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 risk of developing alcoholism has a definite genetic component. Studies have demonstrated that close relatives of people with alcoholism are more likely to become alcoholics themselves. This risk exists even for children adopted away from their biological families at birth and raised in a non-alcoholic adoptive family with no knowledge of their biological family's alcohol use. However, no specific gene for alcoholism has been found, and environmental factors (e.g., stress) and social factors (e.g., peer behavior) are thought to play a role in whether a person becomes alcohol dependent.

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.
Auxiliary groups such as Al-Anon and Nar-Anon, for friends and family members of alcoholics and addicts, respectively, are part of a response to treating addiction as a disease that is enabled by family systems.[4] Adult Children of Alcoholics (ACA or ACOA) addresses the effects of growing up in an alcoholic or otherwise dysfunctional family. Co-Dependents Anonymous (CoDA) addresses compulsions related to relationships, referred to as codependency.
To start with, getting sober and drug-free requires the desire and determination to get clean, and having both of these is crucial. If you’re looking for help for a loved one or a friend, know that they’ll need to be “on board" with the idea of recovery if they are going to have a solid chance of getting clean. If they have not yet recognized their own problem, an addiction intervention may be necessary. During the beginning phases of recovery, an alcohol and drug detox is always necessary to remove any unwanted chemicals from the body, followed by intensive addiction recovery therapy. The latter may take 28-90 days (sometimes more), but completing the program provides all the tools needed to stay substance-free. It is highly beneficial for those leaving rehab to join a recovery support group and even consider spending time in a recovery home.
Recently some researchers have suggested that there are two distinct types of alcoholism. According to these researchers, type 1 alcoholism develops in adulthood, often in the early twenties. It is most often associated with the desire to relieve stress and anxiety and is not associated with any criminal or antisocial behavior. Type 2 alcoholism develops earlier, usually during the teenage years. Drinking is done primarily to get high. Type 2 alcoholism is associated with violence, destructiveness, and other criminal and antisocial behavior. Those who study alcoholism do not universally accept the distinction between these two types of alcoholism. Research continues in this area.

I am appalled that a book written by two extremely disturbed privileged white males who lived in 1930s Jim Crow era America is still the "treatment " standard for addiction. AA has been ruled a religious organization by several federal circuit courts, and it is impossible to work the program without a belief in a God who magically answers prayers for the addict who prays hard enough. It is not possible to turn one's will and life over to the care of Nature, or a Doorknob, or the Group of Drunks. One is guided through the steps by someone who is only qualified by the amount of sober time they claim to have. 12 step groups are especially dangerous for survivors of rape, abuse, and other trauma when they are tasked to examine "their part" in the crimes committed against them, not to mention having to defend themselves against the unethical yet joked about 13th Step.
A chronic, progressive behavioral disorder characterized by a strong urge to consume ethanol and an inability to limit the amount of drinking despite adverse consequences, which may include social or occupational impairment and deterioration of physical health. Both physical dependence (withdrawal symptoms such as nausea, sweating, tremors, and delirium resulting from abstinence) and tolerance (the need to increase alcohol intake to achieve the desired effect) occur.
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.
Humility is the key of Step 7, as individuals are asked to seek God’s will in how their life is to be lived. Humility is defined as the state of being humble or thinking less of oneself than of others. Humility is an important concept in recovery. Meditation is often useful during Step 7 as a method of self-introspection and learning how to apply humility to one’s life. During Step 7, individuals work to remain humble.

 In addition, every federal court in the land that has examined the issue has held that 12-Step programs -- despite their claims to the contrary -- are sufficiently religious that coerced attendance (for example, when a court or probation officer orders mandatory attendance at AA meetings) violates the Establishment Clause of the First Amendment of the U.S. Constitution.  This is explicitly the law in the 2nd, 7th, and 9th federal circuits, as well as the states of New York and Tennessee.

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.

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.
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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.
Alcoholism formerly called alcohol dependence or alcohol addiction, is the more severe end of the alcohol use disorder spectrum. It is a destructive pattern of alcohol use that includes tolerance to or withdrawal from the substance, using more alcohol or using it for longer than planned, and trouble reducing its use or inability to use it in moderation. Other potential symptoms include spending an inordinate amount of time getting, using, or recovering from the use of alcohol, compromised functioning, and/or continuing to use alcohol despite an awareness of the detrimental effects it is having on one's life.

When you opt for the increased success rates common to some of the top residential recovery centers, you give yourself or your loved one the best chance of achieving and maintaining sobriety. However, you'll still need to consider whether to seek addiction treatment locally or take it out-of-state, putting distance between you and any abuse triggers. If you know someone who has gone through an alcoholic recovery program or has received drug treatment, ask them their opinion on the program they attended! For everyone else, calling a toll-free recovery hotline - whether it’s ours or another reputable service's - is an excellent way to start. You can discuss your local drug and alcohol recovery program options and have any questions answered that you might have about substance abuse insurance coverage.
Withdrawal symptoms can range from mild to life threatening. Mild withdrawal symptoms include nausea, achiness, diarrhea, difficulty sleeping, sweatiness, anxiety, and trembling. This phase usually lasts no more than three to five days. More severe effects of withdrawal can include hallucinations in which a patient sees, hears, or feels something that is not actually present, seizures, an unbearable craving for more alcohol, confusion, fever, fast heart rate (tachycardia), high blood pressure (hypertension), and delirium (a fluctuating level of consciousness). Patients at highest risk for the most severe symptoms of withdrawal are those with other medical problems, including malnutrition, liver disease, or Wernicke's syndrome. Severe withdrawal symptoms usually begin about three days after the individual's last drink, and may last a variable number of days.

