Alcohol use disorder is a potentially fatal disease, characterized by cravings, tolerance (needing more), physical dependence, and loss of control over consuming alcohol.  Alcohol intoxication may or may not be obvious to observers. Even in highly functional alcoholics, chronic alcoholism can lead to physical problems. Most common is damage to your liver, which over time can lead to cirrhosis (scarred liver). Other risks include depression, stomach bleeds, pancreatitis, high blood pressure, heart failure, numbness and tingling in your feet and changes in your brain. Alcoholism can also increase your risk for infections including pneumonia, tuberculosis, and chronic gastritis.
When a person struggling with problem drinking or alcohol dependence decides to get help, it is important for them to consult with a doctor regarding how serious their physical condition may be. Gauging the severity of withdrawal symptoms is important, as quitting alcohol suddenly can lead to seizures, which may be deadly. Racing heart rate, high blood pressure, insomnia, vomiting and related dehydration, and fever can also be dangerous alcohol withdrawal symptoms.
Severe acute withdrawal symptoms such as delirium tremens and seizures rarely occur after 1-week post cessation of alcohol. The acute withdrawal phase can be defined as lasting between one and three weeks. In the period of 3–6 weeks following cessation increased anxiety, depression, as well as sleep disturbance, is common;[65] fatigue and tension can persist for up to 5 weeks as part of the post-acute withdrawal syndrome; about a quarter of alcoholics experience anxiety and depression for up to 2 years. These post-acute withdrawal symptoms have also been demonstrated in animal models of alcohol dependence and withdrawal.[66] A kindling effect also occurs in alcoholics whereby each subsequent withdrawal syndrome is more severe than the previous withdrawal episode; this is due to neuroadaptations which occur as a result of periods of abstinence followed by re-exposure to alcohol. Individuals who have had multiple withdrawal episodes are more likely to develop seizures and experience more severe anxiety during withdrawal from alcohol than alcohol-dependent individuals without a history of past alcohol withdrawal episodes. The kindling effect leads to persistent functional changes in brain neural circuits as well as to gene expression.[67] Kindling also results in the intensification of psychological symptoms of alcohol withdrawal.[65] There are decision tools and questionnaires which help guide physicians in evaluating alcohol withdrawal. For example, the CIWA-Ar objectifies alcohol withdrawal symptoms in order to guide therapy decisions which allows for an efficient interview while at the same time retaining clinical usefulness, validity, and reliability, ensuring proper care for withdrawal patients, who can be in danger of death.[68]
If you are still having issues with activation after trying the above mentioned items, please click on the “Gear” icon located on the lower left of the SRS window when it first opens. Next, click on “About” and then click on the check box to “Enable Log For Debugging”. This will turn on the logging feature for Customer Support to be able to further help you solve your issue. Once you have enabled logging, try to activate your license again, then call Customer Support and they will instruct you how to send the log files to them.
United States courts have ruled that inmates, parolees, and probationers cannot be ordered to attend AA. Though AA itself was not deemed a religion, it was ruled that it contained enough religious components (variously described in Griffin v. Coughlin below as, inter alia, "religion", "religious activity", "religious exercise") to make coerced attendance at AA meetings a violation of the Establishment Clause of the First Amendment of the constitution.[82][83] In 2007, the Ninth Circuit of the U.S. Court of Appeals stated that a parolee who was ordered to attend AA had standing to sue his parole office.[84][85]
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...more and more, Bill discovered that new adherents could get sober by believing in each other and in the strength of this group. Men [no women were members yet] who had proven over and over again, by extremely painful experience, that they could not get sober on their own had somehow become more powerful when two or three of them worked on their common problem. This, then—whatever it was that occurred among them—was what they could accept as a power greater than themselves. They did not need the Oxford Group.
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.
Alcoholism is common, serious, and expensive. Physicians encounter alcohol-related cirrhosis, cardiomyopathy, pancreatitis, and gastrointestinal bleeding, as well as intoxication and alcohol addiction, on a daily basis. Alcoholism is also associated with many cancers. Wernicke encephalopathy and Korsakoff psychosis are also important causes of chronic disability as well as dementia. Fetal alcohol syndrome is a leading cause of mental retardation. In addition, accidents (especially automobile), depression, dementia, suicide, and homicide are important consequences of alcoholism.
Based on this study, those who abstain altogether from substances – as advised in the 12-Step model – have better mental health outcomes than those who don’t abstain. The 12-Step model gives people a framework from which to surrender their addiction, process their experience, and move forward into new patterns. As described in an article on Psych Central called Recovery Using the 12 Steps, following the model assists an individual by helping build the following mental and emotional transformative practices and tools:
We take your privacy seriously and understand the magnitude of your current situation, as well as its impact on your career and family. While we are required to report monitoring information for mandated admissions, health care professionals entering IPRP on a voluntary basis have complete confidentiality. So, don't hesitate to pick up the phone and call us for more information. 
