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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.
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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.
Prevention must begin at a young age since the first instance of intoxication usually occurs during the teenage years. It is particularly important that teenagers who are at high risk for alcoholism-those with a family history of alcoholism, early or frequent use of alcohol, a tendency to drink to drunkenness, alcohol use that interferes with school work, a poor family environment, or a history of domestic violence -receive education about alcohol and its long-term effects. How this is best achieved, without alienating these young people and thus losing their attention, is the subject of continuing debate and study.
Recovery is an interesting concept. It implies not only improvement, but potentially remission. The term describes a process as well as a destination. And the underlying premise of recovery is that of hope--hope that a person with a potentially fatal illness can avoid a catastrophic outcome. “Recovery activities” are not professional treatment, but can promote recovery just as professional treatment can. One of the most familiar “recovery activities” engaged in by persons with addiction is participation in the activities of Alcoholics Anonymous (AA).
Other tests are sometimes used for the detection of alcohol dependence, such as the Alcohol Dependence Data Questionnaire, which is a more sensitive diagnostic test than the CAGE questionnaire. It helps distinguish a diagnosis of alcohol dependence from one of heavy alcohol use. The Michigan Alcohol Screening Test (MAST) is a screening tool for alcoholism widely used by courts to determine the appropriate sentencing for people convicted of alcohol-related offenses, driving under the influence being the most common. The Alcohol Use Disorders Identification Test (AUDIT), a screening questionnaire developed by the World Health Organization, is unique in that it has been validated in six countries and is used internationally. Like the CAGE questionnaire, it uses a simple set of questions – a high score earning a deeper investigation. The Paddington Alcohol Test (PAT) was designed to screen for alcohol-related problems amongst those attending Accident and Emergency departments. It concords well with the AUDIT questionnaire but is administered in a fifth of the time. Certain blood tests may also indicate possible alcoholism.
The alcoholic's continual craving for alcohol makes abstinence -- an important goal of treatment -- extremely difficult. The condition is also complicated by denial: Alcoholics might be reluctant to admit their excess drinking either because of denial or guilt. Another barrier to receiving care is that physicians screen only about 15% of their primary care patients for alcohol disorders.
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. 
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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.
For some individuals whose circumstances or conditions don't require a full-time, residential recovery process, outpatient recovery may be a viable recovery option. In an outpatient recovery program, individuals undergo addiction rehabilitation while living at their own homes. They are able to schedule regular check-ins at a clinic or treatment center for medication and counseling on a regular basis.
During Step 8, people commonly resort to writing lists again, and this step is about forgiveness. Often, two lists are formed during this step: The first is a list of those who the person needs to forgive and the second is a list of those from whom they need to seek forgiveness. There will likely be crossover people on both lists. Individuals are encouraged to be honest and write down names of anyone who elicits strong emotions like resentment, shame, guilt, anger, fear, etc.
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.’
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Herbal treatments include milk thistle (Silybum marianum), which is thought to protect the liver against damage. Other herbs are thought to be helpful for the patient suffering through withdrawal. Some of these include lavender (Lavandula officinalis), skullcap (Scutellaria lateriflora), chamomile (Matricaria recutita), peppermint (Mentha piperita) yarrow (Achillea millefolium), and valerian (Valeriana officinalis).
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Schuckit, M. A., Smith, T. L., Danko, G. P., Trim, R., Bucholz, K. K., Edenberg, H. J., ... & Dick, D. M. (2009, May). An evaluation of the full level of response to alcohol model of heavy drinking and problems in COGA offspring. Journal of studies on alcohol and drugs, 70(3), 436-445. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670749/
As AA chapters were increasing in number during the 1930s and 1940s, the guiding principles were gradually defined as the Twelve Traditions. A singleness of purpose emerged as Tradition Five: "Each group has but one primary purpose—to carry its message to the alcoholic who still suffers". Consequently, drug addicts who do not suffer from the specifics of alcoholism involved in AA hoping for recovery technically are not welcome in "closed" meetings unless they have a desire to stop drinking alcohol.