observations The most frequent medical consequences of alcoholism are central nervous system depression and cirrhosis. The severity of each may be greater in the absence of food intake. Alcoholic patients also may suffer from alcoholic gastritis, peripheral neuropathies, auditory hallucinations, and cardiac problems. Abrupt withdrawal of alcohol in addiction causes weakness, sweating, and hyperreflexia. The severe form of alcohol withdrawal is delirium tremens.
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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.
While admitting that the oft-cited success rate of 5 percent “isn’t great,” Dr. Drew Pinsky, a celebrity doctor and addiction medicine specialist argued that “the fact it, [Alcoholics Anonymous] does work when people do it,” saying the real success rate is as high as 12 percent. The American Society of Addiction Medicine speculated that approximately 10 percent of the people who become part of a 12-Step program enjoy long-term success in their recovery. In 2014, AA self-reported that 27 percent of the 6,000 members who participated in an internal study were sober for less than a year; 24 percent retained their sobriety for up to five years, and 13 percent lasted for as long as a decade. Fourteen percent of the study’s participants stayed sober between 10 and 20 years, and 22 percent reported remaining sober for more than two decades.
Hazard duly joined a Christian evangelical movement, known as the Oxford Group. In addition to the basic tenets of the Christian faith (such as honesty and personal change), “personal evangelism” was stressed, or one member of the group sharing his story with someone outside of the group, especially if the other person was undergoing a personal crisis.
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.
Functional subtype: Representing about 19 percent of those struggling with AUD in the study, this group is typically middle aged and, on the surface, appears to have their lives together. They have higher income, more education, and stable relationships compared to other adults struggling with AUD. They drink, on average, every other day, and tend to binge drink on those days.
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While both alcohol abuse and alcoholism are included in the alcohol use disorder diagnosis and involve engaging in maladaptive behaviors in the use of alcohol, abuse of this substance does not include the person having withdrawal symptoms or needing more and more amounts to achieve intoxication (tolerance) unless the person has developed alcoholism.

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.

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] :


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.   
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Jump up ^ Littrell, Jill (2014). Understanding and Treating Alcoholism Volume I: An Empirically Based Clinician's Handbook for the Treatment of Alcoholism: Volume Ii: Biological, Psychological, and Social Aspects of Alcohol Consumption and Abuse. Hoboken: Taylor and Francis. p. 55. ISBN 9781317783145. Archived from the original on 20 July 2017. The World Health Organization defines alcoholism as any drinking which results in problems
For many, beer, wine, and spirits conjure up thoughts of social gatherings and tipsy fun. But alcohol, a depressant, is also associated with damaging behavior and the emotional pain and physical ruin of addiction. Experts debate the benefits and risks of drinking and passionately argue over whether moderation or abstinence is the best option for alcoholics.
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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:
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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."[20]
Chuck Lorre's Mom (2013-), follows dysfunctional daughter/mother duo Christy and Bonnie Plunkett, who are estranged for years while simultaneously struggling with addiction. They attempt to pull their lives and relationships together by trying to stay sober and visiting Alcoholics Anonymous. The show also explores themes of alcoholism, drug addiction and relapse.
More than a quarter (27%) of all 15- to 19-year-olds worldwide consume alcohol. Rates are highest in Europe (44%), followed by the Americas (38%) and the Western Pacific (38%). Total alcohol consumption per capita among those older than 15 years around the world rose from 5.5 liters of pure alcohol in 2005 to 6.4 liters in 2010 and remained at that level in 2016. [1, 2]
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.
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. 

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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).

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Up to 30% of children are offered drugs before graduating high school, and for alcohol, it’s three out of every four kids who are offered. Peer pressure is a beast. Fitting-in is extremely important in high school, and unfortunately drinking alcohol is a common marker of ‘being cool.’ Peer pressure does not end after 12th grade, though. Oftentimes adults are pressured into drinking at social events when they don’t want to. Over time, this can be habit-forming.