Other tests are sometimes used for the detection of alcohol dependence, such as the Alcohol Dependence Data Questionnaire, which is a more sensitive diagnostic test than the CAGE questionnaire. It helps distinguish a diagnosis of alcohol dependence from one of heavy alcohol use.[116] The Michigan Alcohol Screening Test (MAST) is a screening tool for alcoholism widely used by courts to determine the appropriate sentencing for people convicted of alcohol-related offenses,[117] driving under the influence being the most common. The Alcohol Use Disorders Identification Test (AUDIT), a screening questionnaire developed by the World Health Organization, is unique in that it has been validated in six countries and is used internationally. Like the CAGE questionnaire, it uses a simple set of questions – a high score earning a deeper investigation.[118] The Paddington Alcohol Test (PAT) was designed to screen for alcohol-related problems amongst those attending Accident and Emergency departments. It concords well with the AUDIT questionnaire but is administered in a fifth of the time.[119] Certain blood tests may also indicate possible alcoholism.[3]
In collaboration with University of Texas Southwestern (UTSW) psychiatrists, we provide truly integrated care for mental and behavioral health and substance abuse issues. Our expert team is led by Dr. David Atkinson, a full-time psychiatrist who is dually board certified in child adolescent psychiatry and addiction psychiatry. His addiction fellowship training at Mayo Clinic helped him understand the addiction treatment process and its connection to many teens’ mental health issues.
Alcohol detoxification or 'detox' for alcoholics is an abrupt stop of alcohol drinking coupled with the substitution of drugs, such as benzodiazepines, that have similar effects to prevent alcohol withdrawal. Individuals who are only at risk of mild to moderate withdrawal symptoms can be detoxified as outpatients. Individuals at risk of a severe withdrawal syndrome as well as those who have significant or acute comorbid conditions are generally treated as inpatients. Detoxification does not actually treat alcoholism, and it is necessary to follow up detoxification with an appropriate treatment program for alcohol dependence or abuse to reduce the risk of relapse.[7] Some symptoms of alcohol withdrawal such as depressed mood and anxiety typically take weeks or months to abate while other symptoms persist longer due to persisting neuroadaptations.[65] Alcoholism has serious adverse effects on brain function; on average it takes one year of abstinence to recover from the cognitive deficits incurred by chronic alcohol abuse.[126]
Alcoholism is 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, including social or occupational impairment and deterioration of physical health. The disorder includes 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). Excessive drinking may occur daily or during binges separated by intervals of sobriety lasting from days to months. About 30% of U.S. adults drink to excess at least occasionally, and 3-5% of women and 10% of men have chronic problems of excessive drinking. In approximately 40% of those who habitually abuse alcohol, a pattern of inappropriate drinking is evident before age 20. Alcoholism is frequently accompanied by addiction to nicotine and other drugs, anxiety, depression, and antisocial personality. It tends to run in families, but personal history and environmental factors are apparently at least as important as genetic predisposition. Behavioral traits that are typical of alcoholism include solitary drinking, morning drinking, lying about the extent of one's drinking, and maintenance of a secret supply of liquor. Alcoholism costs the U.S. approximately $200 billion yearly. Chronic alcoholism decreases life expectancy by about 15 years. It is associated with an increased incidence of cardiac arrhythmia, hypertension, stroke, acute hepatitis, cirrhosis, gastritis, pancreatitis, syncope, amnesia and personality change. Because ethanol is a rich source of nonnutritive calories, heavy drinking often leads to malnutrition and vitamin deficiency. Degenerative central nervous system disorders associated with alcoholism include Wernicke encephalopathy (due to thiamine deficiency) and Korsakoff psychosis. Alcoholics are more likely than nonalcoholics to be involved in automobile accidents (more than 25% of all traffic deaths involve alcohol) and to commit violent crimes, including spousal and child abuse and homicide. A child born to an alcoholic mother may suffer the stigmata of fetal alcohol syndrome, characterized by low birth weight, facial dysmorphism, cardiac anomalies, and mental retardation. The treatment of alcoholism requires intensive counseling of patient and family. Cognitive-behavioral therapy, motivational enhancement therapy, group therapy, and support groups are all of proven value. Administration of benzodiazepines during withdrawal and use of topiramate or naltrexone to maintain abstinence are often effective. Disulfiram taken regularly can lower the risk of relapse by inducing severe malaise and nausea if alcohol is consumed. Detoxification programs for the management of acute alcoholic intoxication include withdrawal of all alcohol consumption and provision of nutritional, pharmacologic, and psychological support.
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.
Asking Question About 12-Step: This introduces the steps to patients and allows them to voice any questions and concerns . For instance, 12-Step encourages reliance on a spiritual foundation. But many groups give individuals the freedom to choose their own version of a “Higher Power.” This choice often helps patients let go of any religious resentments or preconceived prejudices toward spiritual practices.

