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Alcoholics Anonymous (AA) is an international mutual aid fellowship[1] whose stated purpose is to enable its members to "stay sober and help other alcoholics achieve sobriety."[1][2][3] It was founded in 1935 by Bill Wilson and Bob Smith in Akron, Ohio. With other early members, Bill Wilson and Bob Smith developed AA's Twelve Step program of spiritual and character development. AA's initial Twelve Traditions were introduced in 1946 to help the fellowship be stable and unified while disengaged from "outside issues" and influences.
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 long-term effects of alcohol use disorder can be devastating and even life-threatening. Chronic excessive alcohol consumption can negatively affect virtually every organ system. Specific examples of alcohol-use disorder effects on the body include everything from general effects like poor coordination, thiamine deficiency, and other forms of poor nutrition, cardiovascular effects like hypertension and irregular heartbeat, reproductive effects like impotence and irregular menses, as well as gastrointestinal problems like jaundice, cirrhosis of the liver, and pancreatitis. Alcohol-use disorder complications that involve the brain include, but are by no means limited to, strokes, confusion, and amnesia. Thiamine deficiency that is associated with alcohol use disorder can progress to the point that the sufferer develops vision problems, confusion, and trouble walking (Wernicke's encephalopathy), eventually followed by trouble caring for themselves and memory problems that the person tries to cover for by making things up/confabulating information (Korsakoff syndrome).

I agree with Jann B.'s earlier comments that the resistance of some AA members to pharmacological assistance has helped to create the divide between 12 Step recovery and academic addiction medicine. In fact, resistance by active alcoholics to psychological assisstance - mostly by withholding the true nature of their addiction -  was addressed in AA's original publication in 1939 of the text Alcoholilcs Anonymous. It acknowledged that the alcoholic him/herself was in part responsible for the skepticism many professionals felt when treating alcoholics. However, AA literature also is quite clear (in the text and via subsequent pamphlets) about the importance of seeking outside help and being open-minded to the advice of a helping professional.

That said, I believe the divide between 12 Step recovery and academic addiction medicine is largely a result of AA's non-scientific approach. The nature of addiction and subsequent recovery through 12 Step work is not easily measurable or definable. Academia can measure length of sobriety and certain facts, but is not able to tell us why this occurs...at least not in a quantitative way.  As a result, tends to avoid embracing 12 Step recovery because they cannot define it measurable scientific methods.

Fortunately to the suffering alchoholic who desires escape from the hell of alchoholism, 12 Step recovery doesn't necessitate understanding the process, it requires doing the process.

The transformation to permanent sobriety results from taking action, not from taking thought. Study and debate it all you want, but his pragmatic approach continues to save lives, as it did mine, 31 years ago.

AA meetings are "quasi-ritualized therapeutic sessions run by and for, alcoholics".[41] They are usually informal and often feature discussions. Local AA directories list a variety of weekly meetings. Those listed as "closed" are available to those with a self professed "desire to stop drinking," which cannot be challenged by another member on any grounds.[4] "Open" meetings are available to anyone (nonalcoholics can attend as observers).[42] At speaker meetings, one or two members tell their stories, while discussion meetings allocate the most time for general discussion. Some meetings are devoted to studying and discussing the AA literature.[43]
Alcohol inhibits the receptor for glutamate. Long-term ingestion results in the synthesis of more glutamate receptors. When alcohol is withdrawn, the central nervous system experiences increased excitability. Persons who abuse alcohol over the long term are more prone to alcohol withdrawal syndrome than persons who have been drinking for only short periods. Brain excitability caused by long-term alcohol ingestion can lead to cell death and cerebellar degeneration, Wernicke-Korsakoff syndrome, tremors, alcoholic hallucinosis, delirium tremens, and withdrawal seizures. Opiate receptors are increased in the brains of recently abstinent alcoholic patients, and the number of receptors correlates with cravings for alcohol.
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.
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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:

