At the end of an intervention, the stage is set for entry into addiction treatment programs. There are many different options out there. Some facilities, for example, offer inpatient treatment for addiction. These programs allow people to step away from their day-to-day concerns and tackle an addiction around the clock, every single day. For some people, that tight focus is an ideal setup for healing. But outpatient centers can be ideal for those who want to stay at home, surrounded by family, while they work on addictions to alcohol. It’s a personal decision that families can make in consultation with the person who needs help.
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]
When alcoholism affects a spouse or partner, it’s possible to become too wrapped up in their well-being. This is called codependency. You may get to the point where you feel compelled to help your person get well. However, family members and friends often have deep emotional ties that prevent them from having the objective viewpoint necessary for treatment.

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]

Historically the name "dipsomania" was coined by German physician C. W. Hufeland in 1819 before it was superseded by "alcoholism".[160][161] That term now has a more specific meaning.[162] The term "alcoholism" was first used in 1849 by the Swedish physician Magnus Huss to describe the systematic adverse effects of alcohol.[163] Alcohol has a long history of use and misuse throughout recorded history. Biblical, Egyptian and Babylonian sources record the history of abuse and dependence on alcohol. In some ancient cultures alcohol was worshiped and in others, its abuse was condemned. Excessive alcohol misuse and drunkenness were recognized as causing social problems even thousands of years ago. However, the defining of habitual drunkenness as it was then known as and its adverse consequences were not well established medically until the 18th century. In 1647 a Greek monk named Agapios was the first to document that chronic alcohol misuse was associated with toxicity to the nervous system and body which resulted in a range of medical disorders such as seizures, paralysis, and internal bleeding. In 1920 the effects of alcohol abuse and chronic drunkenness led to the failed prohibition of alcohol in the United States, a nationwide constitutional ban on the production, importation, transportation, and sale of alcoholic beverages that remained in place until 1933. In 2005 alcohol dependence and abuse was estimated to cost the US economy approximately 220 billion dollars per year, more than cancer and obesity.[164]
The program offers a comprehensive array of clinical services for individuals seeking recovery from alcohol and other drug addiction. Our team is unique in that it brings together experts from the field of medicine, psychiatry and addiction, which gives us the ability to care for patients with both addiction and co-existing medical and/or psychiatric illnesses.
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Jump up ^ Agrawal, A; Sartor, CE; Lynskey, MT; Grant, JD; Pergadia, ML; Grucza, R; Bucholz, KK; Nelson, EC; Madden, PA; Martin, NG; Heath, AC (2009). "Evidence for an Interaction Between Age at 1st Drink and Genetic Influences on DSM-IV Alcohol Dependence Symptoms". Alcoholism: Clinical and Experimental Research. 33 (12): 2047–56. doi:10.1111/j.1530-0277.2009.01044.x. PMC 2883563. PMID 19764935.
The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) study suggests the transition from use to dependence was highest for nicotine users, followed by cocaine, alcohol, and cannabis users. [10] An increased risk of transition to dependence among minorities and those with psychiatric or dependence comorbidity highlights the importance of promoting outreach and treatment of these populations.
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.