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.
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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.
Increased incidence of domestic violence, sexual assault and rape, and associated health consequences (including post-traumatic stress disorder). These crimes are often committed by people who are intoxicated by alcohol. People who depend on alcohol regularly drink until they are drunk and are thus frequently in states which increase the likelihood of these experiences.

One review of AA warned of detrimental iatrogenic effects of twelve-step philosophy and concluded that AA uses many methods that are also used by cults.[93] A subsequent study concluded, however, that AA's program bore little resemblance to religious cults because the techniques used appeared beneficial.[94] Another study found that the AA program's focus on admission of having a problem increases deviant stigma and strips members of their previous cultural identity, replacing it with the deviant identity.[95] A survey of group members, however, found they had a bicultural identity and saw AA's program as a complement to their other national, ethnic, and religious cultures.[96]


A medical professional can work with a person attempting to detox from alcohol to help them manage cravings and other withdrawal symptoms. A doctor can also refer their patient to addiction treatment programs and therapists, so the individual can get help overcoming their alcohol abuse issues. If there are no serious withdrawal symptoms, a doctor can recommend over-the-counter remedies to manage pain or nausea. The support of friends and family can help keep the individual focused on sobriety.

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]
Chronic pain conditions require a multifaceted approach to treatment. PaRC's Pain Recovery  Program addresses the bio-psycho-social factors that contribute to chronic pain. We teach patients physical, mental and behavioral techniques that assist them in living life fully and achieving pain relief and management without reliance on addictive medications.
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.
Stanton Peele argued that some AA groups apply the disease model to all problem drinkers, whether or not they are "full-blown" alcoholics.[90] Along with Nancy Shute, Peele has advocated that besides AA, other options should be readily available to those problem drinkers who are able to manage their drinking with the right treatment.[91] The Big Book says "moderate drinkers" and "a certain type of hard drinker" are able to stop or moderate their drinking. The Big Book suggests no program for these drinkers, but instead seeks to help drinkers without "power of choice in drink."[92]
The cause of alcoholism seems to be a blend of genetic, physical, psychological, environmental, and social factors that vary among individuals. A given person's risk of becoming an alcoholic is three to four times greater if a parent is alcoholic. Some children of alcohol abusers, however, overcome the hereditary pattern by not drinking any alcohol at all.

