiovascular benefit is offset by cirrhosis, cancer, and injuries. The amount of alcohol associated with the lowest mortality appears to be 2 drinks per day in men and 1 drink or fewer per day in women. Moderate alcohol consumption reduces the risk of developing diabetes, but heavy alcohol consumption may increase the risk. The cardiovascular benefit becomes important in men older than 40 years and in women older than 50 years. The risk of hypertension is increased with 3 or more drinks daily.

There are no dues or fees for members of AA. Prohibitive cost can be a major hurdle when it comes to sticking with a treatment program. Even if it’s working, someone might drop out if it becomes too expensive for them to stay with it. While a group might do a collection to cover expenses like rent or refreshments, there is no mandatory cost required to join AA.
Drinking enough to cause a blood alcohol concentration (BAC) of 0.03–0.12% typically causes an overall improvement in mood and possible euphoria (a "happy" feeling), increased self-confidence and sociability, decreased anxiety, a flushed, red appearance in the face and impaired judgment and fine muscle coordination. A BAC of 0.09% to 0.25% causes lethargy, sedation, balance problems and blurred vision. A BAC of 0.18% to 0.30% causes profound confusion, impaired speech (e.g. slurred speech), staggering, dizziness and vomiting. A BAC from 0.25% to 0.40% causes stupor, unconsciousness, anterograde amnesia, vomiting (death may occur due to inhalation of vomit (pulmonary aspiration) while unconscious) and respiratory depression (potentially life-threatening). A BAC from 0.35% to 0.80% causes a coma (unconsciousness), life-threatening respiratory depression and possibly fatal alcohol poisoning. With all alcoholic beverages, drinking while driving, operating an aircraft or heavy machinery increases the risk of an accident; many countries have penalties for drunk driving.

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Statistics (US) Alcohol causes half a million hospital admissions/year, 17,000 psychiatric admissions, 80% of all fire-related deaths, 65% of serious head injuries, 50% of homicides, 40% of RTAs/MVAs, 33% of divorces, 33% child abuse cases, 30% of fatal accidents, 30% of domestic accidents, 8 million working days lost, £1.6 billion annual cost to society.

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alcohol dependence = alcohol abuse combined with tolerance, withdrawal, and an uncontrollable drive to drink.[99] The term "alcoholism" was split into "alcohol abuse" and "alcohol dependence" in 1980's DSM-III, and in 1987's DSM-III-R behavioral symptoms were moved from "abuse" to "dependence".[100] It has been suggested that DSM-V merge alcohol abuse and alcohol dependence into a single new entry,[101] named "alcohol-use disorder".[102]

When a service is offered (especially in a crisis), that service is expected to work.  In the case of the addict, simply providing 'treatment' cannot be viewed the same way as other services.  Substance abuse detox that transitions to the 12-step program requires a level of immersion on the end of the user.  I used to HATE hearing 'It works if you work it'.  But... it's true.
In 1955, Wilson acknowledged AA's debt, saying "The Oxford Groupers had clearly shown us what to do. And just as importantly, we learned from them what not to do." Among the Oxford Group practices that AA retained were informal gatherings, a "changed-life" developed through "stages", and working with others for no material gain, AA's analogs for these are meetings, "the steps", and sponsorship. AA's tradition of anonymity was a reaction to the publicity-seeking practices of the Oxford Group, as well as AA's wish to not promote, Wilson said, "erratic public characters who through broken anonymity might get drunk and destroy confidence in us."[20]

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.
There are many kinds of counseling and psychotherapy that can be helpful for the person with addiction, beyond non-specific “supportive psychotherapy” that can be offered in any setting, along with medication management or apart from such an approach. Cognitive Behavioral Therapy is arguably the most widespread ‘evidence based practice’ offered to persons with addiction. This approach challenges irrational thoughts, understands automatic thoughts and thought chains, understands the thoughts and feelings that can lead to relapse behaviors and seeks to minimize relapse by specifying unhealthy cognitions and providing practice in decoupling an unhealthy thought (“stinking thinking,” as some people say) from an unhealthy action. Dialectical Behavioral Therapy and Mindfulness Meditation are two approaches that have enjoyed increased popularity in addiction treatment in this century.
Our program focuses on the whole child, with the ultimate goals of abstinence, improved mental health and better family relationships. Our intensive outpatient program (IOP) is the only one in North Texas that offers this level of care specifically for teens. We incorporate medication management, cognitive behavioral therapy, motivational enhancement therapy, group and individual therapy, and family engagement to help your child gain valuable coping skills to end drug abuse, as well as manage emotional or psychological problems.
I'm sober since 1999, with AA and by the grace of my Higher Power. No religion for me. Meetings, sponsor, litterature and 12 steps every day if possible. I live a wonderful life, quiet and stable. My only enemy is my ego. He often try to bring me back to the "Old Me"... but AA, my sponsor, my sponsees and other members are always there to help me. And I'm there for them.

