Five stages of alcohol and substance abuse disorders have been identified. The first stage is described as having access to alcohol rather than use of alcohol. In that stage, minimizing the risk factors that make a person more vulnerable to using alcohol are an issue. The second stage of alcohol use ranges from experimentation or occasional use to regular weekly use of alcohol. This or any of the more severe stages of alcoholism may involve binge drinking. The third stage is characterized by individuals further increasing the frequency of alcohol use and/or using the substance on a regular basis. This stage may also include either buying or stealing to get alcohol. In the fourth stage of alcohol use, users have established regular alcohol consumption, have become preoccupied with getting intoxicated ("high") and have developed problems in their social, educational, vocational, or family life as a result of using the substance. The final and most serious fifth stage of alcohol use is defined by the person only feeling normal when they are using alcohol. During this stage, risk-taking behaviors like stealing, engaging in physical fights, or driving while intoxicated increase, and they become most vulnerable to having suicidal thoughts.
A twelve-step program is a set of guiding principles outlining a course of action for recovery from addiction, compulsion, or other behavioral problems. Originally proposed by Alcoholics Anonymous (AA) as a method of recovery from alcoholism,[1] the Twelve Steps were first published in the 1939 book Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism.[2] The method was adapted and became the foundation of other twelve-step programs.
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:
Once the person has safely detoxed from alcohol, a comprehensive rehabilitation program is the best step. These programs offer intensive therapy to help clients understand the root causes of their addiction and change their behaviors toward intoxicating substances. The National Institute on Drug Abuse (NIDA) recommends remaining in a rehabilitation program for 90 days, or three months.
Are you ready for some alarming information? A study published by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in 2006 included the analysis of 43,000 people. The researchers determined that waiting until age 21 to drink places the average person at a 9% chance of developing alcoholism. However, start drinking at age 14 or sooner, (which plenty of kids do), and that shoots up to a 47% chance. “In general, each additional year earlier than 21 that a respondent began to drink, the greater the odds that he or she would develop alcohol dependence at some point in life,” says the study.
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.
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.
Alcoholics Anonymous became so well-known that Wilson and other early members of the group were invited to a dinner hosted by John D. Rockefeller, Jr., the patriarch of one of the most powerful families in American history. Despite Wilson’s requests, Rockefeller refused to finance AA, believing that the money would only corrupt the noble ambitions of the group. Instead, Rockefeller felt that the organization’s own characteristics – the personal testimonies, the word-of-mouth, and the anonymity – were key to its success and longevity.
Wilson took this to heart, coming up with additional points to safeguard the integrity and future of his group. To that effect, he wrote that every individual AA group should decline outside contributions and ought to be able to fully support itself. Alcoholics Anonymous was never to be a professional organization; “the only requirement for AA membership,” he wrote, “is a desire to stop drinking.” Above all, groups had to prize anonymity; Wilson wrote that it is “the spiritual foundation of all our traditions,” and that the sacrifice of identity would help members “place principles before personalities.”
Severe acute withdrawal symptoms such as delirium tremens and seizures rarely occur after 1-week post cessation of alcohol. The acute withdrawal phase can be defined as lasting between one and three weeks. In the period of 3–6 weeks following cessation increased anxiety, depression, as well as sleep disturbance, is common;[65] fatigue and tension can persist for up to 5 weeks as part of the post-acute withdrawal syndrome; about a quarter of alcoholics experience anxiety and depression for up to 2 years. These post-acute withdrawal symptoms have also been demonstrated in animal models of alcohol dependence and withdrawal.[66] A kindling effect also occurs in alcoholics whereby each subsequent withdrawal syndrome is more severe than the previous withdrawal episode; this is due to neuroadaptations which occur as a result of periods of abstinence followed by re-exposure to alcohol. Individuals who have had multiple withdrawal episodes are more likely to develop seizures and experience more severe anxiety during withdrawal from alcohol than alcohol-dependent individuals without a history of past alcohol withdrawal episodes. The kindling effect leads to persistent functional changes in brain neural circuits as well as to gene expression.[67] Kindling also results in the intensification of psychological symptoms of alcohol withdrawal.[65] There are decision tools and questionnaires which help guide physicians in evaluating alcohol withdrawal. For example, the CIWA-Ar objectifies alcohol withdrawal symptoms in order to guide therapy decisions which allows for an efficient interview while at the same time retaining clinical usefulness, validity, and reliability, ensuring proper care for withdrawal patients, who can be in danger of death.[68]
A twelve-step program is a set of guiding principles outlining a course of action for recovery from addiction, compulsion, or other behavioral problems. Originally proposed by Alcoholics Anonymous (AA) as a method of recovery from alcoholism,[1] the Twelve Steps were first published in the 1939 book Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism.[2] The method was adapted and became the foundation of other twelve-step programs.
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