AA describes alcoholism as an illness that involves a physical allergy[107]:28 (where "allergy" has a different meaning than that used in modern medicine.[108]) and a mental obsession.[107]:23[109] 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".[107]:XXVI A 1960 study by E. Morton Jellinek is considered the foundation of the modern disease theory of alcoholism.[110] 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.[111]
Alcohol use disorder (which includes a level that's sometimes called alcoholism) is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking.
ASAM’s definition of addiction document concludes that “treatment of addition saves lives,” and it points out that “in some cases of addiction, medication management can improve treatment outcomes,” and that “in most cases of addiction, the integration of psychosocial rehabilitation and ongoing care with evidence-based pharmacological therapy provides the best results.” Much of “what’s new” in the professional treatment of addiction in the past two decades has involved new pharmacological therapies that have been brought into the marketplace. But psychosocial interventions, which are “not as new,” are the foundation of the treatment most persons receive when they seek assistance from an addiction treatment professional or agency.
People going through mild withdrawal are monitored to make sure that more severe symptoms do not develop. Medications usually are unnecessary. Treatment of a patient suffering more severe effects of withdrawal may require sedative medications to relieve the discomfort of withdrawal and to avoid the potentially life-threatening complications of high blood pressure, fast heart rate, and seizures. Benzodiazepine drugs may be helpful in those patients experiencing hallucinations. If the patient vomits for an extended period, fluids may need to be given through a vein (intravenously, IV). Thiamine (a vitamin) is often included in the fluids, because thiamine levels are often very low in alcohol-dependent patients, and deficiency of thiamine is responsible for the Wernicke-Korsakoff syndrome.
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.

Drinking too much damages the circulation by causing consistent high blood pressure. It also causes cardiomyopathy, or drooping of the heart muscle, which reduces the ability of the heart to effectively pump blood throughout the body. Nutrient deficiency can lead to anemia. Other problems with blood can lead to clots, causing strokes or heart attacks.
Alcohol intoxication results as the amount of alcohol in your bloodstream increases. The higher the blood alcohol concentration is, the more impaired you become. Alcohol intoxication causes behavior problems and mental changes. These may include inappropriate behavior, unstable moods, impaired judgment, slurred speech, impaired attention or memory, and poor coordination. You can also have periods called "blackouts," where you don't remember events. Very high blood alcohol levels can lead to coma or even death.
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.


Alcohol affects virtually every organ system in the body and, in high doses, can cause coma and death. It affects several neurotransmitter systems in the brain, including opiates, GABA, glutamate, serotonin, and dopamine. Increased opiate levels help explain the euphoric effect of alcohol, while its effects on GABA cause anxiolytic and sedative effects.
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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.
The Twelve Traditions encourage members to practice the spiritual principle of anonymity in the public media and members are also asked to respect each other's confidentiality.[39] This is a group norm,[39] however, and not legally mandated; there are no legal consequences to discourage those attending twelve-step groups from revealing information disclosed during meetings.[40] Statutes on group therapy do not encompass those associations that lack a professional therapist or clergyman to whom confidentiality and privilege might apply. Professionals and paraprofessionals who refer patients to these groups, to avoid both civil liability and licensure problems, have been advised that they should alert their patients that, at any time, their statements made in meetings may be disclosed.[40]

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A cross-sectional survey of substance-misuse treatment providers in the West Midlands found fewer than 10% integrated twelve-step methods in their practice and only a third felt their consumers were suited for Alcoholics Anonymous or Narcotics Anonymous membership. Less than half were likely to recommend self-help groups to their clients. Providers with nursing qualifications were more likely to make such referrals than those without them. A statistically significant correlation was found between providers' self-reported level of spirituality and their likelihood of recommending AA or NA.[87]