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More than a quarter (27%) of all 15- to 19-year-olds worldwide consume alcohol. Rates are highest in Europe (44%), followed by the Americas (38%) and the Western Pacific (38%). Total alcohol consumption per capita among those older than 15 years around the world rose from 5.5 liters of pure alcohol in 2005 to 6.4 liters in 2010 and remained at that level in 2016. [1, 2]
GENERAL DISCLAIMER: Rehabs.com is designed for educational purposes only and is not engaged in rendering medical advice. The information provided through Rehabs.com should not be used for diagnosing or treating a health problem or disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, you should consult your health care provider. The authors, editors, producers, and contributors shall have no liability, obligation, or responsibility to any person or entity for any loss, damage, or adverse consequences alleged to have happened directly or indirectly as a consequence of material on this website. If you believe you have a medical emergency, you should immediately call 911.
Chemically, alcohol tends to decrease the chemical activity of substances that affect the nervous system, to inhibit behavior (gamma aminobutyric acid, also called GABA signaling) and increase the activity of pleasure-seeking processes (glutamate). That can result in people being less inhibited in their words and actions and more likely to engage in immediately pleasurable activities even if they are unsafe. Even light drinkers can experience shrinking of parts of the brain. Intoxication with alcohol can be characterized by slurred speech, clumsiness, sleepiness, headaches, distorted senses, lapses in memory, nausea, vomiting, and loss of consciousness.
Many start their addiction recovery process with a period of detoxification (detox), where the body rids itself of the toxic influence of drugs and/or alcohol. Detox allows the body to restore itself to a stable starting point from which substance abuse treatment efforts may more effectively begin. While detox programs vary, medical detox programs may utilize certain medications to manage withdrawal, when applicable, and otherwise facilitate this early recovery step.1
To be diagnosed with AUD, individuals must meet certain criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Under DSM–5, the current version of the DSM, anyone meeting any two of the 11 criteria during the same 12-month period receives a diagnosis of AUD. The severity of AUD—mild, moderate, or severe—is based on the number of criteria met.

Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism. The only requirement for membership is a desire to stop drinking. There are no dues or fees for AA membership; we are self-supporting through our own contributions. AA is not allied with any sect, denomination, organization or institution; does not wish to engage in any controversy, neither endorses nor opposes any causes. Our primary purpose is to stay sober and help other alcoholics to achieve sobriety.
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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]


There are no dues or fees for members of AA. Prohibitive cost can be a major hurdle when it comes to sticking with a treatment program. Even if it’s working, someone might drop out if it becomes too expensive for them to stay with it. While a group might do a collection to cover expenses like rent or refreshments, there is no mandatory cost required to join AA.
Sessions led by peers, in which recovering alcoholics meet regularly and provide support for each other's recoveries, are considered among the best methods of preventing a return to drinking. The best-known group following this model is Alcoholics Anonymous (AA), which uses a 12-step program and a buddy (sponsor) system to help people avoid drinking. The AA steps involve recognizing the destructive power that alcohol has held over the individual's life, looking to a higher power for help in overcoming the problem, reflecting on the ways in which the use of alcohol has hurt others and, if possible, making amends to those people. According to the American Psychological Association (APA), anyone, regardless of his or her religious beliefs or lack of religious beliefs, can benefit from participation in 12-step programs such as AA. The number of visits to 12-step self-help groups exceeds the number of visits to all mental health professionals combined.
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Alcoholism is the most severe form of alcohol abuse and involves the inability to manage drinking habits. It is also commonly referred to as alcohol use disorder. Alcohol use disorder is organized into three categories: mild, moderate and severe. Each category has various symptoms and can cause harmful side effects. If left untreated, any type of alcohol abuse can spiral out of control.

Following detoxification, social support to abstain from or moderate drinking is needed for an extended period of time. It is useful for individuals who are recovering from alcohol dependence to identify people who can support them through the process, as it can still be very difficult not to drink alcohol, or to drink in moderation following detoxification. People who have difficulty may wish to investigate whether there is medication which can help them stay away from alcohol. There are range of prescription medicines which might assist some people. Talk to a doctor before taking any medication.
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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":
Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism. The only requirement for membership is a desire to stop drinking. There are no dues or fees for AA membership; we are self-supporting through our own contributions. AA is not allied with any sect, denomination, politics, organization or institution; does not wish to engage in any controversy, neither endorses nor opposes any causes. Our primary purpose is to stay sober and help other alcoholics to achieve sobriety.
Problem drinking in women is much less common than it is in men, and the typical onset of problem drinking in females occurs later than in males. However, progression is more rapid, and females usually enter treatment earlier than males. Women more commonly combine alcohol with prescription drugs of abuse than do males. Women living with substance-abusing men are at high risk.
Following detoxification, social support to abstain from or moderate drinking is needed for an extended period of time. It is useful for individuals who are recovering from alcohol dependence to identify people who can support them through the process, as it can still be very difficult not to drink alcohol, or to drink in moderation following detoxification. People who have difficulty may wish to investigate whether there is medication which can help them stay away from alcohol. There are range of prescription medicines which might assist some people. Talk to a doctor before taking any medication.
Many start their addiction recovery process with a period of detoxification (detox), where the body rids itself of the toxic influence of drugs and/or alcohol. Detox allows the body to restore itself to a stable starting point from which substance abuse treatment efforts may more effectively begin. While detox programs vary, medical detox programs may utilize certain medications to manage withdrawal, when applicable, and otherwise facilitate this early recovery step.1
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A twelve-step program is a set of guiding principles outlining a course of action for recovery from addiction, compulsion, or other behavioral problems. Originally proposed by Alcoholics Anonymous (AA) as a method of recovery from alcoholism,[1] the Twelve Steps were first published in the 1939 book Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism.[2] The method was adapted and became the foundation of other twelve-step programs.
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