Step 6 is about letting go of negativity and the past, and moving forward with the help of the higher power. Individuals pray, asking their higher power to remove their moral failings. People may go back to their lists of wrongdoings during Step 6 or choose to write a whole new list of specific character flaws. Individuals then choose something positive to replace these defects with. For example, lying and secrecy can be replaced with transparency and honesty. During Step 6, it may be helpful to write down several positive affirmations next to personal character issues, thus providing new and healthy methods for living in recovery.

Photodynamic therapy (PDT) is a procedure that treats precancerous cells, in addition to other types of cancer cells. The medical treatment does this with the help of a photosensitizing drug and a light source that activates the applied drug, destroying cancer cells. PDT is approved to treat non-small cell lung cancer, esophageal cancer, and Barrett's esophagus. It's used to treat actinic keratosis, as well as acne, rosacea, skin cancer, sun damage, oily skin, wrinkles, warts, psoriasis, and enlarged sebaceous glands.


Environmental factors and genetics are two components associated with alcoholism, with about half the risk attributed to each.[3] Someone with a parent or sibling with alcoholism is three to four times more likely to become an alcoholic themselves.[3] Environmental factors include social, cultural and behavioral influences.[14] High stress levels and anxiety, as well as alcohol's inexpensive cost and easy accessibility, increase the risk.[3][5] People may continue to drink partly to prevent or improve symptoms of withdrawal.[3] After a person stops drinking alcohol, they may experience a low level of withdrawal lasting for months.[3] Medically, alcoholism is considered both a physical and mental illness.[15][16] Questionnaires and certain blood tests may both detect people with possible alcoholism.[3] Further information is then collected to confirm the diagnosis.[3]
At SOBA College Recovery we provide evidence-based, academically-focused treatment modalities. Our staff consists exclusively of American Society of Addiction Medicine (ASAM) certified psychiatrists working with mental health professionals. Upon admission, all clients will be re-assessed for co-occurring mental health conditions and our psychiatrists will develop a subsequent treatment plan. At SOBA College Recovery, life is just starting. We don’t feel recovery should be a punishment. Students and young adults will meet like-minded peers and counselors dedicated to enjoying life. Our core philosophy is based on role-modeling, openness, hard work, and trust. CALL TODAY 732-204-8325 ! College Recovery Helps Students and Young Adults Get Back On Track!
A. At age 17, it may seem like fun to go out and party and get drunk every night, but its symptomatic that you have let your self cross over the line that leads to self destruction. You have already admitted that you are worried about becoming an alcoholic and being referred to as a "drunk". If that bothers you, you had better get help or stop. If it doesn't bother you that people see you as "a drunk", then there's no point in anyone making any further replies to your post. Sooner or later, something bad will surely happen, that may make you wise up. But for many alcoholics which includes me, they have to hit absolute "rock bottom". Your life will surely go "south" if you keep it up, until you either wise up because of the hangovers, or you get to the bitter end of your rope. The end of the rope could be any of the following: jail, death, car wreck, lose job, lose spouse through divorce, get thrown out of the house, get sick from heart disease, beco
AA's program is an inheritor of Counter-Enlightenment philosophy. AA shares the view that acceptance of one's inherent limitations is critical to finding one's proper place among other humans and God. Such ideas are described as "Counter-Enlightenment" because they are contrary to the Enlightenment's ideal that humans have the capacity to make their lives and societies a heaven on earth using their own power and reason.[33] After evaluating AA's literature and observing AA meetings for sixteen months, sociologists David R. Rudy and Arthur L. Greil found that for an AA member to remain sober a high level of commitment is necessary. This commitment is facilitated by a change in the member's worldview. To help members stay sober AA must, they argue, provide an all-encompassing worldview while creating and sustaining an atmosphere of transcendence in the organization. To be all-encompassing AA's ideology places an emphasis on tolerance rather than on a narrow religious worldview that could make the organization unpalatable to potential members and thereby limit its effectiveness. AA's emphasis on the spiritual nature of its program, however, is necessary to institutionalize a feeling of transcendence. A tension results from the risk that the necessity of transcendence, if taken too literally, would compromise AA's efforts to maintain a broad appeal. As this tension is an integral part of AA, Rudy and Greil argue that AA is best described as a quasi-religious organization.[40]