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United States courts have ruled that inmates, parolees, and probationers cannot be ordered to attend AA. Though AA itself was not deemed a religion, it was ruled that it contained enough religious components (variously described in Griffin v. Coughlin below as, inter alia, "religion", "religious activity", "religious exercise") to make coerced attendance at AA meetings a violation of the Establishment Clause of the First Amendment of the constitution.[82][83] In 2007, the Ninth Circuit of the U.S. Court of Appeals stated that a parolee who was ordered to attend AA had standing to sue his parole office.[84][85]
Our program focuses on the whole child, with the ultimate goals of abstinence, improved mental health and better family relationships. Our intensive outpatient program (IOP) is the only one in North Texas that offers this level of care specifically for teens. We incorporate medication management, cognitive behavioral therapy, motivational enhancement therapy, group and individual therapy, and family engagement to help your child gain valuable coping skills to end drug abuse, as well as manage emotional or psychological problems.
Based on this study, those who abstain altogether from substances – as advised in the 12-Step model – have better mental health outcomes than those who don’t abstain. The 12-Step model gives people a framework from which to surrender their addiction, process their experience, and move forward into new patterns. As described in an article on Psych Central called Recovery Using the 12 Steps, following the model assists an individual by helping build the following mental and emotional transformative practices and tools:
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.
The National Survey on Drug Use and Health (NSDUH) for 2015 found that 86.4 percent of the population ages 18 and older consumed alcohol at some point in their lives; about 56 percent reported that they drank in the past month, indicating a pattern of regular alcohol consumption. Alcohol is legal in the US for people ages 21 and older to consume, but as an intoxicating substance, it is dangerous and can lead to addiction. The NSDUH also found that 26.9 percent of the population engaged in binge drinking in the past month (more than four drinks within two hours), and 7 percent reported that they drank heavily in the past month (more than two drinks per day). These behaviors indicate higher risk for AUD.
People who struggle with AUD may begin drinking because of social situations or anxiety about being around people; however, signs of a potential AUD include changes in friend groups, especially geared toward friends who drink versus those who don’t, and avoiding social situations to drink instead. Those who have a family member who struggles with AUD are more likely to suffer from high stress, emotional and physical abuse, and mental health or substance abuse problems later in life.

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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AA's program extends beyond abstaining from alcohol.[33] Its goal is to effect enough change in the alcoholic's thinking "to bring about recovery from alcoholism"[34] through "an entire psychic change," or spiritual awakening.[35] A spiritual awakening is meant to be achieved by taking the Twelve Steps,[36] and sobriety is furthered by volunteering for AA[37] and regular AA meeting attendance[38] or contact with AA members.[36] Members are encouraged to find an experienced fellow alcoholic, called a sponsor, to help them understand and follow the AA program. The sponsor should preferably have experience of all twelve of the steps, be the same sex as the sponsored person, and refrain from imposing personal views on the sponsored person.[37] Following the helper therapy principle, sponsors in AA may benefit from their relationship with their charges, as "helping behaviors" correlate with increased abstinence and lower probabilities of binge drinking.[39]

Serious social problems arise from alcoholism; these dilemmas are caused by the pathological changes in the brain and the intoxicating effects of alcohol.[40][55] Alcohol abuse is associated with an increased risk of committing criminal offences, including child abuse, domestic violence, rape, burglary and assault.[56] Alcoholism is associated with loss of employment,[57] which can lead to financial problems. Drinking at inappropriate times and behavior caused by reduced judgment can lead to legal consequences, such as criminal charges for drunk driving[58] or public disorder, or civil penalties for tortious behavior, and may lead to a criminal sentence. An alcoholic's behavior and mental impairment while drunk can profoundly affect those surrounding him and lead to isolation from family and friends. This isolation can lead to marital conflict and divorce, or contribute to domestic violence. Alcoholism can also lead to child neglect, with subsequent lasting damage to the emotional development of the alcoholic's children.[59] For this reason, children of alcoholic parents can develop a number of emotional problems. For example, they can become afraid of their parents, because of their unstable mood behaviors. In addition, they can develop considerable amount of shame over their inadequacy to liberate their parents from alcoholism. As a result of this failure, they develop wretched self-images, which can lead to depression.[60]