Most of the warning signs and symptoms of alcoholism are not difficult to pinpoint. However, there are some that are obvious. Often, an alcoholic will not admit that there is a problem. This could be due to denial, or a true belief no problem exists. Generally speaking, the last person to realize that there is a problem is the alcoholic. He or she will likely deny the existence of a problem until irreparable damage is done. This is why the symptoms of alcoholism are important to recognize.
After the individual is no longer drinking and has passed through withdrawal, the next steps involve helping the individual avoid relapsing and a return to drinking. This phase of treatment is referred to as rehabilitation. It can continue for a lifetime. Many programs incorporate the family into rehabilitation therapy, because the family has likely been severely affected by the patient's drinking. Some therapists believe that family members, in an effort to deal with their loved one's drinking problem, develop patterns of behavior that unintentionally support or enable the patient's drinking. This situation is referred to as co-dependence. These patterns should addressed in order to help successfully treat a person's alcoholism.
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.
Naltrexone is a competitive antagonist for opioid receptors, effectively blocking the effects of endorphins and opioids. Naltrexone is used to decrease cravings for alcohol and encourage abstinence. Alcohol causes the body to release endorphins, which in turn release dopamine and activate the reward pathways; hence in the body reduces the pleasurable effects from consuming alcohol.[136] Evidence supports a reduced risk of relapse among alcohol-dependent persons and a decrease in excessive drinking.[135] Nalmefene also appears effective and works in a similar manner.[135]
The World Health Organization estimates that as of 2010 there were 208 million people with alcoholism worldwide (4.1% of the population over 15 years of age).[9][10] In the United States, about 17 million (7%) of adults and 0.7 million (2.8%) of those age 12 to 17 years of age are affected.[11] It is more common among males and young adults, becoming less common in middle and old age.[3] It is the least common in Africa, at 1.1%, and has the highest rates in Eastern Europe, at 11%.[3] Alcoholism directly resulted in 139,000 deaths in 2013, up from 112,000 deaths in 1990.[21] A total of 3.3 million deaths (5.9% of all deaths) are believed to be due to alcohol.[11] It often reduces a person's life expectancy by around ten years.[22] In the United States, it resulted in economic costs of $224 billion USD in 2006.[11] Many terms, some insulting and others informal, have been used to refer to people affected by alcoholism; the expressions include tippler, drunkard, dipsomaniac and souse.[23] In 1979, the World Health Organization discouraged the use of "alcoholism" due to its inexact meaning, preferring "alcohol dependence syndrome".[24]
Detoxification begins 4–6 hours after the last consumption of alcohol and lasts for 5–7 days. In this period, diazepam is administered every six hours to control the detoxification process and withdrawal symptoms. While detoxification often occurs in hospitals, some people undergo detoxification in their homes. However, patients should not consider undergoing detoxification at home if they have suicidal feelings, do not have friends and family to support them, or have experienced severe withdrawal symptoms before.

Excessive alcohol consumption is correlated with increased risk of stroke, liver disease, and decreased life expectancy. In fact, binge drinking during only the weekends is still enough to damage the liver, studies show, and moderate drinking interferes with sleep quality by interrupting circadian rhythms and REM sleep. However, a number of different treatment options are available to address alcoholic dysfunction.
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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.
People who drink too much are at an increased risk of ulcers, digestive problems, low hormone levels, and several cancers, including esophageal, stomach, colon, liver, mouth, and breast cancers. People who drink too much may induce a mood disorder, like anxiety or depression, or they may trigger a seizure disorder due to changes to the GABA system in the brain.
While Wilson and Smith credited their sobriety to working with alcoholics under the auspices of the Oxford Group, a Group associate pastor sermonized against Wilson and his alcoholic Groupers for forming a "secret, ashamed sub-group" engaged in "divergent works".[19] By 1937, Wilson separated from the Oxford Group. AA Historian Ernest Kurtz described the split:[19]
At the end of an intervention, the stage is set for entry into addiction treatment programs. There are many different options out there. Some facilities, for example, offer inpatient treatment for addiction. These programs allow people to step away from their day-to-day concerns and tackle an addiction around the clock, every single day. For some people, that tight focus is an ideal setup for healing. But outpatient centers can be ideal for those who want to stay at home, surrounded by family, while they work on addictions to alcohol. It’s a personal decision that families can make in consultation with the person who needs help.
At secular meetings there is generally much more acceptance of medication-assisted recovery, much less emphasis on deficits in "moral character," and no prayer.  The focus is present-centered, avoiding "war stories," and pragmatic:  "how am I staying sober today?  What tools am I using?" Participants are also generally not required to label themselves as addicts or alcoholics, which can be refreshing for many people new to recovery.  In LifeRing, "crosstalk" is a key element of meetings, so folks in recovery are sharing their strategies for success.