Chuck Lorre's Mom (2013-), follows dysfunctional daughter/mother duo Christy and Bonnie Plunkett, who are estranged for years while simultaneously struggling with addiction. They attempt to pull their lives and relationships together by trying to stay sober and visiting Alcoholics Anonymous. The show also explores themes of alcoholism, drug addiction and relapse.
Alcoholics Anonymous (AA) is a global organization that was created, and is designed, to help former alcoholics through the process of learning to live their lives without the crutch of alcohol abuse. People who attend AA groups have made the decision to stop drinking and stay sober. Some of them join voluntarily; some attend as a continuation of their therapy; some are required to be there because of a court order. Whatever brings them there, the other members of the group act as a support network, explains the American Journal of Public Health; they share success stories and honest accounts of setbacks, and use this emotional connectedness to inspire and encourage each other to keep going.
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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.
Jump up ^ Littrell, Jill (2014). Understanding and Treating Alcoholism Volume I: An Empirically Based Clinician's Handbook for the Treatment of Alcoholism: Volume Ii: Biological, Psychological, and Social Aspects of Alcohol Consumption and Abuse. Hoboken: Taylor and Francis. p. 55. ISBN 9781317783145. Archived from the original on 20 July 2017. The World Health Organization defines alcoholism as any drinking which results in problems
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.
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.
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.
Nervous system. An estimated 30-40% of all men in their teens and twenties have experienced alcoholic blackout from drinking a large quantity of alcohol. This results in the loss of memory of the time surrounding the episode of drinking. Alcohol also causes sleep disturbances, so sleep quality is diminished. Numbness and tingling (parethesia) may occur in the arms and legs. Wernicke's syndrome and Korsakoff's syndrome, which can occur together or separately, are due to the low thiamine (a B vitamin) levels found in many alcohol-dependent people. Wernicke's syndrome results in disordered eye movements, very poor balance, and difficulty walking. Korsakoff's syndrome affects memory and prevents new learning from taking place.
This is the big one. Many scientific arguments for hereditary alcoholism have been made. In fact, we have an extensive article on the topic, worth the read. While less than 20% of alcohol users actually become alcoholics, there are over 930 genes associated with alcohol use, and there is absolutely a genetic factor in risk for alcoholism. Perhaps the one-fifth of drinkers that do develop a disorder is genetically predisposed somehow. More research must be done to say for sure.
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.
Alcohol, especially when consumed in excess, can affect teens, women, men, and the elderly quite differently. Women and the elderly tend to have higher blood concentrations of alcohol compared to men and younger individuals who drink the same amount. Alcoholic women are more at risk for developing physical health problems like cirrhosis of the liver and heart and nerve damage at a faster rate than alcohol-dependent men. Interestingly, men and women seem to have similar learning and memory problems as the result of excessive alcohol intake, but again, women tend to develop those problems twice as fast as men.
Fact: Alcoholism is NOT defined by what you drink, when you drink it, or even how much you drink. It’s the EFFECTS of your drinking that define a problem. If your drinking is causing problems in your home or work life, you have a drinking problem—whether you drink daily or only on the weekends, down shots of tequila or stick to wine, drink three bottles of beers a day or three bottles of whiskey.
Issues with retention and completion rates. Despite how ingrained the 12-Step program is as the standard for alcoholism recovery, the hard numbers tell a different story. According to several studies, the 12-Step Program has been found to be effective for about 20 percent of those that try it, with the other 80 percent usually stopping after just one month. At any given time, only five percent of those still attending AA has been there for a year.

NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used. To access online sources, copy and paste the URL into your browser.
In professional and research contexts, the term "alcoholism" sometimes encompasses both alcohol abuse and alcohol dependence,[97] and sometimes is considered equivalent to alcohol dependence. Talbot (1989) observes that alcoholism in the classical disease model follows a progressive course: if a person continues to drink, their condition will worsen. This will lead to harmful consequences in their life, physically, mentally, emotionally and socially.[98] Johnson (1980) explores the emotional progression of the addict’s response to alcohol. He looks at this in four phases. The first two are considered "normal" drinking and the last two are viewed as "typical" alcoholic drinking.[98] Johnson's four phases consist of:

The story behind the steps starts in Switzerland, specifically with Carl Jung, the famous psychiatrist and psychologist who is considered the father of analytical psychology. Renowned as he is for his pioneering work in the understanding of the psyche and the self, Jung was also a pantheist; his study of world religions and mythologies was instrumental in his belief that spiritual health was vital to an individual’s wellbeing. This came into play when Jung was confronted with an alcoholic patient, Rowland Hazard III, whose problem was so severe that contemporary methods of treatment proved ineffective. Jung counseled the patient that the last remaining measure to overcome the demon of addiction was to experience a spiritual rebirth.
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