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, which may include social or occupational impairment and deterioration of physical health. 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) occur.
An intervention is a useful way for friends, family, and healthcare professionals to express concern for an individual’s wellbeing. This is a time to explain the harm that alcohol abuse has done to the individual’s body, mind, or social and family circles. A person struggling with AUD does not need to hit rock bottom for an intervention to be effective. If the intervention focuses on concern for the person’s health, expressing the desire that they get better, and offers help if they choose to change their behavior, it can be effective.
One review warned of detrimental iatrogenic effects of twelve-step philosophy and labeled the organizations as cults, while another review asserts that these programs bore little semblance to religious cults and that the techniques used appeared beneficial to some. Another study found that a twelve-step program's focus on self-admission of having a problem increases deviant stigma and strips members of their previous cultural identity, replacing it with the deviant identity. Another study asserts that the prior cultural identity may not be replaced entirely, but rather members found adapted a bicultural identity.
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.
With treatment, about 70% of people with alcoholism are able to decrease the number of days they consume alcohol and improve their overall health status within six months. On the other hand, most individuals who have been treated for a moderate to severe alcohol-use disorder have relapsed at least once during the first year after treatment. Those individuals seem to drink less often and lower amounts after receiving treatment compared with before treatment.
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Alcoholism often reduces a person's life expectancy by around ten years. The most common cause of death in alcoholics is from cardiovascular complications. There is a high rate of suicide in chronic alcoholics, which increases the longer a person drinks. Approximately 3–15 percent of alcoholics commit suicide, and research has found that over 50 percent of all suicides are associated with alcohol or drug dependence. This is believed to be due to alcohol causing physiological distortion of brain chemistry, as well as social isolation. Suicide is also very common in adolescent alcohol abusers, with 25 percent of suicides in adolescents being related to alcohol abuse. Among those with alcohol dependence after one year, some met the criteria for low-risk drinking, even though only 25.5 percent of the group received any treatment, with the breakdown as follows: 25 percent were found to be still dependent, 27.3 percent were in partial remission (some symptoms persist), 11.8 percent asymptomatic drinkers (consumption increases chances of relapse) and 35.9 percent were fully recovered—made up of 17.7 percent low-risk drinkers plus 18.2 percent abstainers. In contrast, however, the results of a long-term (60-year) follow-up of two groups of alcoholic men indicated that "return to controlled drinking rarely persisted for much more than a decade without relapse or evolution into abstinence." There was also "return-to-controlled drinking, as reported in short-term studies, is often a mirage."
Abstinence-based recovery, as the name suggests, focuses on complete abstinence from drug use, thereby breaking the cycle of addiction and dependency. To achieve remission from the disease of addiction, complete withdrawal of all mind-altering substances, including alcohol, is required. Abstinence-based recovery teaches us how to live a life of freedom that no longer requires us to turn to mood or mind-altering substances in order to help change the way we feel. The 12-Steps are an abstinence-based program that offers a lifeline of support to anyone hoping to recover from addiction.
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.”
Each person will have their own idea of who or what the higher power is to them, and in Step 3, individuals are asked to turn their lives over to this power for healing purposes. Steps 1 and 2 are all about reflection, learning that alcohol (or drugs) is a driving force in life and that a higher power is needed to recover and remain sober. With Step 3, individuals are called to action and to a willingness to change moving forward.
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.
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Historically the name "dipsomania" was coined by German physician C. W. Hufeland in 1819 before it was superseded by "alcoholism". That term now has a more specific meaning. The term "alcoholism" was first used in 1849 by the Swedish physician Magnus Huss to describe the systematic adverse effects of alcohol. Alcohol has a long history of use and misuse throughout recorded history. Biblical, Egyptian and Babylonian sources record the history of abuse and dependence on alcohol. In some ancient cultures alcohol was worshiped and in others, its abuse was condemned. Excessive alcohol misuse and drunkenness were recognized as causing social problems even thousands of years ago. However, the defining of habitual drunkenness as it was then known as and its adverse consequences were not well established medically until the 18th century. In 1647 a Greek monk named Agapios was the first to document that chronic alcohol misuse was associated with toxicity to the nervous system and body which resulted in a range of medical disorders such as seizures, paralysis, and internal bleeding. In 1920 the effects of alcohol abuse and chronic drunkenness led to the failed prohibition of alcohol in the United States, a nationwide constitutional ban on the production, importation, transportation, and sale of alcoholic beverages that remained in place until 1933. In 2005 alcohol dependence and abuse was estimated to cost the US economy approximately 220 billion dollars per year, more than cancer and obesity.
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, 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. The method was adapted and became the foundation of other twelve-step programs.