Given the malnutrition that many alcoholics suffer from, gradual correction of that condition is also important, both to prevent or correct the consequences of malnutrition (like low thiamine level) and to prevent the potential results of correcting nutrition problems too rapidly. One example of the latter is that people with chronic alcohol-induced low sodium levels in the bloodstream (hyponatremia) are at risk for severe neurological problems due to a loss of the outer, insulating covering of nerve cells in parts of the brain (central pontine myelinolysis) if low sodium levels are corrected too rapidly.
Some of the divide between 12-Step recovery and academic addiction medicine came about because of resistance by some AA members to the use of any pharmaceuticals whatsoever. Newcomers were told to abandon any and all medications. While this attitude is receding, stories of members with advanced cancer refusing opiates are still told with admiration in meetings.
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.
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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This inventory of self is meant to be comprehensive, searching, and fearless. This does not mean that it is without fear, but that individuals are encouraged to push past their fears and be honest with listing their shortcomings. Writing lists is often an important part of Step 4 as individuals are called to cite incidents, thoughts, feelings, and past experiences that may be difficult to think about.
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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:
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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.
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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.
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.
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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.
The World Health Organization, the European Union and other regional bodies, national governments and parliaments have formed alcohol policies in order to reduce the harm of alcoholism. Targeting adolescents and young adults is regarded as an important step to reduce the harm of alcohol abuse. Increasing the age at which licit drugs of abuse such as alcohol can be purchased, the banning or restricting advertising of alcohol has been recommended as additional ways of reducing the harm of alcohol dependence and abuse. Credible, evidence based educational campaigns in the mass media about the consequences of alcohol abuse have been recommended. Guidelines for parents to prevent alcohol abuse amongst adolescents, and for helping young people with mental health problems have also been suggested.
Choosing to seek help for an alcohol addiction is one of the biggest decisions you will face. There are different forms of treatment available based on frequency and severity of alcohol abuse. Recovering from alcohol addiction is a process that continues long after rehab. It takes commitment to practice and apply the techniques you learn in rehab, counseling, support groups and other types of therapy.
AA is the most widely available 12-Step program, and meeting times and locations are easily found on the Internet. Our Continuum of Care staff provides recommendations for solution-based meetings with a solid foundation of support. At Origins Behavioral HealthCare, we familiarize our patients with 12-Step meetings during their stay and connect them with 12-Step resources in their own communities.
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We have found in clinical treatment that the 12-Step philosophy is a vital part of permanent sobriety. When a person maintains a 12-Step practice, including getting a sponsor and working with others, recovery is about more than relapse prevention – it is a pathway to an existence that is happy, joyous, and free. The 12-Step program a gateway into longterm recovery. By focusing attention on the 12-Steps, we set our patients up for long-term success. We engage patients in this paradigm because:
Prior to entering any inpatient or outpatient rehabilitation program for alcohol use disorder, the possibility that the person with this disorder could suffer from physical symptoms of alcohol withdrawal needs to be addressed. People who have a pattern of extensive alcohol abuse are at risk for developing a potentially fatal set of withdrawal symptoms (delirium tremens or DTs) that may include irregular heartbeat, sweating, high fever, shaking/tremors, hallucinations, and even fatal seizures, three days after withdrawal symptoms begin. Those individuals will need to enter a detoxification (detox) program that includes the use of close medical support, monitoring, and prescription of medications like chlordiazepoxide (Librium) or clonazepam (Klonopin) to help prevent and ease the symptoms of alcohol withdrawal.
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One review of AA warned of detrimental iatrogenic effects of twelve-step philosophy and concluded that AA uses many methods that are also used by cults. A subsequent study concluded, however, that AA's program bore little resemblance to religious cults because the techniques used appeared beneficial. Another study found that the AA program's focus on admission of having a problem increases deviant stigma and strips members of their previous cultural identity, replacing it with the deviant identity. A survey of group members, however, found they had a bicultural identity and saw AA's program as a complement to their other national, ethnic, and religious cultures.
