Caucasians have a much lower abstinence rate (11.8%) and much higher tolerance to symptoms (3.4±2.45 drinks) of alcohol than Chinese (33.4% and 2.2±1.78 drinks respectively). Also, the more acculturation there is between cultures, the more influenced the culture is to adopt Caucasians drinking practices.[175] Peyote, a psychoactive agent, has even shown promise in treating alcoholism. Alcohol had actually replaced peyote as Native Americans’ psychoactive agent of choice in rituals when peyote was outlawed.[176]
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Added fat and scar tissue on the liver due to excessive alcohol consumption can lead to all sorts of problems, but most often either cirrhosis or alcohol-induced hepatitis. Liver failure among those who drink heavily for many years is likely. Pancreatitis, or the consistent inflammation of the pancreas, can also cause damage to the body, including high blood sugar leading to diabetes.

WHO's ICD-10	"alcohol harmful use" and "alcohol dependence syndrome"	Definitions are similar to that of the DSM-IV. The World Health Organization uses the term "alcohol dependence syndrome" rather than alcoholism.[24] The concept of "harmful use" (as opposed to "abuse") was introduced in 1992's ICD-10 to minimize underreporting of damage in the absence of dependence.[100] The term "alcoholism" was removed from ICD between ICD-8/ICDA-8 and ICD-9.[103]

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Diabetes: There is a high risk of developing diabetes type 2, and people with diabetes have a high chance of complications if they regularly consume more alcohol than is recommended. Alcohol prevents the release of glucose from the liver, resulting in hypoglycemia. If a person with diabetes is already using insulin to lower their blood sugar levels, hypoglycemia could have serious consequences.
ASAM’s definition of addiction document concludes that “treatment of addition saves lives,” and it points out that “in some cases of addiction, medication management can improve treatment outcomes,” and that “in most cases of addiction, the integration of psychosocial rehabilitation and ongoing care with evidence-based pharmacological therapy provides the best results.” Much of “what’s new” in the professional treatment of addiction in the past two decades has involved new pharmacological therapies that have been brought into the marketplace. But psychosocial interventions, which are “not as new,” are the foundation of the treatment most persons receive when they seek assistance from an addiction treatment professional or agency.