Alcoholics Anonymous (AA) is an international mutual aid fellowship[1] whose stated purpose is to enable its members to "stay sober and help other alcoholics achieve sobriety."[1][2][3] It was founded in 1935 by Bill Wilson and Bob Smith in Akron, Ohio. With other early members, Bill Wilson and Bob Smith developed AA's Twelve Step program of spiritual and character development. AA's initial Twelve Traditions were introduced in 1946 to help the fellowship be stable and unified while disengaged from "outside issues" and influences.
There are few medications that are considered effective in treating moderate to severe alcohol use disorder. Naltrexone (Trexan, Revia, or Vivitrol) has been found effective in managing this illness. It is the most frequently used medication in treating alcohol use disorder . It decreases the alcoholic's cravings for alcohol by blocking the body's euphoric ("high") response to it. Naltrexone is either taken by mouth on a daily basis or through monthly injections. Disulfiram (Antabuse) is prescribed for about 9% of alcoholics. It decreases the alcoholic's craving for the substance by producing a negative reaction to drinking. Acamprosate (Campral) works by decreasing cravings for alcohol in those who have stopped drinking. Ondansetron (Zofran) has been found to be effective in treating alcohol use disorder in people whose problem drinking began before they were 25 years old. None of these medications have been specifically approved to treat alcoholism in people less than 18 years of age. Baclofen (Lioresal) has been found to be a potentially effective treatment to decrease alcohol cravings and withdrawal symptoms. Some research indicates that psychiatric medications like lithium (Eskalith, Lithobid) and sertraline (Zoloft) may be useful in decreasing alcohol use in people who have another mental health disorder in addition to alcohol use disorder.

Drinking enough to cause a blood alcohol concentration (BAC) of 0.03–0.12% typically causes an overall improvement in mood and possible euphoria (a "happy" feeling), increased self-confidence and sociability, decreased anxiety, a flushed, red appearance in the face and impaired judgment and fine muscle coordination. A BAC of 0.09% to 0.25% causes lethargy, sedation, balance problems and blurred vision. A BAC of 0.18% to 0.30% causes profound confusion, impaired speech (e.g. slurred speech), staggering, dizziness and vomiting. A BAC from 0.25% to 0.40% causes stupor, unconsciousness, anterograde amnesia, vomiting (death may occur due to inhalation of vomit (pulmonary aspiration) while unconscious) and respiratory depression (potentially life-threatening). A BAC from 0.35% to 0.80% causes a coma (unconsciousness), life-threatening respiratory depression and possibly fatal alcohol poisoning. With all alcoholic beverages, drinking while driving, operating an aircraft or heavy machinery increases the risk of an accident; many countries have penalties for drunk driving.

Alcohol use disorder (which includes a level that's sometimes called alcoholism) is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking.


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:
Steps 1-9 set up a strong spiritual foundation and a new way of life without drugs and alcohol. With Step 10, individuals are seeking daily accountability for their actions. Recovery is ongoing, and individuals continue to examine how their thoughts, words, behaviors, and actions impact daily life and how to keep themselves in line with their faith and God’s will. Individuals are asked to take inventory every day and immediately correct any wrongs that are apparent. This may be accomplished by keeping a journal or devising another method of self-examination each evening, for instance. By understanding how certain things may make a person feel and therefore act, individuals can become more aware of themselves and their behaviors. Step 10 involves personal reflections and a kind of spot-checking to keep oneself balanced emotionally.

Diabetes: There is a high risk of developing diabetes type 2, and people with diabetes have a high chance of complications if they regularly consume more alcohol than is recommended. Alcohol prevents the release of glucose from the liver, resulting in hypoglycemia. If a person with diabetes is already using insulin to lower their blood sugar levels, hypoglycemia could have serious consequences.
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.

