Is Twelve-Step Recovery an antiquated concept or intervention? Many addiction specialist physicians contend that while the majority of continuing medical education in addiction, aimed at sharing novel breakthroughs and improving practice and outcomes, addresses pharmacotherapies, it is the psychosocial therapies which warrant at least equal attention. Some addiction medicine physicians are concerned that not only do biological interventions predominate in continuing education curriculums, but they dominate graduate medical education in addiction, and some of these physicians are concerned that fellowship training programs in addiction as well as residency programs in primary care, psychiatry, and other medical specialties should include training about and in Twelve Step Facilitation and on Twelve-Step Recovery in order for the physician to have an appropriately well-rounded educational experience and a full skill and knowledge base in the rapidly-growing specialty of addiction medicine.
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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.
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.

Stanton Peele argued that some AA groups apply the disease model to all problem drinkers, whether or not they are "full-blown" alcoholics.[90] Along with Nancy Shute, Peele has advocated that besides AA, other options should be readily available to those problem drinkers who are able to manage their drinking with the right treatment.[91] The Big Book says "moderate drinkers" and "a certain type of hard drinker" are able to stop or moderate their drinking. The Big Book suggests no program for these drinkers, but instead seeks to help drinkers without "power of choice in drink."[92]


Parents may also inadvertently contribute to children’s alcohol problems, especially if they model bad drinking behaviors. Kids who grow up in homes with a great deal of drinking may come to see the behavior as normal. If their parents drink as a coping mechanism for stress or anxiety, kids may come to do the same. In this case, the genes aren’t at the root of the problem; it’s the behaviors parents model that causes concern.
alcohol dependence = alcohol abuse combined with tolerance, withdrawal, and an uncontrollable drive to drink.[99] The term "alcoholism" was split into "alcohol abuse" and "alcohol dependence" in 1980's DSM-III, and in 1987's DSM-III-R behavioral symptoms were moved from "abuse" to "dependence".[100] It has been suggested that DSM-V merge alcohol abuse and alcohol dependence into a single new entry,[101] named "alcohol-use disorder".[102]
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]

Non-12-step support groups provide a secular alternative to the 12-step programs and may be more comfortable for those not wanting to place such an emphasis on a higher power for recovery. Non-12-step groups sometimes involve fewer group sharing scenarios—which can provide some relief for those individuals who aren't as comfortable sharing sensitive personal information in group settings. Below are a few examples of non-12-step programs:


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Though it can feel as if you are hiding a unique or embarrassing problem, the fact is that families across the country are experiencing the exact same thing you are. You are not alone with the disease, and you will not be alone as you seek the treatment necessary to begin to heal and start a new life in recovery. Alcohol.org is available to provide education and support all along the way.
According to the National Survey on Drug Use and Health, approximately 15 million American adults misuse alcohol or are alcohol dependent. In the United States, nearly 20% of patients treated in general medical practices report drinking at levels considered "risky" or "hazardous." According to NIAAA, less than 10% of patients with alcohol use disorder receive treatment.
ASAM’s definition of addiction document concludes that “treatment of addition saves lives,” and it points out that “in some cases of addiction, medication management can improve treatment outcomes,” and that “in most cases of addiction, the integration of psychosocial rehabilitation and ongoing care with evidence-based pharmacological therapy provides the best results.” Much of “what’s new” in the professional treatment of addiction in the past two decades has involved new pharmacological therapies that have been brought into the marketplace. But psychosocial interventions, which are “not as new,” are the foundation of the treatment most persons receive when they seek assistance from an addiction treatment professional or agency.
In Step 4, individuals are asked to be thorough and honest in their personal inventory, writing down anything that comes to mind, and then to explore the effects and particulars of each incident. Self-reflection and introspection into how each event may have impacted family and loved ones as well as individual feelings are delved into during this step. People may wish to start a personal journal. This inventory during Step 4 can take some time to complete. Individuals may therefore spend a lot of time on Step 4, writing, praying, and receiving encouragement from others in their support group.
In 1939, High Watch Farm in Kent, Connecticut was founded by Bill Wilson and Marty Mann. Sister Francis who owned the farm tried to gift the spiritual retreat for alcoholics to Alcoholics Anonymous, however citing the sixth tradition Bill W. turned down the gift but agreed to have a separate non-profit board run the facility composed of AA members. Bill Wilson and Marty Mann served on the High Watch board of directors for many years. High Watch was the first and therefore the oldest 12 step based treatment center in the world still operating today.
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Thank you. Twelve Steps and AA culture is a great bridge to extended self help. It works great when most of those working together come from diverse backgrounds. In my humble opinion, it gets difficult when the professional treatment world extends so deep into self help that they begin to set the standards for CBT in terms of acceptable attitudes. I am disheartened by the almost organized labor or mob influence on the traditional meetings.
The various health problems associated with long-term alcohol consumption are generally perceived as detrimental to society, for example, money due to lost labor-hours, medical costs due to injuries due to drunkenness and organ damage from long-term use, and secondary treatment costs, such as the costs of rehabilitation facilities and detoxification centers. Alcohol use is a major contributing factor for head injuries, motor vehicle accidents (due to drunk driving), domestic violence, and assaults. Beyond the financial costs that alcohol consumption imposes, there are also significant social costs to both the alcoholic and their family and friends.[55] For instance, alcohol consumption by a pregnant woman can lead to fetal alcohol syndrome,[165] an incurable and damaging condition.[166] Estimates of the economic costs of alcohol abuse, collected by the World Health Organization, vary from one to six percent of a country's GDP.[167] One Australian estimate pegged alcohol's social costs at 24% of all drug abuse costs; a similar Canadian study concluded alcohol's share was 41%.[168] One study quantified the cost to the UK of all forms of alcohol misuse in 2001 as £18.5–20 billion.[148][169] All economic costs in the United States in 2006 have been estimated at $223.5 billion.[170]