Historically the name "dipsomania" was coined by German physician C. W. Hufeland in 1819 before it was superseded by "alcoholism".[160][161] That term now has a more specific meaning.[162] The term "alcoholism" was first used in 1849 by the Swedish physician Magnus Huss to describe the systematic adverse effects of alcohol.[163] Alcohol has a long history of use and misuse throughout recorded history. Biblical, Egyptian and Babylonian sources record the history of abuse and dependence on alcohol. In some ancient cultures alcohol was worshiped and in others, its abuse was condemned. Excessive alcohol misuse and drunkenness were recognized as causing social problems even thousands of years ago. However, the defining of habitual drunkenness as it was then known as and its adverse consequences were not well established medically until the 18th century. In 1647 a Greek monk named Agapios was the first to document that chronic alcohol misuse was associated with toxicity to the nervous system and body which resulted in a range of medical disorders such as seizures, paralysis, and internal bleeding. In 1920 the effects of alcohol abuse and chronic drunkenness led to the failed prohibition of alcohol in the United States, a nationwide constitutional ban on the production, importation, transportation, and sale of alcoholic beverages that remained in place until 1933. In 2005 alcohol dependence and abuse was estimated to cost the US economy approximately 220 billion dollars per year, more than cancer and obesity.[164]
Another important point about 12 Step programs is their cost and accessibility.  What other chronic lifelong disease has an equally accessible and cost effective (free) intervention?    Like any disease, part of our job as physicians is to recommend effective treatment which our patients can both access and afford.  I'd like for my patients to be able to access and afford all useful modalities of addiction treatment, but here at least is one they can all use.   
12-Step has also been criticized for putting vulnerable folks new to recovery into the hands of untrained "sponsors" who often give unsound advice and make unduly onerous demands.  Meetings have also recently been criticized for sometimes being unsafe; with no organizational supervision (every meeting is "autonomous"), there have been numerous reports in the news of sexual harassment, and even assault, occurring in the program.
Alcoholics Anonymous (AA) is an international mutual aid fellowship[1] whose stated purpose is to enable its members to "stay sober and help other alcoholics achieve sobriety."[1][2][3] It was founded in 1935 by Bill Wilson and Bob Smith in Akron, Ohio. With other early members, Bill Wilson and Bob Smith developed AA's Twelve Step program of spiritual and character development. AA's initial Twelve Traditions were introduced in 1946 to help the fellowship be stable and unified while disengaged from "outside issues" and influences.
At least two thirds of all alcohol consumed by Australians is consumed at levels which present either long or short term health risks. Some 10% of Australian men and women consume more than the average number of drinks recommended in the Australian guidelines. While a smaller proportion of Indigenous Australians drink than non-Indigenous Australians, a higher proportion of Indigenous Australians (20%) exceed the recommended average daily drinking limits than non-Indigenous Australians.
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]
Thank you. Twelve Steps and AA culture is a great bridge to extended self help. It works great when most of those working together come from diverse backgrounds. In my humble opinion, it gets difficult when the professional treatment world extends so deep into self help that they begin to set the standards for CBT in terms of acceptable attitudes. I am disheartened by the almost organized labor or mob influence on the traditional meetings.
Thank you for letting Los Angles Central Office serve and support you. LACO maintains this website and publishes both the online and print meeting directories, and it is the information hub for AA in the Los Angeles area. At Central Office volunteers are of service 365 days a year answering the phones and sharing experience, strength and hope. Let us know how we can help your group carry the message.
Ascites, the accumulation of fluid in the abdominal cavity is most commonly caused by cirrhosis of the liver. Some of the other causes of ascites include portal hypertension, congestive heart failure, blood clots, and pancreatitis. The most common symptoms include increased abdominal girth and size, abdominal bloating, and abdominal pain. Treatment depends on the cause of ascites.
Jump up ^ Morse, RM; Flavin, DK (August 1992). "The definition of alcoholism. The Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine to Study the Definition and Criteria for the Diagnosis of Alcoholism". JAMA: The Journal of the American Medical Association. 268 (8): 1012–4. doi:10.1001/jama.1992.03490080086030. ISSN 0098-7484. PMID 1501306.
Jump up ^ Agrawal, A; Sartor, CE; Lynskey, MT; Grant, JD; Pergadia, ML; Grucza, R; Bucholz, KK; Nelson, EC; Madden, PA; Martin, NG; Heath, AC (2009). "Evidence for an Interaction Between Age at 1st Drink and Genetic Influences on DSM-IV Alcohol Dependence Symptoms". Alcoholism: Clinical and Experimental Research. 33 (12): 2047–56. doi:10.1111/j.1530-0277.2009.01044.x. PMC 2883563. PMID 19764935.
Narcotics Anonymous (NA). Narcotics Anonymous is an organization that adapted the same principles as Alcoholics Anonymous. Just like AA, NA emphasizes a spiritual connection to a higher power. The program is targeted towards men and women for whom drugs have become a major problem. These people come together regularly in support group meetings and help one another to maintain abstinence as they recover from their addictions.
Using “I” statements reduces accusation and lets you be an active participant in the discussion. It may be helpful to bring up a specific concern. You may mention when alcohol caused an unwanted effect, such as violent behavior or economic problems. Rather than saying, “You’re an alcoholic — you need to get help now,” you can say, “I love you and you’re very important to me. I’m concerned about how much you’re drinking, and it may be harming your health.”
Monitor your teen’s activity: Know where your teen goes and who they hang out with. Remove or lock away alcohol from your home and routinely check potential hiding places for alcohol—in backpacks, under the bed, between clothes in a drawer, for example. Explain to your teen that this lack of privacy is a consequence of having been caught using alcohol.
Alcohol Use Disorder is a pattern of disordered drinking that can involve interference in daily tasks, withdrawal symptoms, discord in relationships, and risky decisions that place oneself or others in harm's way. More than 15 million American adults struggle with this condition, according to the National Institute on Alcohol Abuse and Alcoholism. Like all addictions, alcohol use disorder is inextricably linked to a complex matrix of biological, social, and psychological factors. Research highlights a genetic component to the disease, as about half of one's predisposition to alcoholism can be attributed to his or her genetic makeup. As a psychological malady, people may turn to alcohol to cope with trauma or other co-occurring mental disorders. Socially, alcoholism may be tied to familial dysfunction or a culture embedded with binge drinking. The brain's reward pathways also play an essential role: Alcohol consumption is associated with increased dopamine activity, which corresponds with pleasure, craving, and habit formation.

"We will comprehend the word serenity and we will know peace." (Alcoholics Anonymous, p. 84)          Just For Today          Life takes on new meaning in A.A. To watch people recover, to see them help others, to watch loneliness vanish, to see a fellowship grow up about you, to have a host of friends - this is an experience not to be missed. (from the 12&12 and Alcoholics Anonymous)          
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AA is a spiritual organization that calls for people to believe in a higher power and to accept God as they understand him to be. God, or a higher power, can come in many forms and does not have to be taken in the traditional sense. What Step 2 calls for is faith that a higher power exists and that this power is necessary to restore sanity. For those who don’t believe in God per se, this higher power can represent any number of other things, like the stark reality that recreational drug use is unrealistic.

Prevention must begin at a young age since the first instance of intoxication usually occurs during the teenage years. It is particularly important that teenagers who are at high risk for alcoholism-those with a family history of alcoholism, early or frequent use of alcohol, a tendency to drink to drunkenness, alcohol use that interferes with school work, a poor family environment, or a history of domestic violence -receive education about alcohol and its long-term effects. How this is best achieved, without alienating these young people and thus losing their attention, is the subject of continuing debate and study.
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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