During 2018, Celebrate your "Sobriety Birthday" by contributing a $ amount to Central Office equal to the number of years of sobriety you're celebrating. Click Here for the latest listing of the Buck-a-year program participants. On your AA Birthday, make your contribution at Central Office by cash, check, or credit card, or by check in the mail. (Note: include with your contribution your 1st name, last initial, home group & sobriety date.) Or you can contribute online using PAYPAL or a credit or debit card - enter your 1st name, last initial, home group & sobriety date in the boxes below, then click Pay Now, enter the amount, and choose your method of payment
AA meetings do not exclude other alcoholics, though some meetings cater to specific demographics such as gender, profession, age, sexual orientation,[44][45] or culture.[46][47] Meetings in the United States are held in a variety of languages including Armenian, English, Farsi, Finnish, French, Japanese, Korean, Russian, and Spanish.[48][45] While AA has pamphlets that suggest meeting formats,[49][50] groups have the autonomy to hold and conduct meetings as they wish "except in matters affecting other groups or AA as a whole".[4] Different cultures affect ritual aspects of meetings, but around the world "many particularities of the AA meeting format can be observed at almost any AA gathering".[51]
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This final step is the service aspect, and it asks individuals to give back to others who are also struggling with addiction. After coming to God or a higher power, individuals are then taught to share this spirituality with others and support them in recovery. During Step 12, individuals are often asked to share their stories, testimonies, and struggles with others in order to provide hope and encouragement.
When alcohol dependence is mild or moderate, health practitioners commonly provide counselling or support to change behaviour. They may recommend particular strategies for avoiding situations which involve a high risk of excessive alcohol consumption (e.g. nightclubs) or coping with stressful situations without drinking alcohol. Health professionals can help identify sources of support, and suggest strategies that will help people dependent on alcohol regulate their own consumption (e.g. by having one or two alcohol-free days per week).
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The first few sips of an alcoholic beverage can lead to pleasant feelings. When alcohol is metabolized into the bloodstream and enters the brain, it binds to the gamma-aminobutyric acid (GABA) receptors, which are involved in the stress response. If a person has active production of GABA, which is absorbed by receptors rapidly, they may experience several conditions, from anxiety to seizure disorders. Alcohol slows this neuron firing down, so even people without anxiety or stress feel relaxed. The substance also inhibits glutamate absorption, which further reduces stress or anxiety.