Located in the heart of Casper, Wyoming, Wyoming Recovery takes a personal approach to your rehabilitation process. With a quaint 17-bed facility, we take a one-on-one approach to your recovery. While we use the 12-step program for alcohol abuse and alcohol dependency, we have an effective and reliable holistic approach to all forms of recovery in the Casper, Wyoming area.

Alcoholism is the most severe form of alcohol abuse and involves the inability to manage drinking habits. It is also commonly referred to as alcohol use disorder. Alcohol use disorder is organized into three categories: mild, moderate and severe. Each category has various symptoms and can cause harmful side effects. If left untreated, any type of alcohol abuse can spiral out of control.
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Although the concept of an intervention is pervasive in popular culture – even leading to the development of a reality television show – there are types of interventions that are more helpful than suddenly accusing a loved one of struggling with addiction. Family and friends may create an intervention – which requires a plan, including specific requirements and consequences – or a therapist, doctor, or other healthcare professional may conduct an intervention. Often, these are brief interventions, which occur after a person has been hospitalized due to side effects from drinking too much or after a person is diagnosed with a chronic illness due to problem drinking.
Alcoholism is common, serious, and expensive. Physicians encounter alcohol-related cirrhosis, cardiomyopathy, pancreatitis, and gastrointestinal bleeding, as well as intoxication and alcohol addiction, on a daily basis. Alcoholism is also associated with many cancers. Wernicke encephalopathy and Korsakoff psychosis are also important causes of chronic disability as well as dementia. Fetal alcohol syndrome is a leading cause of mental retardation. In addition, accidents (especially automobile), depression, dementia, suicide, and homicide are important consequences of alcoholism.
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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).
Information provided is for the purpose of locating meetings of Alcoholics Anonymous and to procure information about A.A. in Southern California. No other use is authorized and printing is prohibited. Groups listed in the meeting directory are not funded or managed by Los Angeles Central Office. Groups are registered at their request and listed because they are organized in alignment with the guidelines to list a meeting in our directory and they attest they receive no support from outside their group . That we list a group in our directory does not constitute or imply Los Angeles Central Office approves or endorses a group's approach to or practice of the A.A. program of recovery. Each group is autonomous, Los Angeles Central Office does not govern.
Following detoxification, social support to abstain from or moderate drinking is needed for an extended period of time. It is useful for individuals who are recovering from alcohol dependence to identify people who can support them through the process, as it can still be very difficult not to drink alcohol, or to drink in moderation following detoxification. People who have difficulty may wish to investigate whether there is medication which can help them stay away from alcohol. There are range of prescription medicines which might assist some people. Talk to a doctor before taking any medication.

