The Big Book was originally written as a guide for people who couldn’t attend AA fellowship meetings, but it soon became a model for the program in general. It has since been adopted as a model for a wide range of addiction peer-support and self-help programs designed to help drive behavioral change. In addition to the original Alcoholics Anonymous (AA) group, various offshoots now exist, such as Narcotics Anonymous (NA), Heroin Anonymous (HA), and Gamblers Anonymous (GA).
Hazard duly joined a Christian evangelical movement, known as the Oxford Group. In addition to the basic tenets of the Christian faith (such as honesty and personal change), “personal evangelism” was stressed, or one member of the group sharing his story with someone outside of the group, especially if the other person was undergoing a personal crisis.
According to information derived from the United States National Longitudinal Alcohol Epidemiologic Study released in 2006, about 8% of American adults are dependent on alcohol (estimates range from 5-10%). About 34% of adult Americans do not use alcohol at all. Another 44% are occasional or non-dependent users. Alcohol is the third leading cause of preventable death in the United States (smoking and obesity rank first and second) and is responsible for about 85,000 deaths annually, about half from injury and half from disease. Alcoholism is involved in about 30% of homicides and 22% of suicides. It is the cause of about 20% of fatal motor vehicle accidents and is a contributing factor in between one-third and one-half of all vehicular accidents. Alcoholism costs the United States about $185 billion annually in costs related to violence, traffic accidents, lost work productivity, and direct medical expenses. The National Institute on Alcohol Abuse and Alcoholism estimates that at least 6.6 million children under age 18 live in households with at least one alcoholic parent and that before age 18 about 25% of children are exposed to family alcohol dependency or alcohol abuse.
One review of AA warned of detrimental iatrogenic effects of twelve-step philosophy and concluded that AA uses many methods that are also used by cults. A subsequent study concluded, however, that AA's program bore little resemblance to religious cults because the techniques used appeared beneficial. Another study found that the AA program's focus on admission of having a problem increases deviant stigma and strips members of their previous cultural identity, replacing it with the deviant identity. A survey of group members, however, found they had a bicultural identity and saw AA's program as a complement to their other national, ethnic, and religious cultures.
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A disorder characterized by a persistent pattern of alcohol use that causes harm or distress. It typically involves cravings for alcohol, inability to control the amount consumed, withdrawal symptoms in its absence, and the need to consume greater quantities in order to feel the same effects, and often results in impaired social functioning and significant damage to physical health.
We take your privacy seriously and understand the magnitude of your current situation, as well as its impact on your career and family. While we are required to report monitoring information for mandated admissions, health care professionals entering IPRP on a voluntary basis have complete confidentiality. So, don't hesitate to pick up the phone and call us for more information.
Twelve-step programs approach alcoholism and drug addiction as diseases that can only be managed by surrendering one’s will to a higher power. In spite of their reliance on the disease model of addiction, 12-step groups offer rewarding experiences that reinforce healthy, sober behaviors. In this sense, the 12 steps reflect the principles of positive psychology, notes the Journal of Substance Abuse Treatment. Positive psychology is based on the belief that gratifying experiences will encourage the individual to repeat a healthy behavior, such as attending meetings or reading AA literature, rather than reverting to a self-destructive behavior, such as drinking or using drugs.
As with similar substances with a sedative-hypnotic mechanism, such as barbiturates and benzodiazepines, withdrawal from alcohol dependence can be fatal if it is not properly managed. Alcohol's primary effect is the increase in stimulation of the GABAA receptor, promoting central nervous system depression. With repeated heavy consumption of alcohol, these receptors are desensitized and reduced in number, resulting in tolerance and physical dependence. When alcohol consumption is stopped too abruptly, the person's nervous system suffers from uncontrolled synapse firing. This can result in symptoms that include anxiety, life-threatening seizures, delirium tremens, hallucinations, shakes and possible heart failure. Other neurotransmitter systems are also involved, especially dopamine, NMDA and glutamate.
The path to getting sober and drug-free is never exactly the same for any two people. However, anyone looking to find out more about rehab and recovery - either for themselves or their loved ones - will recognize some common steps, particularly when it comes to inpatient residential treatment programs. These steps are usually similar whether you’re looking for private alcoholism treatment or a drug addiction recovery center.
Treating underlying problems: There may be problems with self-esteem, stress, anxiety, depression, or other aspects of mental health. It is important to treat these problems, too, as they can increase the risks posed by alcohol. Common alcohol-related issues, such as hypertension, liver diseases, and possibly heart diseases, will need to be treated too.
Studies suggest that certain individuals are more likely to become alcoholics. People with a history of alcoholism in their family have an increased chance of becoming alcoholics. People who start drinking at an early age are also at a greater risk of developing alcoholic tendencies than those who begin drinking later in life. Men are more prone to become alcoholics, but women are much more likely to develop harmful medical effects that are linked to drinking such as liver disease.
Alcohol, especially when consumed in excess, can affect teens, women, men, and the elderly quite differently. Women and the elderly tend to have higher blood concentrations of alcohol compared to men and younger individuals who drink the same amount. Alcoholic women are more at risk for developing physical health problems like cirrhosis of the liver and heart and nerve damage at a faster rate than alcohol-dependent men. Interestingly, men and women seem to have similar learning and memory problems as the result of excessive alcohol intake, but again, women tend to develop those problems twice as fast as men.
Heavy drinking has a lot of other risks. It can lead to liver disease, pancreatitis, some forms of cancer, brain damage, serious memory loss, and high blood pressure. It also makes someone more likely to die in a car wreck or from murder or suicide. And any alcohol abuse raises the odds of domestic violence, child abuse and neglect, and fetal alcohol syndrome.
When a person struggling with problem drinking or alcohol dependence decides to get help, it is important for them to consult with a doctor regarding how serious their physical condition may be. Gauging the severity of withdrawal symptoms is important, as quitting alcohol suddenly can lead to seizures, which may be deadly. Racing heart rate, high blood pressure, insomnia, vomiting and related dehydration, and fever can also be dangerous alcohol withdrawal symptoms.
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.
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For people in the first stage of alcohol use (having access but not having yet used alcohol), preventive measures are used. Therefore, limiting access to alcohol or other drugs, addressing any risk factors of the alcohol consumer or family, as well as optimal parental supervision for youth and expression regarding expectations are often recommended. The approach to those who have experimented with alcohol should not be minimized by mental health professionals, since infrequent use can progress to the more serious stages of alcohol use if not addressed. Therefore, professionals recommend that the alcohol-consuming individual be thoroughly educated about the effects and risks of alcohol, that fair but firm limits be set on the use of alcohol, and that the user be referred for brief counseling, a self-help group, and/or family support group. People who have progressed to the more advanced stages of alcoholism are typically treated intensively, using a combination of the medical, individual, and familial interventions already described.
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.
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.
WHO's ICD-10 "alcohol harmful use" and "alcohol dependence syndrome" Definitions are similar to that of the DSM-IV. The World Health Organization uses the term "alcohol dependence syndrome" rather than alcoholism. The concept of "harmful use" (as opposed to "abuse") was introduced in 1992's ICD-10 to minimize underreporting of damage in the absence of dependence. The term "alcoholism" was removed from ICD between ICD-8/ICDA-8 and ICD-9.
The endpoint of “recovery” from addiction, if there is an endpoint, is to change one’s life for the better, to gain stability in one’s life, and to become more functional in one’s family and in one’s community. Being responsible, being reliable, being interested in others and not just in oneself, and being a loving being who cares about and is helpful to others, are all part of recovery.
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.