Most Twelve Step participants view addiction as a lifelong disease and see the Twelve Steps as their new design for living. When people whose lives have been affected by addiction work the Twelve Steps, they can better sort out the things which they have no control over, and the things for which they are responsible. Group meetings offer a safe place to share one's experience, strength and hope, and to receive support and fellowship.


The term “self-help” is often used to describe AA groups, but it is somewhat of a misnomer: it isn’t “professional help,” but it is more about listening and accepting guidance from a peer or mentor than it is about using “self” to move beyond active addiction. And while Twelve-Step approaches accept that addiction is a disease and isn’t simply a sign of “moral weakness,” there is a focus on values and morals in Twelve-Step Recovery, as the individual is encouraged to engage in a process of taking a “moral inventory” of one’s life and past actions in preparation for “making amends” to others, as indicated, possible, and appropriate.
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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When it comes to maintaining long-term sobriety outside of a rehabilitation treatment program, the oldest and probably most well-known organization is Alcoholics Anonymous (AA). Founded in 1935, AA and its 12-Step Program has been the go-to for treating alcoholism for decades, with many addiction treatment centers incorporating at least some version of the 12 Steps in their own treatment therapies.
Unhealthy alcohol use includes any alcohol use that puts your health or safety at risk or causes other alcohol-related problems. It also includes binge drinking — a pattern of drinking where a male consumes five or more drinks within two hours or a female downs at least four drinks within two hours. Binge drinking causes significant health and safety risks.
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:

Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism. The only requirement for membership is a desire to stop drinking. There are no dues or fees for AA membership; we are self-supporting through our own contributions. AA is not allied with any sect, denomination, politics, organization or institution; does not wish to engage in any controversy, neither endorses nor opposes any causes. Our primary purpose is to stay sober and help other alcoholics to achieve sobriety.
FAS is the leading cause of mental retardation in the United States. One to two of every 1,000 infants born in the United States are afflicted with FAS. The incidence of FAS in children whose mothers drink heavily is 4% much higher than the rate in the general population. Research studies that have followed infants with FAS and FAEs across time have found that many of these children continue to have cognitive difficulties (e.g., lower IQ scores, more learning problems, poorer short-term memory functioning) and behavioral problems (e.g., high impulsivity, high activity level) into childhood and adolescence.

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.’

Information provided is for the purpose of locating meetings of Alcoholics Anonymous and to procure information about A.A. in Southern California. No other use is authorized and printing is prohibited. Groups listed in the meeting directory are not funded or managed by Los Angeles Central Office. Groups are registered at their request and listed because they are organized in alignment with the guidelines to list a meeting in our directory and they attest they receive no support from outside their group . That we list a group in our directory does not constitute or imply Los Angeles Central Office approves or endorses a group's approach to or practice of the A.A. program of recovery. Each group is autonomous, Los Angeles Central Office does not govern.
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Moderate alcohol consumption appears to increase the risk of breast cancer in women. Total mortality is reduced with moderate alcohol consumption but not with heavy alcohol consumption; the cardiovascular benefit is offset by cirrhosis, cancer, and injuries. The amount of alcohol associated with the lowest mortality appears to be 2 drinks per day in men and 1 drink or fewer per day in women. Moderate alcohol consumption reduces the risk of developing diabetes, but heavy alcohol consumption may increase the risk. The cardiovascular benefit becomes important in men older than 40 years and in women older than 50 years. The risk of hypertension is increased with 3 or more drinks daily.

AA has remained mostly unchanged since it was founded. Obviously, the world is not the same as it was in 1935, as well as addiction, how we see it, and how we treat it. While newer sober support programs like SMART Recovery make it a point to keep up with the latest in the science of recovery treatment, AA and its 12 Steps have relied on the same “one-size-fits-all” techniques for almost 80 years, techniques that may no longer be as effective in today’s world.


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.

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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