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]
It’s not always easy to see when your alcohol intake has crossed the line from moderate or social drinking to problem drinking. But if you consume alcohol to cope with difficulties or to avoid feeling bad, you’re in potentially dangerous territory. Drinking problems can sneak up on you, so it’s important to be aware of the warning signs of alcohol abuse and alcoholism and take steps to cut back if you recognize them. Understanding the problem is the first step to overcoming it and either cutting back to healthy levels or quitting altogether.
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:
More informally than not, AA's membership has helped popularize the disease concept of alcoholism, though AA officially has had no part in the development of such postulates which had appeared as early as the late eighteenth century.[58] Though AA initially avoided the term "disease", in 1973 conference-approved literature categorically stated that "we had the disease of alcoholism."[59][better source needed] Regardless of official positions, from AA's inception most members have believed alcoholism to be a disease.[60]
Clear communication by parents about the negative effects of alcohol, as well as about their expectations regarding drug use, has been found to significantly decrease alcohol use in teens. Adequate parental supervision has also been found to be a deterrent to underage alcohol abuse. Alcohol, and other drug use, has been found to occur most often between the hours of 3 p.m. and 6 p.m., immediately after school and prior to parents' arrival at home from work. Teen participation in extracurricular activities has therefore been revealed to be an important prevention measure for the use of alcohol in this age group. Parents can also help educate teens about appropriate coping and stress-management strategies. For example, 15- to 16-year-olds who use religion to cope with stress tend to use drugs significantly less often and have fewer problems as a result of drinking than their peers who do not use religion to cope.
We have found in clinical treatment that the 12-Step philosophy is a vital part of permanent sobriety. When a person maintains a 12-Step practice, including getting a sponsor and working with others, recovery is about more than relapse prevention – it is a pathway to an existence that is happy, joyous, and free. The 12-Step program a gateway into longterm recovery. By focusing attention on the 12-Steps, we set our patients up for long-term success. We engage patients in this paradigm because:
While this provides a blanket of comfort and security to the many thousands of people it helps, the secrecy has not gone over well with the more scientifically minded in the treatment community. The success and acceptance of the program has clashed with the desire for evidence and statistics, leading to Pacific Standard saying that AA is not a form of professional treatment, and it offers mixed results; but as a “mutual aid organization,” the 12-Step method comes into its own. Similarly, The Atlantic goes so far as to call Alcoholics Anonymous a pseudoscientific organization, one that dictated the treatment conversation for generations (to the point where its claimed success rate of 75 percent went unquestioned for decades), but has overstayed its privileged place in American culture.
The first book written to cover the 12 step program was titled "Alcoholics Anonymous", affectionately known as the Big Book by program members. Following the subsequent extensive growth of twelve step programs for other addictive and dysfunctional behaviors, many additional books were written and recordings and videos were produced. These cover the steps in greater detail and how people have specifically applied the steps in their lives. An extensive chronology and background about the history of A.A. has been put together at Dick B.'s website.

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. 


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.
"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."
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections.

Sessions led by peers, in which recovering alcoholics meet regularly and provide support for each other's recoveries, are considered among the best methods of preventing a return to drinking. The best-known group following this model is Alcoholics Anonymous (AA), which uses a 12-step program and a buddy (sponsor) system to help people avoid drinking. The AA steps involve recognizing the destructive power that alcohol has held over the individual's life, looking to a higher power for help in overcoming the problem, reflecting on the ways in which the use of alcohol has hurt others and, if possible, making amends to those people. According to the American Psychological Association (APA), anyone, regardless of his or her religious beliefs or lack of religious beliefs, can benefit from participation in 12-step programs such as AA. The number of visits to 12-step self-help groups exceeds the number of visits to all mental health professionals combined.