Steps one through three deal with the individual’s acceptance of their inability to control their addiction alone and the need of support to remain abstinent. Steps four through nine teach the individual to take responsibility for their own actions and characteristics in order to create change in their life. Steps four, six and eight require self-reflection while steps five, seven and nine are the application of those reflections. The focus in steps 10 through 12 is on maintaining recovery. Each step builds upon the previous step in a progressive course of action.
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The World Health Organization, the European Union and other regional bodies, national governments and parliaments have formed alcohol policies in order to reduce the harm of alcoholism.[122][123] Targeting adolescents and young adults is regarded as an important step to reduce the harm of alcohol abuse. Increasing the age at which licit drugs of abuse such as alcohol can be purchased, the banning or restricting advertising of alcohol has been recommended as additional ways of reducing the harm of alcohol dependence and abuse. Credible, evidence based educational campaigns in the mass media about the consequences of alcohol abuse have been recommended. Guidelines for parents to prevent alcohol abuse amongst adolescents, and for helping young people with mental health problems have also been suggested.[124]
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At Wyoming Recovery, a patient may begin treatment at residential or outpatient levels of care, depending on the assessment of multiple dimensions, such as: need for detoxification, presence of complicating physical or emotional symptoms and level of support in home/work environments. Typically, a patient will transition from one level to another depending on progress, there is not a fixed length of stay. We offer the following levels of care:
Binge drinking statistics from the CDC estimate more than 38 million US adults binge drink an average of 4 times a month and the most drinks they consume on average is 8. The report found that binge drinking is more common among households with incomes ≥$75,000, but the largest number of drinks consumed per occasion is highest among households with incomes of < $25,000. [11]  According to the 2015 National Survey on Drug Use and Health (NSDUH), 26.9% of people ages 18 or older reported that they engaged in binge drinking in the past month; 7% reported that they engaged in heavy alcohol use in the past month. [8]
While consuming alcohol is, by definition, necessary to develop alcoholism, the use of alcohol by itself does not predict the development of alcoholism. The quantity, frequency, and regularity of alcohol consumption required to develop alcoholism varies greatly from person to person. People's response to alcohol may be affected by their size, age, general state of health, and by the medications they are taking. In some, fewer drinks can still cause health problems. Since there is no known "safe" alcohol level for pregnant women, the Surgeon General advises women who are, or are planning to be, pregnant to abstain from drinking.

Alcohol is a depressant – probably not a good substance for someone already experiencing depression in life. Worse yet, depression and alcohol share a two-way street. Because depression causes feelings of sadness, loneliness and disinterest, many depressed people self-medicate with alcohol. Also, the NIAAA in a 2002 study published proof that 30% to 50% of alcohol abusers also have clinical depression.


Meditation, prayer, and journaling make up Step 11 as individuals use these tools to form a spiritual connection with God or the higher power. Quiet time and solitude provide for self-reflection, and meditation can be helpful to increase the connection between the body, mind, and soul. When a person is in tune with themselves physically and emotionally, the spiritual aspect is also strengthened. Journaling during Step 11 can be a beneficial way to explore thoughts and emotions more fully as well.
SMART Recovery: As previously mentioned, Self-Management and Recovery Training (SMART Recovery), is based on scientific research and is always evolving to match the latest knowledge in the field of addiction treatment. Like the 12 Steps, SMART Recovery is broken down into multiple stages, but focused on motivation, creating an overall positive atmosphere, and changing not just behaviors but also the emotions and thoughts behind them.
According to the National Institute on Drug Abuse’s Principles of Drug Addiction Treatment: A Research-Based Guide, short-term residential programs developed the idea of using a modified 12-Step approach to provide a shorter stay in treatment that included follow-up through a 12-Step fellowship. This is seen as a way to provide the important post-treatment structure that helps people maintain long-term recovery. Other programs have also incorporated the 12 Steps, both by encouraging clients to attend 12-Step fellowship meetings, and by incorporating 12-Step ideas into their practices.
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.

Alcohol biomarkers are physiologic indicators of alcohol exposure or ingestion and may reflect the presence of an alcohol use disorder. These biomarkers are not meant to be a substitute for a comprehensive history and physical examination. Indirect alcohol biomarkers, which suggest heavy alcohol use by detecting the toxic effects of alcohol, include the following [4] :
Smith and Wilson left the Oxford Group in 1937 to focus on developing Alcoholics Anonymous, and by 1938, they had successfully brought the message to almost a hundred alcoholics in the Ohio and New York areas. Looking to capitalize on their momentum, they decided to document the group in a book. Wilson took the lead on the project, naming the resulting publication, Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism. He included 12 guidelines that, if followed, would grow the individual’s spirit to the point of overcoming the temptation to drink, and help the person make reparations for all the damage done during the days of drinking. These became known as the 12 Steps, and the book’s popularity led to Wilson’s group adopting the name of the book itself.
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