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.
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Since Alcoholics Anonymous was founded in the 1930s, 12-step treatment models have gained widespread acceptance among psychologists, therapists, social workers and medical doctors. Twelve-step groups like AA have also become a gold standard of recovery for many members of the general public. What makes the 12 steps such an effective model for drug and alcohol rehab? The psychology behind these principles indicates that these non-profit, mutual self-help groups fulfill several important needs, such as:
During Step 9, individuals will attempt to make amends for wrongdoings done to specific individuals. People are encouraged to reach out to these individuals and let them know that they would like to approach them to make amends. It can be very humbling to do so. In some cases, it is not possible to have these conversations directly, or doing so would be more harmful, so indirect methods may be ideal. Individuals can write a letter to the person (even if it will never actually be delivered), or they may choose to donate to a charity in their honor or help someone else in need.
To share their method, Wilson and other members wrote the initially-titled book, Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism, from which AA drew its name. Informally known as "The Big Book" (with its first 164 pages virtually unchanged since the 1939 edition), it suggests a twelve-step program in which members admit that they are powerless over alcohol and need help from a "higher power". They seek guidance and strength through prayer and meditation from God or a Higher Power of their own understanding; take a moral inventory with care to include resentments; list and become ready to remove character defects; list and make amends to those harmed; continue to take a moral inventory, pray, meditate, and try to help other alcoholics recover. The second half of the book, "Personal Stories" (subject to additions, removal and retitling in subsequent editions), is made of AA members' redemptive autobiographical sketches. 
An analysis in the United Kingdom in 2010 found that overall, alcohol was found to be the most harmful drug to the person consuming and to others. However, this study does not mean that substances other than alcohol have no harmful consequences; heroin, cocaine, and methamphetamine were found to be the most harmful drugs to individuals themselves. In addition, this study did not address the issue of polydrug abuse, which is a common phenomenon in individuals abusing substances. The combination of alcohol and other substances can lead to serious adverse effects, and such combinations were not explored in this study. 
AA says it is "not organized in the formal or political sense", and Bill Wilson called it a "benign anarchy". In Ireland, Shane Butler said that AA “looks like it couldn’t survive as there’s no leadership or top-level telling local cumanns what to do, but it has worked and proved itself extremely robust.” Butler explained that "AA’s 'inverted pyramid' style of governance has helped it to avoid many of the pitfalls that political and religious institutions have encountered since it was established here in 1946."
Since its origin with AA, the 12-Step model has been adopted and altered by many groups to fit other programs – for addiction treatment and otherwise. Many groups, like Narcotics Anonymous, use the steps exactly as they were conceived by AA. Others have modified the steps to fit their own needs and cultures. For example, a Native American group has combined the 12 Steps with the Native American concept of the Medicine Wheel to create a program designed specifically to help indigenous Americans who struggle with alcoholism and addiction, the Medicine Wheel and 12 Steps program. Others have come up with similar ideas to integrate the basic ideas of the 12 Steps into a cultural framework that makes sense for members of that culture.
While this provides a blanket of comfort and security to the many thousands of people it helps, the secrecy has not gone over well with the more scientifically minded in the treatment community. The success and acceptance of the program has clashed with the desire for evidence and statistics, leading to Pacific Standard saying that AA is not a form of professional treatment, and it offers mixed results; but as a “mutual aid organization,” the 12-Step method comes into its own. Similarly, The Atlantic goes so far as to call Alcoholics Anonymous a pseudoscientific organization, one that dictated the treatment conversation for generations (to the point where its claimed success rate of 75 percent went unquestioned for decades), but has overstayed its privileged place in American culture.
Alcoholism can also lead to impotence in men, damage to the fetus in pregnant women, and an elevated risk of cancer of the larynx, esophagus, liver, breast, stomach, pancreas, and upper gastrointestinal tract. Because heavy drinkers seldom have adequate diets, they may have nutritional deficiencies. Heavy drinkers typically have impaired liver function, and up to one in five develops cirrhosis.
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. 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.
Severe childhood trauma is also associated with a general increase in the risk of drug dependency. Lack of peer and family support is associated with an increased risk of alcoholism developing. Genetics and adolescence are associated with an increased sensitivity to the neurotoxic effects of chronic alcohol abuse. Cortical degeneration due to the neurotoxic effects increases impulsive behaviour, which may contribute to the development, persistence and severity of alcohol use disorders. There is evidence that with abstinence, there is a reversal of at least some of the alcohol induced central nervous system damage. The use of cannabis was associated with later problems with alcohol use. Alcohol use was associated with an increased probability of later use of tobacco, cannabis, and other illegal drugs.
Q. Alcoholism Steve 26 yr old suffered with bi-polar and the related drugs that eventually lead to his over dose. He died in where he felt a connection to the intellectual environment. After suffering with Steve for so many years, I am convinced that this disease is genetic; his grandmother also suffered with drug addiction and a mental disorder, but had that gene that must have been inherited by Steve. Any one in the area of mental health and genetic engineering Research? We want to set up or get involved with public awareness on the devastation of this disease which kills 100+ thousands in this country each year; yet society treats it as a social problem -- The advancement of mental research has been slow almost medieval -- Please help. No one, no family should have to suffer the way my beautiful son suffered and who had so much to give to humanity.
In most parts of the world, alcohol is legal for adults to both purchase and consume. As a result, beverages that contain alcohol are available almost everywhere, and clearly, many adults partake. Since use is so common, it might seem hard to determine who is drinking alcohol in an appropriate manner and who is drinking in a manner that could lead to alcohol abuse or alcoholism. Experts suggest there are key signs to look for.
