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Based on combined data from SAMHSA's 2004–2005 National Surveys on Drug Use & Health, the rate of past-year alcohol dependence or abuse among persons aged 12 or older varied by level of alcohol use: 44.7% of past month heavy drinkers, 18.5% binge drinkers, 3.8% past month non-binge drinkers, and 1.3% of those who did not drink alcohol in the past month met the criteria for alcohol dependence or abuse in the past year. Males had higher rates than females for all measures of drinking in the past month: any alcohol use (57.5% vs. 45%), binge drinking (30.8% vs. 15.1%), and heavy alcohol use (10.5% vs. 3.3%), and males were twice as likely as females to have met the criteria for alcohol dependence or abuse in the past year (10.5% vs. 5.1%).[83]
Signs of a drinking problem include behaviors like drinking for the purpose of getting drunk, drinking alone or keeping it secret, drinking to escape problems, hiding alcohol in odd places, getting irritated when you are unable to obtain alcohol to drink, and having problems at work, school, home, or legally as a result of your drinking. Other warning signs of alcohol use disorder include losing interest in activities you used to enjoy, having blackouts because of heavy drinking, and getting annoyed when loved ones say you may have a drinking problem. Behaviors that may indicate that a person is suffering from alcoholism include being able to drink more and more alcohol, trouble stopping once you start drinking, powerful urges to drink, and having withdrawal symptoms like nervousness, nausea, shaking, or having cold sweats, and even hallucinations when you don't have a drink.

Risk factors for developing problems with alcohol arise from many interconnected factors, including your genetics, how you were raised, your social environment, and your emotional health. Some racial groups, such as American Indians and Native Alaskans, are more at risk than others of developing drinking problems or alcohol addiction. People who have a family history of alcoholism or who associate closely with heavy drinkers are more likely to develop drinking problems. Finally, those who suffer from a mental health problem such as anxiety, depression, or bipolar disorder are also particularly at risk, because alcohol is often used to self-medicate.


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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.

The Landing is a unique and highly effective residential treatment program where adult men can receive intense personalized treatment that is focused on promoting recovery and optimizing brain health. With a unique holistic approach that incorporates the best of science-supported western medicine with centuries-old techniques of eastern healing, The Landing provides the comprehensive services that enable men to experience true healing in body, mind, and spirit. Men who choose to heal at The Landing will work in close collaboration with teams of dedicated and experienced treatment professionals, including a board-certified psychiatrist, licensed therapist, certified substance abuse counselors, marriage and family therapy interns, nurses, and clinical technicians. By focusing solely on the specific needs of men who are struggling with chemical dependency and related co-occurring disorders, The Landing is able to provide targeted treatment that helps men to focus on their recovery, set goals, and develop the tools they need in order to reinforce their recovery from alcohol, cocaine, and other substances. Gender-specific treatment enables men to discuss sensitive and personal issues that they may be hesitant to address in a mixed-gender environment. At The Landing, men can concentrate on their recovery process without worrying about social approval and the impression they may be making on others and can form an invaluable cohesive social network with other recovering men.
There are many clues which can lead a doctor to suspect a patient is alcohol dependent, and will not usually require a physical examination. For example, a doctor may suspect alcohol dependence if a patient often asks for a medical certificate for time off work, has a mental health problem (e.g. depression) or physical conditions associated with alcohol consumption (especially liver cirrhosis). In such cases, a good doctor will ask the patient questions about their alcohol consumption patterns, or ask them to complete a questionnaire about alcohol, to assess whether or not their alcohol consumption is presenting a health risk.
In my 30 years as an addiction counselor I've been amazed by the practically obsessive attempts to push the 12-step philosophy to the forefront of treatment methodology, and to ignore research.  Does anyone remember that Bill W. once remarked that he never considered AA to be a panacea for addiction?  In fact, few people know he considered the nutritional therapy of Vitamin B3 to be perhaps the most effective means of treating symptoms of depression he found closely linked to alcoholism.  He wanted to be remembered more for promoting B3 therapy than AA itself.  The point is, support is support, and science is science.  I've never had any qualms whatsoever about my clients attending AA or NA meetings. It's their free time; they can attend or not.  If my role is to teach or persuade them to go, why do I need a clinical license and a Master's Degree?  Why did I need to take exams? (Which, by the way, never 'assessed' my ability as AA promoter.) I take my work more seriously than just encouraging support group concepts or involvement.  I see my role alternately as providing up-to-date information about behavioral therapies, relapse prevention approaches, and being a force for connection and inspiration.  We should be appalled by the slow transfer of research to practice.  There's a lot more we can do for our clients, and we're not doing it.  I think it's high time for the traditionalists in our field to recognize that our clients need the benefits of science, not more AA instruction and orientation.  
With regard to pregnancy, fetal alcohol syndrome is the leading known cause of mental retardation (1 in 1000 births). More than 2000 infants annually are born with this condition in the United States. Alcohol-related birth defects and neurodevelopmental problems are estimated to be 3 times higher. Even small amounts of alcohol consumption may be risky in pregnancy. A 2001 study by Sood et al reported that children aged 6–7 years whose mothers consumed alcohol even in small amounts had more behavioral problems. [18] In a study from 2003, Baer et al showed that moderate alcohol consumption while pregnant resulted in a higher incidence of offspring problem drinking at age 21 years, even after controlling for family history and other environmental factors. [19] All women who are pregnant or planning to become pregnant should avoid alcohol.
Secular Organizations for Sobriety (SOS). SOS is presented as a secular alternative to the more spiritual 12-step addiction recovery programs (such as AA and NA) that encourage people to reach out to a higher power. The program targets substance abusers who would like to separate sobriety from spirituality and religion. The organization credits the individual for maintaining sobriety as opposed to crediting a higher power. SOS is comprised of a network of autonomous local groups that help individuals achieve and maintain sobriety. The organization has meetings in many cities across the United States. In SOS, sobriety is presented as the number one priority for individuals suffering from alcoholism or addiction. It emphasizes the use of clear communication and scientific knowledge in choosing the most rational approach to living a sober and rewarding life.
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]