Following detoxification, social support to abstain from or moderate drinking is needed for an extended period of time. It is useful for individuals who are recovering from alcohol dependence to identify people who can support them through the process, as it can still be very difficult not to drink alcohol, or to drink in moderation following detoxification. People who have difficulty may wish to investigate whether there is medication which can help them stay away from alcohol. There are range of prescription medicines which might assist some people. Talk to a doctor before taking any medication.
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.
A lot of people get wrapped up in abusing psychoactive substances that make them feel good.  Physical and psychological dependence ensue.  Both states of withdrawal may ensue.  There are people who just need motivation and life change to get away from their addiction.  There is another class of people who cannot stop.  The 12-steps are being attacked because they can't do anything for you.  You have to use the 12-steps for them to help you.  I have the disease, nothing else could help me. 
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The Big Book was originally written as a guide for people who couldn’t attend AA fellowship meetings, but it soon became a model for the program in general. It has since been adopted as a model for a wide range of addiction peer-support and self-help programs designed to help drive behavioral change. In addition to the original Alcoholics Anonymous (AA) group, various offshoots now exist, such as Narcotics Anonymous (NA), Heroin Anonymous (HA), and Gamblers Anonymous (GA).


"Learning basic Twelve Step philosophy and language can open the lines of communication," continued Cathy. "Once you understand some Twelve Step principles, concepts such as powerlessness, spiritual awakening, higher power and making amends, they will seem less like cult mantras and more like the simple guides they are intended to be." A Twelve Step program is one that adapts the Twelve Steps of AA to fit the particular needs of a mutual-help group. Narcotics Anonymous, Al-Anon, Alateen, Gamblers Anonymous, Nicotine Anonymous, and Adult Children of Alcoholics are examples of groups with a Twelve Step foundation.
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.

Friends and family members of alcoholic individuals have often developed a codependent relationship with the substance abuser. Specifically, they often feel compelled to either help their loved one secure alcohol or to repair situations caused by the alcoholic's alcohol use. Social control involves family members and other significant others of the alcoholic in treatment.


Alcohol withdrawal can occur when alcohol use has been heavy and prolonged and is then stopped or greatly reduced. It can occur within several hours to four or five days later. Signs and symptoms include sweating, rapid heartbeat, hand tremors, problems sleeping, nausea and vomiting, hallucinations, restlessness and agitation, anxiety, and occasionally seizures. Symptoms can be severe enough to impair your ability to function at work or in social situations.

interventions Extreme caution should be used in administering drugs to alcoholic patients because of the possibility of additive central nervous system depression and toxicity caused by inability of the liver to metabolize the drugs. Treatment consists of psychotherapy (especially group therapy by organizations such as Alcoholics Anonymous), or administration of drugs such as disulfiram that cause an aversion to alcohol. See also acute alcoholism, chronic alcoholism.
Mike Superb per usual Excellent elucidation of Twelve Step Facillitation and the Principles of AA unfortunately prior posters critical of AA don't share my Experience with that Fellowship AA recommends that members seek out Docs with understanding of the Disease of Addiction It cautions about the use of benzos  hypnotics and MJ Maintenance AA does not oppose ANY OF THE MEDICATIONS that you have described  I have encountered some problem in that regard with NA 
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Alcoholism is appropriately considered a disease rather than a weakness of character or chosen pattern of bad behavior. It is the third most common mental illness, affecting more than 14 million people in the United States. Other facts and statistics about alcohol dependence include its pattern of afflicting about 4% of women and 10% of men. It costs more than $200 billion per year in lower productivity, early death, and costs for treatment. Worldwide, alcohol is thought to contribute to more than 200 illnesses and injuries, like liver disease, heart disease, and neurological problems. Alcohol-related deaths number more than 3 million per year, nearly 6% of all deaths worldwide. For adults between 20-40 years of age, that percentage rises to about 25% of deaths due to alcohol.

But not everyone in the treatment community is as skeptical toward Alcoholics Anonymous. Scientific American grants that it’s not a perfect solution, but claims that criticisms of the group are often unfair or based on false assumptions. For many alcoholics, AA’s wide availability of meetings and lack of expense make it a worthy consideration. The Recent Developments in Alcoholism journal said 12-Step programs are “an ideal recovery recourse,” and the Alcoholic Research & Health journal notes that the rise of other treatment methods have not displaced the model of mutual health groups, which are still the most widely sought-after source of help for alcoholism and other substance abuse problems.
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