A large body of evidence indicates that maternal alcohol consumption during pregnancy contributes adversely to a fetus's development. Abnormalities in infants and children associated with maternal alcohol consumption may include prenatal and postnatal physical retardation, neurological deficits (e.g., impaired attention control), mental retardation, behavioral problems (e.g., impulsivity), skull or brain malformations, and facial malformations (e.g., a thin upper lip and elongated flattened midface). These abnormalities, influenced by maternal alcohol consumption during pregnancy, are referred to as fetal alcohol effects (FAEs), or fetal alcohol syndrome (FAS) if a sufficient number of effects are apparent in the child.
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).
AA is a faith-based program where, in order to succeed in their recovery and progress through the 12 steps, members are instructed to admit their lack of control over both alcohol and their own lives and turn themselves over to a higher power. While the foundations of AA are based in Christianity, the 12-Step program is meant to be nonspecific regarding religion and focus more on a spiritual awakening.
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Programs like AA and other 12-Step groups provide a healthy community of support and solidarity filled with individuals who are all seeking to remain sober on a long-term basis. Individuals who regularly attend AA meetings are about twice as likely to remain abstinent over those who don’t, per the Journal of Addictive Disorders. The 12 Steps can go a long way in providing individuals in recovery with the support they need.
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.
Because denial is common, you may not feel like you have a problem with drinking. You might not recognize how much you drink or how many problems in your life are related to alcohol use. Listen to relatives, friends or co-workers when they ask you to examine your drinking habits or to seek help. Consider talking with someone who has had a problem drinking, but has stopped.

You have a wealth of choices when it comes to alcohol and drug addiction treatment. Depending on your situation, the severity and type of addiction and your resources, you may opt for a residential recovery program, an outpatient one, support groups, or a combination of them. It really comes down to the person and their needs. If you or your loved one need help but are still feeling a bit lost or overwhelmed by the choices in front of you, our helpline advisors work 24/7 via our toll-free number to connect you with the best treatment. Call when you’re ready to get clean and sober – 1-888-319-2606 Who Answers? .


Alcoholics may also require treatment for other psychotropic drug addictions and drug dependences. The most common dual dependence syndrome with alcohol dependence is benzodiazepine dependence, with studies showing 10–20 percent of alcohol-dependent individuals had problems of dependence and/or misuse problems of benzodiazepine drugs such as valium or clonazopam. These drugs are, like alcohol, depressants. Benzodiazepines may be used legally, if they are prescribed by doctors for anxiety problems or other mood disorders, or they may be purchased as illegal drugs. Benzodiazepine use increases cravings for alcohol and the volume of alcohol consumed by problem drinkers.[145] Benzodiazepine dependency requires careful reduction in dosage to avoid benzodiazepine withdrawal syndrome and other health consequences. Dependence on other sedative-hypnotics such as zolpidem and zopiclone as well as opiates and illegal drugs is common in alcoholics. Alcohol itself is a sedative-hypnotic and is cross-tolerant with other sedative-hypnotics such as barbiturates, benzodiazepines and nonbenzodiazepines. Dependence upon and withdrawal from sedative-hypnotics can be medically severe and, as with alcohol withdrawal, there is a risk of psychosis or seizures if not properly managed.[146]

"I discovered how good relationships get better and how unhealthy relationships get exposed when you work your program," said Cathy. "I've been friends with Hannah for years, but we had been partying friends. So when I entered recovery, we were really careful around each other. Then we began talking—really talking. Now our friendship is deeper and more honest. Recovery has been good for both of us."


Once a person is addicted to alcohol, to stop it may take hospitalizations, rehabilitations, and re-rehabilitations all of which hemorrhage expenses — not to mention destroy relationships and property. The estimated cost to the system of this specialized addiction care is $24.6 billion. Since addiction is a disease that rewires the brain, the individual is unlikely to quit through “willpower” alone, and it often takes something dramatic (or “hitting rock bottom”) before they will make changes. There are costs associated with these dramatic scenarios. In the case of car accidents caused by driving drunk, costs include not just hospitalization, but the cost to insurance companies, car owners, municipal employees responding to the accident, and a continued chain reaction of costs that could ultimately include vehicular homicides and funeral expenses.
Asking Question About The 12 Steps: This introduces the steps to patients and allows them to voice any questions and concerns. For instance, The 12 Steps encourage reliance on a spiritual experience – by establishing a relationship with a Power greater than ourselves. But many groups give individuals the freedom to choose their own version of a “Higher Power.” This choice often helps patients let go of any religious resentments or pre-conceived prejudices toward spiritual practices.
Alcoholism is a disease that can affect both children and adults, but it doesn’t affect everyone the same way. For some people, just one drink can result in intoxication, while for others, many more drinks are necessary to create the same effect. A “drink” is classified as 12 ounces of beer, 5 ounces of wine or 1.5 ounces of distilled spirits, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA). In terms of the effects on the body and brain, excessive alcohol consumption can increase the risk for various health issues for any user. The big question is: Are the effects of alcoholism reversible?
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Mike, I applaud you for this excellent treatise supporting the relevance of 12-Step recovery in modern addiction treatment.  Upon careful study, the goal is to achieve "A A" = autonomy and agency.  That this method is unwaveringly spelled out, is freely and widely available, requires no Prior Auth or co-pay, has no drug-drug interactions or side effects and enjoys a success rate commensurate with all other offerings is compelling.  For some validated evidence of things that work in recovery (including 12-Step) I invite you to visit our (RRI) website.

