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.
The mental obsession is described as the cognitive processes that causes the individual to repeat the compulsive behavior after some period of abstinence, either knowing that the result will be an inability to stop or operating under the delusion that the result will be different. The description in the First Step of the life of the alcoholic or addict as "unmanageable" refers to the lack of choice that the mind of the addict or alcoholic affords concerning whether to drink or use again.
Women tend to be more sensitive to the effects of alcohol and may develop alcohol-related health problems sooner and after consuming less alcohol than men do. Alcohol use in pregnant women can lead to miscarriage, stillbirth, premature birth, low birth weight, and other problems in the baby, such as abnormal facial features, malformation of organs (such as the brain and heart), growth deficits, and hearing and vision problems. Brain damage due to a mother's alcohol use may result in behavioral problems, speech and language delays, and learning disabilities, according to the March of Dimes.
There is a group of physicians within ASAM who are concerned that twelve-step recovery is not being taught to new physicians entering this field (most physicians currently enter addiction practice in mid-career, rather than straight out of residency training). Referring to themselves as “Like Minded Docs,” they communicate regularly among each other, leaning on each other via email for support and guidance, and occasionally reaching out to ASAM regarding policies of the Society. One of their stated concerns is that continuing education programs for physicians newly involved with addiction or considering a mid-career switch into addiction medicine have more content on pharmacotherapies and less content on psychosocial therapies, and that Twelve-Step Facilitation therapy and twelve-step recovery overall are at risk of becoming ‘dying arts.’
Alcoholism often reduces a person's life expectancy by around ten years. The most common cause of death in alcoholics is from cardiovascular complications. There is a high rate of suicide in chronic alcoholics, which increases the longer a person drinks. Approximately 3–15 percent of alcoholics commit suicide, and research has found that over 50 percent of all suicides are associated with alcohol or drug dependence. This is believed to be due to alcohol causing physiological distortion of brain chemistry, as well as social isolation. Suicide is also very common in adolescent alcohol abusers, with 25 percent of suicides in adolescents being related to alcohol abuse. Among those with alcohol dependence after one year, some met the criteria for low-risk drinking, even though only 25.5 percent of the group received any treatment, with the breakdown as follows: 25 percent were found to be still dependent, 27.3 percent were in partial remission (some symptoms persist), 11.8 percent asymptomatic drinkers (consumption increases chances of relapse) and 35.9 percent were fully recovered—made up of 17.7 percent low-risk drinkers plus 18.2 percent abstainers. In contrast, however, the results of a long-term (60-year) follow-up of two groups of alcoholic men indicated that "return to controlled drinking rarely persisted for much more than a decade without relapse or evolution into abstinence." There was also "return-to-controlled drinking, as reported in short-term studies, is often a mirage."
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.
Alcoholics Anonymous (AA) was the first 12-step program established and many other support groups have branched off from AA using this model. AA is an organization that unites people who have struggled with alcohol dependency, providing strength and faith in one another to overcome addiction. Its mission is to “stay sober and help other alcoholics to achieve sobriety” without judgment or segregation. AA founders Bill Wilson and Dr. Bob Smith developed the 12 steps based on concepts from Carl Jung’s theories as influenced by Eastern philosophy, and from spiritual values such as those rooted in the principles of the Oxford Group.
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Beyond the directory, Addiction Recovery Now also provides support in the form of a 24-hour hotline for answering all your questions about recovery. Our agents are compassionate, professional, and dedicated to serving you, not the rehabilitation centers.The agents at Addiction Recovery Now are well-educated in the industry and are waiting to put your mind at ease.
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.
In asking questions about mental health symptoms, mental health professionals are often exploring if the individual suffers from alcohol or other drug abuse or dependence disorders, as well as depression and/or manic symptoms, anxiety, hallucinations, or delusions or behavioral disorders. Physicians may provide the people they evaluate with a quiz or self-test as a screening tool for substance-use disorders. Since some of the symptoms of alcohol use disorder can also occur in other mental illnesses, the mental health screening is to determine if the individual suffers from a mood disorder or anxiety disorder, as well as schizophrenia, schizoaffective disorder, and other psychotic disorders, or personality or behavior disorders like attention deficit hyperactivity disorder (ADHD).
For people in the first stage of alcohol use (having access but not having yet used alcohol), preventive measures are used. Therefore, limiting access to alcohol or other drugs, addressing any risk factors of the alcohol consumer or family, as well as optimal parental supervision for youth and expression regarding expectations are often recommended. The approach to those who have experimented with alcohol should not be minimized by mental health professionals, since infrequent use can progress to the more serious stages of alcohol use if not addressed. Therefore, professionals recommend that the alcohol-consuming individual be thoroughly educated about the effects and risks of alcohol, that fair but firm limits be set on the use of alcohol, and that the user be referred for brief counseling, a self-help group, and/or family support group. People who have progressed to the more advanced stages of alcoholism are typically treated intensively, using a combination of the medical, individual, and familial interventions already described.