Alcoholics Anonymous (AA) : Alabama • Alaska • American Samoa • Arizona • Arkansas • California • Colorado • Connecticut • Delaware • Federated States of Micronesia • Florida • Georgia • Guam • Hawaii • Idaho • Illinois • Indiana • Iowa • Kansas • Kentucky • Louisiana • Maine • Marshall Islands • Maryland • Massachusetts • Michigan • Minnesota • Mississippi • Missouri • Montana • Nebraska • Nevada • New Hampshire • New Jersey • New Mexico • New York • North Carolina • North Dakota • Northern Mariana Islands • Ohio • Oklahoma • Oregon • Pennsylvania • Rhode Island • South Carolina • South Dakota • Tennessee • Texas • Tribal Areas • Utah • Vermont • Virgin Islands • Virginia • Washington • Washington DC • West Virginia • Wisconsin • Wyoming
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The purpose of the Central Office is to receive, distribute and follow up on calls for help, to answer inquiries about AA, to cooperate with local public information committees, maintain information about local hospitals and recovery facilities for alcoholics, to provide local AA meeting lists, to provide a newsletter, and to order, sell and distribute AA literature.  
Based on combined data from SAMHSA's 2004–2005 National Surveys on Drug Use & Health, the rate of past-year alcohol dependence or abuse among persons aged 12 or older varied by level of alcohol use: 44.7% of past month heavy drinkers, 18.5% binge drinkers, 3.8% past month non-binge drinkers, and 1.3% of those who did not drink alcohol in the past month met the criteria for alcohol dependence or abuse in the past year. Males had higher rates than females for all measures of drinking in the past month: any alcohol use (57.5% vs. 45%), binge drinking (30.8% vs. 15.1%), and heavy alcohol use (10.5% vs. 3.3%), and males were twice as likely as females to have met the criteria for alcohol dependence or abuse in the past year (10.5% vs. 5.1%).[83]
Withdrawal symptoms can range from mild to life threatening. Mild withdrawal symptoms include nausea, achiness, diarrhea, difficulty sleeping, sweatiness, anxiety, and trembling. This phase usually lasts no more than three to five days. More severe effects of withdrawal can include hallucinations in which a patient sees, hears, or feels something that is not actually present, seizures, an unbearable craving for more alcohol, confusion, fever, fast heart rate (tachycardia), high blood pressure (hypertension), and delirium (a fluctuating level of consciousness). Patients at highest risk for the most severe symptoms of withdrawal are those with other medical problems, including malnutrition, liver disease, or Wernicke's syndrome. Severe withdrawal symptoms usually begin about three days after the individual's last drink, and may last a variable number of days.
Severe childhood trauma is also associated with a general increase in the risk of drug dependency.[69] Lack of peer and family support is associated with an increased risk of alcoholism developing.[69] Genetics and adolescence are associated with an increased sensitivity to the neurotoxic effects of chronic alcohol abuse. Cortical degeneration due to the neurotoxic effects increases impulsive behaviour, which may contribute to the development, persistence and severity of alcohol use disorders. There is evidence that with abstinence, there is a reversal of at least some of the alcohol induced central nervous system damage.[74] The use of cannabis was associated with later problems with alcohol use.[75] Alcohol use was associated with an increased probability of later use of tobacco, cannabis, and other illegal drugs.[76]
Michael M. Miller, MD, FASAM, FAPA, is the medical director of the Herrington Recovery Center at Rogers Memorial Hospital-Oconomowoc. He is a board-certified general psychiatrist and addiction psychiatrist. Dr. Miller has practiced addiction medicine for more than 30 years and is certified in addiction medicine by the American Board of Addiction Medicine. Dr. Miller is also an at-large director of the American Board of Addiction Medicine and The ABAM Foundation. He is a past president of ASAM.

Meditation, prayer, and journaling make up Step 11 as individuals use these tools to form a spiritual connection with God or the higher power. Quiet time and solitude provide for self-reflection, and meditation can be helpful to increase the connection between the body, mind, and soul. When a person is in tune with themselves physically and emotionally, the spiritual aspect is also strengthened. Journaling during Step 11 can be a beneficial way to explore thoughts and emotions more fully as well.
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