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).
Added fat and scar tissue on the liver due to excessive alcohol consumption can lead to all sorts of problems, but most often either cirrhosis or alcohol-induced hepatitis. Liver failure among those who drink heavily for many years is likely. Pancreatitis, or the consistent inflammation of the pancreas, can also cause damage to the body, including high blood sugar leading to diabetes.
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.

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.

Whether you choose to go to rehab, rely on self-help programs, get therapy, or take a self-directed treatment approach, support is essential. Recovering from alcohol addiction is much easier when you have people you can lean on for encouragement, comfort, and guidance. Without support, it’s easy to fall back into old patterns when things get tough.
Chemically, alcohol tends to decrease the chemical activity of substances that affect the nervous system, to inhibit behavior (gamma aminobutyric acid, also called GABA signaling) and increase the activity of pleasure-seeking processes (glutamate). That can result in people being less inhibited in their words and actions and more likely to engage in immediately pleasurable activities even if they are unsafe. Even light drinkers can experience shrinking of parts of the brain. Intoxication with alcohol can be characterized by slurred speech, clumsiness, sleepiness, headaches, distorted senses, lapses in memory, nausea, vomiting, and loss of consciousness.
Elderly people who drink excessively are at risk for having more serious illnesses, doctor visits, and symptoms of depression, with less life satisfaction and smaller social support networks compared to senior citizens who have never consumed alcohol. While binge drinking is often thought to be a symptom of young people, an often unknown fact is that a significant percentage of middle-aged and elderly individuals also engage in binge drinking. This behavior increases the risk for driving drunk, no matter what the age. That, in turn, puts the individual at risk for being arrested for driving under the influence (DUI) of alcohol.
With Step 9, individuals are apologizing for their actions while under the influence of drugs or alcohol or for the damages their addiction has caused. Individuals may then attempt to offer restitution and seek forgiveness and reconciliation but need to be aware that they may not receive it. Working through Step 9 helps to set things right so everyone can move on.
Alcohol detoxification or 'detox' for alcoholics is an abrupt stop of alcohol drinking coupled with the substitution of drugs, such as benzodiazepines, that have similar effects to prevent alcohol withdrawal. Individuals who are only at risk of mild to moderate withdrawal symptoms can be detoxified as outpatients. Individuals at risk of a severe withdrawal syndrome as well as those who have significant or acute comorbid conditions are generally treated as inpatients. Detoxification does not actually treat alcoholism, and it is necessary to follow up detoxification with an appropriate treatment program for alcohol dependence or abuse to reduce the risk of relapse.[7] Some symptoms of alcohol withdrawal such as depressed mood and anxiety typically take weeks or months to abate while other symptoms persist longer due to persisting neuroadaptations.[65] Alcoholism has serious adverse effects on brain function; on average it takes one year of abstinence to recover from the cognitive deficits incurred by chronic alcohol abuse.[126]
An initial step in detecting liver damage is a simple blood test to determine the presence of certain liver enzymes in the blood. Under normal circumstances, these enzymes reside within the cells of the liver. But when the liver is injured, these enzymes are spilled into the blood stream, and can lead to diseases like fatty liver, type 2 diabetes, obesity, and hepatitis. Several medications also can increase liver enzyme test results.
Alcohol use is the fourth leading cause of preventable death in the United States (after smoking, high blood pressure, and obesity). According to a 2018 report from the WHO, in 2016 the harmful use of alcohol resulted in about 3 million deaths, or 5.3% of all deaths around the world, with most of these occurring among men. [1, 2] The economic costs of excessive alcohol consumption in 2010 were estimated at $249 billion, or $2.05 a drink. [3]
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.
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Many 12-Step groups exist for individuals who are uncomfortable with the religious nature of traditional AA, such as AA Agnostica, which is designed for atheists and agnostics. The goal of Step 2 is often taken to be more spiritual in nature than religious, as it asks each individual to accept that they require help from something greater than themselves in order to move forward in recovery.
We are excited by the launch of our new Alcoholics Resource Center web site and hope that each of you will share in that excitement. The purpose of this site is to provide information and social networking to support our fellow AA members. We believe that this site will meet a need for those interested in all matters related to AA within the scope of the Traditions.
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Many 12-Step groups exist for individuals who are uncomfortable with the religious nature of traditional AA, such as AA Agnostica, which is designed for atheists and agnostics. The goal of Step 2 is often taken to be more spiritual in nature than religious, as it asks each individual to accept that they require help from something greater than themselves in order to move forward in recovery.
Prevention must begin at a young age since the first instance of intoxication usually occurs during the teenage years. It is particularly important that teenagers who are at high risk for alcoholism-those with a family history of alcoholism, early or frequent use of alcohol, a tendency to drink to drunkenness, alcohol use that interferes with school work, a poor family environment, or a history of domestic violence -receive education about alcohol and its long-term effects. How this is best achieved, without alienating these young people and thus losing their attention, is the subject of continuing debate and study.
The mental obsession is described as the cognitive processes that causes the individual to repeat the compulsive behavior after some period of abstinence, either knowing that the result will be an inability to stop or operating under the delusion that the result will be different. The description in the First Step of the life of the alcoholic or addict as "unmanageable" refers to the lack of choice that the mind of the addict or alcoholic affords concerning whether to drink or use again.[20]
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