Recovery from alcoholism is a life-long process. The potential for relapse remains present and must be acknowledged and respected. Many individuals stop drinking and then relapse multiple times before attaining extended periods of sobriety. Statistics suggest that, among middle-class alcohol-dependent individuals in stable financial and family situations who have undergone treatment, 60% or more successfully stop drinking for at least one year.
I agree with many of the earlier comments highlighting the drawbacks of 12-Step for many folks seeking recovery. Although the program claims to be "spiritual" and "not religious," it's roots are in the Oxford Group, an early evangelical Protestant organization, and the 12 Steps (12, because there were 12 apostles) are taken directly from Oxford Group, which maintained that people were "powerless over sin." Bill W. simply replaced "sin" with "alcohol" and kept the rest unchanged.
Whether you’re the loved one of someone struggling with alcohol addiction, or you yourself are struggling, it’s important to be aware of these signs and to know that you’re not alone. Thousands of people from all walks of life battle alcoholism every day, and thousands make the decision to seek help. The Recovery Village offers various programs at facilities throughout the country that are designed to treat alcoholism, among other disorders. All you have to do is call, and one of our intake coordinators will take care of the rest.
The endpoint of “recovery” from addiction, if there is an endpoint, is to change one’s life for the better, to gain stability in one’s life, and to become more functional in one’s family and in one’s community. Being responsible, being reliable, being interested in others and not just in oneself, and being a loving being who cares about and is helpful to others, are all part of recovery.
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Young antisocial subtype: This group represents about 21 percent of people struggling with AUD, according to the NIAAA study. On average, this group is about 26 years old – so still young, but not as young as the young adult group. They are defined by having antisocial personality disorder; this mental health condition leads them to begin drinking in adolescence, around age 15 on average, and they display symptoms of AUD by age 18. They are also more likely to struggle with polydrug abuse, especially abuse of tobacco and marijuana. There is no overlap between the young adult and young antisocial subtypes.
Around a third of individuals with alcohol dependence resolve their alcohol consumption problems without professional intervention. Others need the support of a health professional who can recommend a range of treatments. While there are many effective treatments, people who overcome alcohol dependence often relapse (i.e. develop alcohol dependency once again).
In 1941, interviews on American radio and favorable articles in US magazines, including a piece by Jack Alexander in The Saturday Evening Post, led to increased book sales and membership. By 1946, as the growing fellowship quarreled over structure, purpose, and authority, as well as finances and publicity, Wilson began to form and promote what became known as AA's "Twelve Traditions," which are guidelines for an altruistic, unaffiliated, non-coercive, and non-hierarchical structure that limited AA's purpose to only helping alcoholics on a non-professional level while shunning publicity. Eventually he gained formal adoption and inclusion of the Twelve Traditions in all future editions of the Big Book. At the 1955 conference in St. Louis, Missouri, Wilson relinquished stewardship of AA to the General Service Conference, as AA grew to millions of members internationally.
Abstinence-based recovery, as the name suggests, focuses on complete abstinence from drug use, thereby breaking the cycle of addiction and dependency. To achieve remission from the disease of addiction, complete withdrawal of all mind-altering substances, including alcohol, is required. Abstinence-based recovery teaches us how to live a life of freedom that no longer requires us to turn to mood or mind-altering substances in order to help change the way we feel. The 12-Steps are an abstinence-based program that offers a lifeline of support to anyone hoping to recover from addiction.
The World Health Organization examined mental disorders in primary care offices and found that alcohol dependence or harmful use was present in 6% of patients. In Britain, 1 in 3 patients in community-based primary care practices had at-risk drinking behavior. Alcoholism is more common in France than it is in Italy, despite virtually identical per capita alcohol consumption.
So changes in the brain caused by alcohol actually cause alcoholism. However, alcohol itself also causes issues with the body. Short-term effects include drunkenness, difficulty walking, slurred speech, slowed reaction time, trouble with balance, poor judgment, unpredictable behavior, and temporarily memory loss… basically all the things associated with being drunk. Long-term effects are much nastier, and can include Wernicke-Korsakoff Syndrome, delirium tremens, liver failure, up to ten types of cancer, and ultimately death.
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. 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.
First developed in 1935 by Bill Wilson & Dr. Bob during the founding of Alcoholics Anonymous (AA), The 12 Steps are a program of recovery designed to help individuals suffering from alcoholism and addiction attain long-lasting, contented sobriety. The 12 Steps outline a path to spiritual progress through a series of actions designed to elicit what The Big Book of Alcoholics Anonymous refers to as a “psychic change” – a complete mental, emotional and spiritual shift in perception.