A complex mixture of genetic and environmental factors influences the risk of the development of alcoholism.[69] Genes that influence the metabolism of alcohol also influence the risk of alcoholism, and may be indicated by a family history of alcoholism.[70] One paper has found that alcohol use at an early age may influence the expression of genes which increase the risk of alcohol dependence.[71] Individuals who have a genetic disposition to alcoholism are also more likely to begin drinking at an earlier age than average.[72] Also, a younger age of onset of drinking is associated with an increased risk of the development of alcoholism,[72] and about 40 percent of alcoholics will drink excessively by their late adolescence. It is not entirely clear whether this association is causal, and some researchers have been known to disagree with this view.[73]


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]
Alcohol addiction is a gradual process that occurs within the human brain. When alcohol is consumed, it alters the levels of certain chemicals in the brain, mainly gamma-aminobutyric acid, or GABA, and dopamine. GABA monitors and controls a person's impulsivity, and frequently drinking copious amounts of alcohol alters this chemical's production, often making people more impulsive and less aware of what they are doing. Dopamine is one of the chemicals in the brain that, when released, causes pleasurable feelings like happiness, joy, or even euphoria. As more and more alcohol is consumed on a frequent basis, the brain begins to grow accustomed to this chemical imbalance. If an alcoholic tries to stop drinking, then the brain is deprived of the alcohol's effect, which results in unpleasant withdrawal symptoms such as sweating, shaking, tremors, or even hallucination.
A complex mixture of genetic and environmental factors influences the risk of the development of alcoholism.[69] Genes that influence the metabolism of alcohol also influence the risk of alcoholism, and may be indicated by a family history of alcoholism.[70] One paper has found that alcohol use at an early age may influence the expression of genes which increase the risk of alcohol dependence.[71] Individuals who have a genetic disposition to alcoholism are also more likely to begin drinking at an earlier age than average.[72] Also, a younger age of onset of drinking is associated with an increased risk of the development of alcoholism,[72] and about 40 percent of alcoholics will drink excessively by their late adolescence. It is not entirely clear whether this association is causal, and some researchers have been known to disagree with this view.[73]

The same survey showed that AA received 32% of its membership from other members, another 32% from treatment facilities, 30% were self-motivated to attend AA, 12% of its membership from court–ordered attendance, and only 1% of AA members decided to join based on information obtained from the Internet. People taking the survey were allowed to select multiple answers for what motivated them to join AA.[64]
While 12-Step facilitation programs don’t necessarily follow the steps, they promote the use of a 12-Step methodology, in the hope that clients will move to a 12-Step program after rehab to help maintain sobriety. In addition, certain treatment centers base their model for service around some of the ideas promoted through the 12-Step program. These centers can offer research-based services and promote a more scientific understanding of addiction treatment, but they incorporate some of the spiritual, psychological, and practical practices that the 12-Step program promotes. This results in an encompassing model of care designed to support clients through rehab and to give tools that they can use after treatment to maintain their recovery for the long-term.
Support groups provide people with understanding peers and ongoing support, in church basements, community centers, and public facilities scattered all across the country. Here, people can come together to discuss addiction’s difficulties, and they can meet with other addicted people to gain support and insight. Alumni groups are similar, in that they link peers together to discuss addiction, but these groups contain people who all worked within the same facility for help.
Gastrointestinal system. Alcohol causes loosening of the muscular ring that prevents the stomach's contents from re-entering the esophagus. Acid from the stomach flows backward into the esophagus(acid reflux), burning those tissues, and causing pain and bleeding. Inflammation of the stomach also can result in ulcers, bleeding, pain, and a decreased desire to eat. A major cause of severe, uncontrollable bleeding (hemorrhage) in an people with alcoholism is the development of enlarged (dilated) blood vessels within the esophagus, which are called esophageal varices. These varices develop in response to liver disease, and are extremely prone to bursting and hemorrhaging. Hemorrhaging varices are often fatal. Diarrhea is a common symptom, due to alcohol's effect on the pancreas. In addition, inflammation of the pancreas (pancreatitis) is a serious and painful problem in many people who abuse alcohol. Throughout the intestinal tract, alcohol interferes with the absorption of nutrients, which can result in a malnourished state. Alcohol is broken down (metabolized) in the liver and interferes with a number of important chemical reactions that occur in that organ. The liver begins to enlarge and fill with fat (fatty liver). Fibrous scar tissue interferes with the liver's normal structure and function (cirrhosis), and the liver may become inflamed (hepatitis).
For every addiction, there are recovery programs and support groups to help those looking to kick their habits. Generally speaking, these programs can be grouped into one of two big buckets: those following a 12-step approach, and those that do not. Which you choose will be a matter of personal preference and – to some – whether you believe in a higher power, which 12-step programs typically promote. Either way, these resources can help you stay happy, healthy and social after your course of recovery from drug addiction or alcoholism treatment.
An alcohol use disorder can range from mild to severe. Mild patterns may develop into more serious complications. Early treatment and intervention can help people with alcohol use disorder. While it’s up to the person to willingly start their sobriety journey, you can also help. Read on for some steps you can take to help your friend, family member, or loved one.

