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.
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.
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.
Fact: Alcoholism is NOT defined by what you drink, when you drink it, or even how much you drink. It’s the EFFECTS of your drinking that define a problem. If your drinking is causing problems in your home or work life, you have a drinking problem—whether you drink daily or only on the weekends, down shots of tequila or stick to wine, drink three bottles of beers a day or three bottles of whiskey.
The effects of alcoholism are far reaching. Alcohol affects every body system, causing a wide range of health problems. Problems include poor nutrition, memory disorders, difficulty with balance and walking, liver disease (including cirrhosis and hepatitis), high blood pressure, muscle weakness (including the heart), heart rhythm disturbances, anemia, clotting disorders, decreased immunity to infections, gastrointestinal inflammation and irritation, acute and chronic problems with the pancreas, low blood sugar, high blood fat content, interference with reproductive fertility, increased risk of cancer of the liver, esophagus, and breast, weakened bones, sleep disturbances, anxiety, and depression. About 20% of adults admitted to the hospital (for any reason) are alcohol dependent. Men are more than twice as likely to be alcohol dependent than women, and smokers who are alcohol dependent are much more likely to develop serious or fatal health problems associated with alcoholism.
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Prioritizing coping over healing. While AA obviously wants its members to avoid relapse and maintain sobriety, the means of doing so is heavily focused on using skills to cope with addictive behaviors rather than addressing the underlying issues that are causing them. Because of this, many people find the 12-Step program might help them stay sober, but leave them still struggling with the problems that led to becoming alcoholics in the first place.
As dependence increases, individuals are more likely to experience health and social consequences. The consumption of alcohol in moderation has health benefits for some (e.g. it reduces the risk of cardiovascular disease in older people). On the other hand, excessive alcohol consumption, especially when it is caused by alcohol dependence, is associated with an increased risk of numerous health problems. These include:
In a closed AA meeting, the only people who may attend are those who are recovering addicts (or those interested in learning more about overcoming their addiction). Open meetings allow the attendance of friends, spouses and family members. Whether you decide to go to a closed or open meeting depends exclusively on what you’re comfortable with. Some people would rather keep their recovery separate from the rest of their life. Others thrive on the support that loved ones can provide during meetings.
Addictions affect people from every walk of life. There are particular issues that make diagnosis, treatment and reentry challenging when addiction occurs in a physician, nurse, pharmacist, attorney, executive or other professional. Often there are highly developed defenses, as well as heightened senses of guilt and shame. Regulation and licensure issues can permanently threaten careers. Wyoming Recovery’s Professionals Program incorporates local recovering professionals, support groups, augmented psychological/psychiatric assessments, advocacy, and aftercare.
A medical professional can work with a person attempting to detox from alcohol to help them manage cravings and other withdrawal symptoms. A doctor can also refer their patient to addiction treatment programs and therapists, so the individual can get help overcoming their alcohol abuse issues. If there are no serious withdrawal symptoms, a doctor can recommend over-the-counter remedies to manage pain or nausea. The support of friends and family can help keep the individual focused on sobriety.
In my 30 years as an addiction counselor I've been amazed by the practically obsessive attempts to push the 12-step philosophy to the forefront of treatment methodology, and to ignore research. Does anyone remember that Bill W. once remarked that he never considered AA to be a panacea for addiction? In fact, few people know he considered the nutritional therapy of Vitamin B3 to be perhaps the most effective means of treating symptoms of depression he found closely linked to alcoholism. He wanted to be remembered more for promoting B3 therapy than AA itself. The point is, support is support, and science is science. I've never had any qualms whatsoever about my clients attending AA or NA meetings. It's their free time; they can attend or not. If my role is to teach or persuade them to go, why do I need a clinical license and a Master's Degree? Why did I need to take exams? (Which, by the way, never 'assessed' my ability as AA promoter.) I take my work more seriously than just encouraging support group concepts or involvement. I see my role alternately as providing up-to-date information about behavioral therapies, relapse prevention approaches, and being a force for connection and inspiration. We should be appalled by the slow transfer of research to practice. There's a lot more we can do for our clients, and we're not doing it. I think it's high time for the traditionalists in our field to recognize that our clients need the benefits of science, not more AA instruction and orientation.
Many newcomers who attend 12-step meetings find personal validation in the stories of other addicts. Substance abusers who have been isolated by their disease have the opportunity to relieve their pain by sharing their experiences with others. Alcoholics who have lost their jobs, families, and dignity can recover their self-respect and restore broken relationships with the help of the fellowship and the 12 steps.
Using “I” statements reduces accusation and lets you be an active participant in the discussion. It may be helpful to bring up a specific concern. You may mention when alcohol caused an unwanted effect, such as violent behavior or economic problems. Rather than saying, “You’re an alcoholic — you need to get help now,” you can say, “I love you and you’re very important to me. I’m concerned about how much you’re drinking, and it may be harming your health.”
When a service is offered (especially in a crisis), that service is expected to work. In the case of the addict, simply providing 'treatment' cannot be viewed the same way as other services. Substance abuse detox that transitions to the 12-step program requires a level of immersion on the end of the user. I used to HATE hearing 'It works if you work it'. But... it's true.
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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.
The twelve steps of alcoholics anonymous do not come from the Oxford Groups because there were twelve apostles the Oxford Groups practised six steps all of which AA adopted but also added six which had to do specifically with a non denominational or religious numinous power and the specific effects of alcohol addiction on the character on the afflicted. As many addicts -- probably many more -- have been harmed by the ignorant prescription or pharmaceuticals to people in recovery for AA as have been harmed by a lay AA sponsor telling a member that all prescriptions are bad. .
No conversation about alcoholism or substance abuse recovery is complete without mentioning Alcoholics Anonymous. The group has become synonymous with the concept of addiction rehabilitation in general, and it was instrumental in changing the conversation in how people with drinking problems came to be understood and regarded. As the science and psychology of addiction evolves, the role of Alcoholics Anonymous is also changing, but it remains a cornerstone of the aftercare experience.
As is true with virtually any mental health diagnosis, there is no one test that definitively indicates that someone has an alcohol-use disorder. Screening tools, including online or other tests may help identify individuals who are at risk for having a drinking problem. Therefore, health care professionals diagnose alcohol abuse or dependence by gathering comprehensive medical, family, and mental health information. The practitioner will also either perform a physical examination or request that the individual's primary care doctor perform one. The medical examination will usually include lab tests to evaluate the person's general health and to explore whether or not the individual has a medical condition that might have mental health symptoms.
When alcohol dependence is mild or moderate, health practitioners commonly provide counselling or support to change behaviour. They may recommend particular strategies for avoiding situations which involve a high risk of excessive alcohol consumption (e.g. nightclubs) or coping with stressful situations without drinking alcohol. Health professionals can help identify sources of support, and suggest strategies that will help people dependent on alcohol regulate their own consumption (e.g. by having one or two alcohol-free days per week).
Depending on the addiction type and intensity, you or someone you care about may require anything from a thirty day in-patient drug or alcohol treatment program all the way up to a 4-month or longer one. Certain drugs may allow for outpatient services while severe cases may need longer-term treatment services. However, you can find a Cheyenne treatment facility to fit just about any personal need.
Auxiliary groups such as Al-Anon and Nar-Anon, for friends and family members of alcoholics and addicts, respectively, are part of a response to treating addiction as a disease that is enabled by family systems. Adult Children of Alcoholics (ACA or ACOA) addresses the effects of growing up in an alcoholic or otherwise dysfunctional family. Co-Dependents Anonymous (CoDA) addresses compulsions related to relationships, referred to as codependency.