The term alcoholism is commonly used amongst laypeople, but the word is poorly defined. The WHO calls alcoholism "a term of long-standing use and variable meaning", and use of the term was disfavored by a 1979 WHO expert committee. The Big Book (from Alcoholics Anonymous) states that once a person is an alcoholic, they are always an alcoholic, but does not define what is meant by the term alcoholic in this context. In 1960, Bill W., co-founder of Alcoholics Anonymous (AA), said:


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.
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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.

The 12-step approach to rehabilitation treatment is embraced throughout the world, so it’s always easy to find support where you are or wherever you go. Accordingly, we advise patients to keep in contact with ‘sober supports’ they make during treatment at one of our locations. We also encourage them to continue attending 12-step groups on a regular basis after discharge. Being able to discuss mistakes or relapses, as needed, in a supportive environment helps to keep patients accountable for their actions.
Al-Anon and Alateen. Al-Anon is an organization comprised of support groups targeted towards friends and family of individuals suffering from alcoholism. In these groups, family members and friends are able to share their personal experiences, discuss difficulties and find effective ways to deal with problems—regardless of whether the alcohol abusing individual in their lives have completed an addiction recovery program. Alateen is a fellowship that is specifically targeted towards younger Al-Anon members, particularly teenagers.
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Friends and family members are interconnected—suspended in delicate balance. When a loved one begins the arduous journey of recovery, the balance shifts. With work and understanding, relationships can be reshaped into something better and a healthier balance can be achieved. Recovery and support for the recovering person are reciprocal gifts that keep on giving.
Though it can feel as if you are hiding a unique or embarrassing problem, the fact is that families across the country are experiencing the exact same thing you are. You are not alone with the disease, and you will not be alone as you seek the treatment necessary to begin to heal and start a new life in recovery. Alcohol.org is available to provide education and support all along the way.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has modified some of the criteria involved in the medical definition of an alcohol use disorder. There are 11 criteria listed to help clinicians determine if their patient has AUD and how serious the problem is. A mild AUD involves experiencing two or three of the 11 symptoms for one year; a moderate AUD involves four or five of the symptoms; and a severe AUD involves six or more of the listed criteria.
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The illness of the spiritual dimension, or "spiritual malady," is considered in all twelve-step groups to be self-centeredness.[17][18] The process of working the steps is intended to replace self-centeredness with a growing moral consciousness and a willingness for self-sacrifice and unselfish constructive action.[18] In twelve-step groups, this is known as a spiritual awakening not a religious experience.[21] This should not be confused with abreaction, which produces dramatic, but ephemeral, changes.[22] In twelve-step fellowships, "spiritual awakening" is believed to develop, most frequently, slowly over a period of time.[23]
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