AA describes alcoholism as an illness that involves a physical allergy:28 (where "allergy" has a different meaning than that used in modern medicine.) and a mental obsession.:23 The doctor and addiction specialist Dr. William D. Silkworth M.D. writes on behalf of AA that "Alcoholics suffer from a "(physical) craving beyond mental control".:XXVI A 1960 study by E. Morton Jellinek is considered the foundation of the modern disease theory of alcoholism. Jellinek's definition restricted the use of the word alcoholism to those showing a particular natural history. The modern medical definition of alcoholism has been revised numerous times since then. The American Medical Association uses the word alcoholism to refer to a particular chronic primary disease.
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Because denial is common, you may not feel like you have a problem with drinking. You might not recognize how much you drink or how many problems in your life are related to alcohol use. Listen to relatives, friends or co-workers when they ask you to examine your drinking habits or to seek help. Consider talking with someone who has had a problem drinking, but has stopped.
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Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections.
Copyright © 2018 by Alcoholics Anonymous World Services, Inc. All rights reserved. This is the official Website of the General Service Office (G.S.O.) of Alcoholics Anonymous. Videos or graphic images may not be downloaded, copied or duplicated without the express written permission of Alcoholics Anonymous World Services, Inc. The “Blue People” graphic is a trademark of Alcoholics Anonymous World Services, Inc. All rights reserved.
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Many start their addiction recovery process with a period of detoxification (detox), where the body rids itself of the toxic influence of drugs and/or alcohol. Detox allows the body to restore itself to a stable starting point from which substance abuse treatment efforts may more effectively begin. While detox programs vary, medical detox programs may utilize certain medications to manage withdrawal, when applicable, and otherwise facilitate this early recovery step.1
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Received income in an amount equal to or greater than $250 from: Blue Cross Blue Shield Federal Employee Program
Received royalty from Lippincott Williams & Wilkins for book editor; Received grant/research funds from National Alliance for Research in Schizophrenia and Depression for independent contractor; Received consulting fee from Blue Cross Blue Shield Association for consulting. for: Received book royalty from American Psychiatric Publishing Inc.
Topiramate, a derivative of the naturally occurring sugar monosaccharide D-fructose, has been found effective in helping alcoholics quit or cut back on the amount they drink. Evidence suggests that topiramate antagonizes excitatory glutamate receptors, inhibits dopamine release, and enhances inhibitory gamma-aminobutyric acid function. A 2008 review of the effectiveness of topiramate concluded that the results of published trials are promising, however, as of 2008, data was insufficient to support using topiramate in conjunction with brief weekly compliance counseling as a first-line agent for alcohol dependence. A 2010 review found that topiramate may be superior to existing alcohol pharmacotherapeutic options. Topiramate effectively reduces craving and alcohol withdrawal severity as well as improving quality-of-life-ratings.
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:
I am appalled that a book written by two extremely disturbed privileged white males who lived in 1930s Jim Crow era America is still the "treatment " standard for addiction. AA has been ruled a religious organization by several federal circuit courts, and it is impossible to work the program without a belief in a God who magically answers prayers for the addict who prays hard enough. It is not possible to turn one's will and life over to the care of Nature, or a Doorknob, or the Group of Drunks. One is guided through the steps by someone who is only qualified by the amount of sober time they claim to have. 12 step groups are especially dangerous for survivors of rape, abuse, and other trauma when they are tasked to examine "their part" in the crimes committed against them, not to mention having to defend themselves against the unethical yet joked about 13th Step.
The twelve steps of the program are listed above and on the steps page in generic form. Other groups who have adopted the 12 steps to address their own particular addictive or dysfunctional behavior have similar ideas, usually with only minor variations. These steps are meant to be worked sequentially as a process of getting rid of addictive behaviors and should result in a growth in freedom and happiness, as outlined in the Promises. The general governing approach for A.A. groups was originally laid out in the Twelve Traditions, and they remain the guiding principles for most 12 step groups today.