ASAM’s definition of addiction document concludes that “treatment of addition saves lives,” and it points out that “in some cases of addiction, medication management can improve treatment outcomes,” and that “in most cases of addiction, the integration of psychosocial rehabilitation and ongoing care with evidence-based pharmacological therapy provides the best results.” Much of “what’s new” in the professional treatment of addiction in the past two decades has involved new pharmacological therapies that have been brought into the marketplace. But psychosocial interventions, which are “not as new,” are the foundation of the treatment most persons receive when they seek assistance from an addiction treatment professional or agency.

I am surprised that along with the detailed description of the utility of CBT in aiding recovery from addictions that no mention was made of the SMART Recovery Self-Help Network. The SMART Recovery Program (Self-Management And Recovery Training) which is grounded in CBT along with several other evidence-based tools. There are about 1,500 free SMART Recovery meetings available in communities & prisons around the world. smartrecovery.org is an interactive website which receives about 120,000 unique visitors per month and has over 135,000 registrants. 30 online SMART Recovery meetings per week are available online. 160 SMART facilitators per month are being trained via an interactive online program; many are professionals. About 1/3 of regular SMART Recovery participants also attend 12-Step meetings, at least occasionally, There have been >25,000 SMART meetings in MA where 2/3 of participants are professionally referred and the majority of meetings occur in hospitals. SMART Recovery has no objection to appropriate, medically-prescribed pharmaceuticals being used in the course of recovery from an addiction.

Though it can feel as if you are hiding a unique or embarrassing problem, the fact is that families across the country are experiencing the exact same thing you are. You are not alone with the disease, and you will not be alone as you seek the treatment necessary to begin to heal and start a new life in recovery. Alcohol.org is available to provide education and support all along the way.
At least two thirds of all alcohol consumed by Australians is consumed at levels which present either long or short term health risks. Some 10% of Australian men and women consume more than the average number of drinks recommended in the Australian guidelines. While a smaller proportion of Indigenous Australians drink than non-Indigenous Australians, a higher proportion of Indigenous Australians (20%) exceed the recommended average daily drinking limits than non-Indigenous Australians.

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.
Demographic preferences related to the addicts' drug of choice has led to the creation of Cocaine Anonymous, Crystal Meth Anonymous and Marijuana Anonymous. Behavioral issues such as compulsion for, and/or addiction to, gambling, crime, food, sex, hoarding, debting and work are addressed in fellowships such as Gamblers Anonymous, Overeaters Anonymous, Sexaholics Anonymous and Debtors Anonymous.
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