While 12-Step facilitation programs don’t necessarily follow the steps, they promote the use of a 12-Step methodology, in the hope that clients will move to a 12-Step program after rehab to help maintain sobriety. In addition, certain treatment centers base their model for service around some of the ideas promoted through the 12-Step program. These centers can offer research-based services and promote a more scientific understanding of addiction treatment, but they incorporate some of the spiritual, psychological, and practical practices that the 12-Step program promotes. This results in an encompassing model of care designed to support clients through rehab and to give tools that they can use after treatment to maintain their recovery for the long-term.
Alcohol use disorder (which includes a level that's sometimes called alcoholism) is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking.
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.
Alcoholics Anonymous is based on the 12 Steps, devised by its co-founder, Bill W., and based on the Christian beliefs he adopted as part of his sobriety. The 12 Steps are presented as a set of principles to guide former alcoholics on how to tackle the problems caused by their addiction, how to make amends, and how to continue in their new lives as recovering drinkers. The 12 Steps have proven iconic enough to be adapted by other self-help and addiction recovery groups, such as Gamblers Anonymous, Narcotics Anonymous, and Food Addicts in Recovery Anonymous, with the precise terms adapted to represent the focus of the particular group. Additionally, many groups have changed the explicitly Christian overtones of the original 12 Steps to reflect secular or agnostic philosophies.
Programs like AA and other 12-Step groups provide a healthy community of support and solidarity filled with individuals who are all seeking to remain sober on a long-term basis. Individuals who regularly attend AA meetings are about twice as likely to remain abstinent over those who don’t, per the Journal of Addictive Disorders. The 12 Steps can go a long way in providing individuals in recovery with the support they need.
Benzodiazepines, while useful in the management of acute alcohol withdrawal, if used long-term can cause a worse outcome in alcoholism. Alcoholics on chronic benzodiazepines have a lower rate of achieving abstinence from alcohol than those not taking benzodiazepines. This class of drugs is commonly prescribed to alcoholics for insomnia or anxiety management. Initiating prescriptions of benzodiazepines or sedative-hypnotics in individuals in recovery has a high rate of relapse with one author reporting more than a quarter of people relapsed after being prescribed sedative-hypnotics. Those who are long-term users of benzodiazepines should not be withdrawn rapidly, as severe anxiety and panic may develop, which are known risk factors for relapse into alcohol abuse. Taper regimes of 6–12 months have been found to be the most successful, with reduced intensity of withdrawal.
Relapse can be avoided by getting sufficient aftercare. Oftentimes, aftercare involves a peer support group, ongoing therapy, and even a maintenance medication like naltrexone, which reduces or eliminates cravings. Support from family and friends is also a very important part of sustained recovery, so finding a supportive home environment – through a sober home, moving to a new house, or clearing drugs and alcohol out of one’s existing home – is very important. Working with an evidence-based treatment program can help one gather resources about nearby or online support groups and therapists.
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.
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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.
Codependency is the tendency to interact with another person in an excessively passive or caretaking manner that negatively affects the quality of the codependent individual's life. The codependent person has a pattern of putting their own needs below those of others, likely has low self-esteem, and tends to engage in denial, excessive compliance, and control. Individuals who are codependent are at risk for engaging in addictive behaviors, including alcoholism, drug or sexual addiction, as well as eating disorders or self-destructive or other self-defeating behaviors. Psychotherapy and participation in support groups are the usual treatments for codependency.
But Twelve-Step Facilitation therapy is still a tried-and-true proven approach. It is far more than advising a patient to “go to AA” and providing them a list of meeting locations and times. In Twelve-Step Faciliation, the therapist actively probes and nudges, encouraging not only attendance, but participation, in meetings; it explains the potential benefits of working with a sponsor and promotes the individual developing a relationship with a sponsor; it explores problems or psychological resistances to attendance, participation, actual “working the steps,” and the development of a sponsor-sponsee relationship; and it opens the door to “AA-related activities” such as volunteer service to one’s AA “home group” or AA “clubhouse” and involvement with AA-related social events, retreats, and local and state conventions.
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.
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.
Alcohol affects virtually every organ system in the body and, in high doses, can cause coma and death. It affects several neurotransmitter systems in the brain, including opiates, GABA, glutamate, serotonin, and dopamine. Increased opiate levels help explain the euphoric effect of alcohol, while its effects on GABA cause anxiolytic and sedative effects.
Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
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.
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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."
AA meetings do not exclude other alcoholics, though some meetings cater to specific demographics such as gender, profession, age, sexual orientation, or culture. Meetings in the United States are held in a variety of languages including Armenian, English, Farsi, Finnish, French, Japanese, Korean, Russian, and Spanish. While AA has pamphlets that suggest meeting formats, groups have the autonomy to hold and conduct meetings as they wish "except in matters affecting other groups or AA as a whole". 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".
No laboratory tests exist that can screen for alcoholism with a high level of accuracy. Most alcoholism is diagnosed through patient and family history. However, alcoholism can be difficult to diagnose until late-stage physical symptoms become apparent because alcohol-dependent people often lie or about underestimate their alcohol use. In addition, many physicians do not routinely screen their patients using standardized questionnaires that may reveal alcohol problems.
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.
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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.
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Addiction is a complex brain disease that impacts people emotionally, physically, socially, financially, behaviorally, and personally. Families and loved ones are negatively affected as well. Addiction recovery is aided by professional treatment programs and by engaging in support groups that can offer encouragement, hope, and healthy peer interactions. These self-help groups aid in facilitating the formation of groups of people who have similar goals for sobriety and long-term abstinence from drugs and alcohol. The idea of a 12-Step program began with Alcoholics Anonymous, or AA, a program designed to support individuals struggling with addiction to alcohol in their recovery efforts.