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Recovery is an interesting concept. It implies not only improvement, but potentially remission. The term describes a process as well as a destination. And the underlying premise of recovery is that of hope--hope that a person with a potentially fatal illness can avoid a catastrophic outcome. “Recovery activities” are not professional treatment, but can promote recovery just as professional treatment can. One of the most familiar “recovery activities” engaged in by persons with addiction is participation in the activities of Alcoholics Anonymous (AA).
More than a quarter (27%) of all 15- to 19-year-olds worldwide consume alcohol. Rates are highest in Europe (44%), followed by the Americas (38%) and the Western Pacific (38%). Total alcohol consumption per capita among those older than 15 years around the world rose from 5.5 liters of pure alcohol in 2005 to 6.4 liters in 2010 and remained at that level in 2016. [1, 2]
AA meetings do not exclude other alcoholics, though some meetings cater to specific demographics such as gender, profession, age, sexual orientation,[44][45] or culture.[46][47] Meetings in the United States are held in a variety of languages including Armenian, English, Farsi, Finnish, French, Japanese, Korean, Russian, and Spanish.[48][45] While AA has pamphlets that suggest meeting formats,[49][50] groups have the autonomy to hold and conduct meetings as they wish "except in matters affecting other groups or AA as a whole".[4] Different cultures affect ritual aspects of meetings, but around the world "many particularities of the AA meeting format can be observed at almost any AA gathering".[51]
Steps one through three deal with the individual’s acceptance of their inability to control their addiction alone and the need of support to remain abstinent. Steps four through nine teach the individual to take responsibility for their own actions and characteristics in order to create change in their life. Steps four, six and eight require self-reflection while steps five, seven and nine are the application of those reflections. The focus in steps 10 through 12 is on maintaining recovery. Each step builds upon the previous step in a progressive course of action.
Alcohol use disorder is a potentially fatal disease, characterized by cravings, tolerance (needing more), physical dependence, and loss of control over consuming alcohol.  Alcohol intoxication may or may not be obvious to observers. Even in highly functional alcoholics, chronic alcoholism can lead to physical problems. Most common is damage to your liver, which over time can lead to cirrhosis (scarred liver). Other risks include depression, stomach bleeds, pancreatitis, high blood pressure, heart failure, numbness and tingling in your feet and changes in your brain. Alcoholism can also increase your risk for infections including pneumonia, tuberculosis, and chronic gastritis.
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Alcohol inhibits the receptor for glutamate. Long-term ingestion results in the synthesis of more glutamate receptors. When alcohol is withdrawn, the central nervous system experiences increased excitability. Persons who abuse alcohol over the long term are more prone to alcohol withdrawal syndrome than persons who have been drinking for only short periods. Brain excitability caused by long-term alcohol ingestion can lead to cell death and cerebellar degeneration, Wernicke-Korsakoff syndrome, tremors, alcoholic hallucinosis, delirium tremens, and withdrawal seizures. Opiate receptors are increased in the brains of recently abstinent alcoholic patients, and the number of receptors correlates with cravings for alcohol.
Support in sobriety and in attaining long-lasting recovery is found in 12-Step practice and regular participation in 12-Step programs and groups. These groups are designed for the addict, the alcoholic, and the family members of those with addiction. The philosophy is based on developing a relationship with a Higher Power and a helping fellowship that encourages an honest mindset and self-sacrifice. 12-Step fellowships facilitate a daily practice for sober and healthy living.
Nervous system. An estimated 30-40% of all men in their teens and twenties have experienced alcoholic blackout from drinking a large quantity of alcohol. This results in the loss of memory of the time surrounding the episode of drinking. Alcohol also causes sleep disturbances, so sleep quality is diminished. Numbness and tingling (parethesia) may occur in the arms and legs. Wernicke's syndrome and Korsakoff's syndrome, which can occur together or separately, are due to the low thiamine (a B vitamin) levels found in many alcohol-dependent people. Wernicke's syndrome results in disordered eye movements, very poor balance, and difficulty walking. Korsakoff's syndrome affects memory and prevents new learning from taking place.
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.
I disagree. The underlying premise of "recovery" is not hope, but wellness. Becoming well. Staying well. By AA's own statistics, only 10.4% of participants continue with the program after the first year. What about the 89.6% that don't continue? According to AA, they failed. It's their fault. They weren't "working" the program. Or, they're "constitutionally incapable of being honest." If one defines normality as what the vast majority of people do in a given situation, then it is "normal" for people to fail in AA.

This final step is the service aspect, and it asks individuals to give back to others who are also struggling with addiction. After coming to God or a higher power, individuals are then taught to share this spirituality with others and support them in recovery. During Step 12, individuals are often asked to share their stories, testimonies, and struggles with others in order to provide hope and encouragement.
To conduct its business, Area 37 meets in assembly four times per year. Each assembly consists of elected officers, district committee members (DCMs), individual group service representatives (GSRs) and the chairpersons of several standing committees. Area 37’s standing committee structure is closely aligned to that of the General Service Conference committee structure. In assembly, reports are heard and area affairs are discussed. Who may attend and vote? All A.A. members are welcome, but only those elected or appointed as a District Committee Member (DCM), General Service Representative (GSR), Officers/Alternate Officers, past Delegates, and Area Standing Committee Chairs may cast a...
A member who accepts a service position or an organizing role is a "trusted servant" with terms rotating and limited, typically lasting three months to two years and determined by group vote and the nature of the position. Each group is a self-governing entity with AA World Services acting only in an advisory capacity. AA is served entirely by alcoholics, except for seven "nonalcoholic friends of the fellowship" of the 21-member AA Board of Trustees.[25]
Support in sobriety and in attaining long-lasting recovery is found in 12-Step practice and regular participation in 12-Step programs and groups. These groups are designed for the addict, the alcoholic, and the family members of those with addiction. The philosophy is based on developing a relationship with a Higher Power and a helping fellowship that encourages an honest mindset and self-sacrifice. 12-Step fellowships facilitate a daily practice for sober and healthy living.

Drinking too much damages the circulation by causing consistent high blood pressure. It also causes cardiomyopathy, or drooping of the heart muscle, which reduces the ability of the heart to effectively pump blood throughout the body. Nutrient deficiency can lead to anemia. Other problems with blood can lead to clots, causing strokes or heart attacks.
Often, family members and close friends feel obligated to cover for the person with the drinking problem. So they take on the burden of cleaning up your messes, lying for you, or working more to make ends meet. Pretending that nothing is wrong and hiding away all of their fears and resentments can take an enormous toll. Children are especially sensitive and can suffer long-lasting emotional trauma when a parent or caretaker is an alcoholic or heavy drinker.
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The first book written to cover the 12 step program was titled "Alcoholics Anonymous", affectionately known as the Big Book by program members. Following the subsequent extensive growth of twelve step programs for other addictive and dysfunctional behaviors, many additional books were written and recordings and videos were produced. These cover the steps in greater detail and how people have specifically applied the steps in their lives. An extensive chronology and background about the history of A.A. has been put together at Dick B.'s website.
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