Many people use alcohol as a de-stressor. While some beer may be a temporarily relief from the stress of the day, ultimately alcohol is stressing you out even more. Research shows that long-term drinking can increase perceived stress in the brain. For example, a stressful situation would be handled worse by an alcoholic than by a non-alcoholic. Many other factors play into how we handle such situations, but without a doubt drinking alcohol will not help.
Alcoholics Anonymous (AA). Alcoholics Anonymous is a self-help recovery organization that is made up of support groups for people who are committed to beating alcoholism. AA first introduced, and still uses, the 12 steps of recovery, which have been in use in the United States and Canada for the last 60 years. This alcohol recovery program encourages its members to reach out to a higher power to help people overcome their addictions. With more than 56,500 AA support groups and alcohol addiction recovery programs throughout the United States, most communities have at least one AA support group. Support group meetings may be open or closed. Open meetings allow the attendance of both the substance abuser and his or her family members. Closed meetings only allow the attendance of the substance abuser. Members are expected to attend meetings regularly and encouraged to seek out a sponsor who has managed to successfully maintain sobriety.
For Windows 10, right click on the Windows Start icon in the lower left corner of the Desktop. Click on Programs and Features in the pop up list. This will bring up the Uninstall or change a program window. Find Seagate Recovery Suite in the list of installed programs and click on it. At the top of the window in the Organize bar click Uninstall. Follow the prompts to complete the uninstall.
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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.
Alcohol dependence is a legitimate health problem. Health professionals can provide advice, support and in some cases medication to help reduce alcohol dependence. You may feel embarrassed talking to a doctor about drinking too much, but remember that doctors and other health workers are there to help fix health problems, not to judge or berate their patients. A good doctor will encourage their patients to drink in moderation or perhaps abstain for periods of time, not make their patients feel guilty or bad for drinking drink too much alcohol.
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.
According to information derived from the United States National Longitudinal Alcohol Epidemiologic Study released in 2006, about 8% of American adults are dependent on alcohol (estimates range from 5-10%). About 34% of adult Americans do not use alcohol at all. Another 44% are occasional or non-dependent users. Alcohol is the third leading cause of preventable death in the United States (smoking and obesity rank first and second) and is responsible for about 85,000 deaths annually, about half from injury and half from disease. Alcoholism is involved in about 30% of homicides and 22% of suicides. It is the cause of about 20% of fatal motor vehicle accidents and is a contributing factor in between one-third and one-half of all vehicular accidents. Alcoholism costs the United States about $185 billion annually in costs related to violence, traffic accidents, lost work productivity, and direct medical expenses. The National Institute on Alcohol Abuse and Alcoholism estimates that at least 6.6 million children under age 18 live in households with at least one alcoholic parent and that before age 18 about 25% of children are exposed to family alcohol dependency or alcohol abuse.
Short-term effects of alcohol abuse can be just as dangerous as long-term effects. For instance, drinking can impact your reaction time, causing you to have slow reflexes and coordination. That’s why drinking and driving is extremely dangerous. Getting behind the wheel of a car can alter your perception of speed and distance, putting yourself and others at risk.
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:
Jump up ^ Sullivan, JT; Sykora, K; Schneiderman, J; Naranjo, CA; Sellers, EM (November 1989). "Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar)" (PDF). Br J Addict. 84 (11): 1353–7. CiteSeerX 10.1.1.489.341. doi:10.1111/j.1360-0443.1989.tb00737.x. PMID 2597811. Archived from the original (PDF) on 10 August 2013. Retrieved 25 October 2017.
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.
The Serenity Prayer is learned, which is meant to be used whenever individuals need a reminder in their lives. The Serenity Prayer is as follows: “God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference.” This prayer is considered a cornerstone of many 12-Step programs as it embodies the idea that individuals need to accept the control that alcohol and drugs have over them, gain strength to work at remaining sober, and know when things are changeable and when they are not. Step 3 asks individuals to be willing to let God, in whatever form that is for each person, fully into their lives.
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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.
The term is also used by outlets like Salon and New York Magazine, which suggest that the time has come for Alcoholics Anonymous to be decoupled from mainstream alcoholism recovery. The point is made by Mia Szalavitz, a recovering addict and now an addiction researcher and author, who wrote a book about how developments in neuroscience and psychology might render AA obsolete. Szalavitz takes issue with the AA concept of “hitting rock bottom,” the moment when a person experiences a personal loss (e.g., a DUI, eviction, divorce, firing, etc.) as a sign that the addiction has become too damaging to ignore. This expectation, writes Szalavitz, is “harsh and humiliating,” in the sense that help is withheld until the person crosses a tragic Rubicon. But so deeply does it run in the DNA of Alcoholics Anonymous that it has influenced how any 12-Step methodology treats addiction therapy. This, says Szalavitz, has made the treatment community on the whole “embrace a totally false, harmful view of what addiction is.”