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But Twelve-Step Facilitation therapy is still a tried-and-true proven approach. It is far more than advising a patient to “go to AA” and providing them a list of meeting locations and times. In Twelve-Step Faciliation, the therapist actively probes and nudges, encouraging not only attendance, but participation, in meetings; it explains the potential benefits of working with a sponsor and promotes the individual developing a relationship with a sponsor; it explores problems or psychological resistances to attendance, participation, actual “working the steps,” and the development of a sponsor-sponsee relationship; and it opens the door to “AA-related activities” such as volunteer service to one’s AA “home group” or AA “clubhouse” and involvement with AA-related social events, retreats, and local and state conventions.
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:

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.
Jump up ^ Morse, RM; Flavin, DK (August 1992). "The definition of alcoholism. The Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine to Study the Definition and Criteria for the Diagnosis of Alcoholism". JAMA: The Journal of the American Medical Association. 268 (8): 1012–4. doi:10.1001/jama.1992.03490080086030. ISSN 0098-7484. PMID 1501306.
The diagnosis of an alcohol problem is best made by the history. Screening instruments for alcohol problems include the CAGE ([need to] cut down [on drinking], annoyance, guilt [about drinking], [need for] eye-opener) questionnaire and the AUDIT (alcohol use disorders identification test). The CAGE questions should be given face-to-face, whereas AUDIT can be given as a paper-and-pencil test.
Of men aged 18–25 years, 60% binge drink. (Binge drinking is defined as 5 alcoholic drinks for men [4 for women] in a row.) Binge drinking significantly increases the risk of injury and contracting sexually transmitted diseases. Women who binge drink at this age are at higher risk of becoming pregnant and potentially harming an unborn child. (Any amount of alcohol consumption during pregnancy is risky.) Cohort data from the Prospective Epidemiological Study of Myocardial Infarction (PRIME) investigated alcohol use patterns on ischemic heart disease in Northern Ireland and France. Regular and moderate alcohol use throughout the week, a typical pattern in middle-aged men in France, was associated with a lower risk of ischemic heart disease, whereas the binge drinking pattern more prevalent in Northern Ireland was associated with a higher risk of ischemic heart disease. [17]
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Alcohol addiction is a gradual process that occurs within the human brain. When alcohol is consumed, it alters the levels of certain chemicals in the brain, mainly gamma-aminobutyric acid, or GABA, and dopamine. GABA monitors and controls a person's impulsivity, and frequently drinking copious amounts of alcohol alters this chemical's production, often making people more impulsive and less aware of what they are doing. Dopamine is one of the chemicals in the brain that, when released, causes pleasurable feelings like happiness, joy, or even euphoria. As more and more alcohol is consumed on a frequent basis, the brain begins to grow accustomed to this chemical imbalance. If an alcoholic tries to stop drinking, then the brain is deprived of the alcohol's effect, which results in unpleasant withdrawal symptoms such as sweating, shaking, tremors, or even hallucination.

Recently some researchers have suggested that there are two distinct types of alcoholism. According to these researchers, type 1 alcoholism develops in adulthood, often in the early twenties. It is most often associated with the desire to relieve stress and anxiety and is not associated with any criminal or antisocial behavior. Type 2 alcoholism develops earlier, usually during the teenage years. Drinking is done primarily to get high. Type 2 alcoholism is associated with violence, destructiveness, and other criminal and antisocial behavior. Those who study alcoholism do not universally accept the distinction between these two types of alcoholism. Research continues in this area.


Secular Organizations for Sobriety (SOS). SOS is presented as a secular alternative to the more spiritual 12-step addiction recovery programs (such as AA and NA) that encourage people to reach out to a higher power. The program targets substance abusers who would like to separate sobriety from spirituality and religion. The organization credits the individual for maintaining sobriety as opposed to crediting a higher power. SOS is comprised of a network of autonomous local groups that help individuals achieve and maintain sobriety. The organization has meetings in many cities across the United States. In SOS, sobriety is presented as the number one priority for individuals suffering from alcoholism or addiction. It emphasizes the use of clear communication and scientific knowledge in choosing the most rational approach to living a sober and rewarding life.
Fact: Alcohol is a drug, and alcoholism is every bit as damaging as drug addiction. Alcohol addiction causes changes in the body and brain, and long-term alcohol abuse can have devastating effects on your health, your career, and your relationships. Alcoholics go through physical withdrawal when they stop drinking, just like drug users do when they quit.

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In one section, Dr. Miller discusses the importance of pharmacological therapy for the treatment of addiction. In another section he discusses the importance of AA in recovery, knowing full well that AA, with their definition of  "abstinence" does not welcome those receiving medication into their program. This is not only disingenuous, it is hypocritical. And AA's definition of abstinence, it is killing people. Those who have an addiction to opioids, when they relapse, too many of them, they die. They need to be on medication, and they need to stay on medication. Medication to treat this brain disorder of structure and function that we call addiction. They need to get their life back. And keep it. And if those still wedded to the ideology of AA, to the beliefs of the 1930's, when there were no medications for the treatment of addiction, don't like it, then oh well. Too bad.
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]
When a health care professional is caught or suspected of diversion, the nursing board, board of pharmacy, attorney general, or another regulatory agency may require admission into IPRP. This may also result in local, State or Federal investigations and charges. IPRP is required to be transparent with all participating agencies if admission is mandated, thus potentially having a much greater negative effect on the professional's career. 
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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.

Rational Recovery (RR). This secular, non-12-step recovery program mainly utilizes Addictive Voice Recognition Techniques. The techniques enable individuals to identify and manage the "Addictive Voice"—which is defined as any thought or feeling that supports the continued use of drugs and alcohol. The program encourages individuals to make a commitment to abstinence. Unlike other addiction recovery programs, attendance of RR support groups is not considered necessary once an individual has learned the techniques.

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.
Alcohol abuse, now included in the diagnosis of alcohol use disorder, is a disease. While many have described this disorder as dipsomania, the latter term more accurately describes the intense craving that can be a symptom of alcohol use disorder. A maladaptive pattern of drinking alcohol that results in negative work, medical, legal, educational, and/or social effects on a person's life characterizes the disorder. The individual who abuses this substance tends to continue to use it despite such consequences. Effects of alcohol use disorder on families can include increased domestic abuse/domestic violence. The effects that parental alcoholism can have on children can be significantly detrimental in other ways as well. For example, the sons and daughters of alcoholics seem to be at higher risk for experiencing feelings that are more negative, stress, and alienation as well as aggression. There are a multitude of negative psychological effects of alcohol use disorder, including depression and antisocial behaviors.
Self Management and Recovery Training (SMART Recovery). SMART Recovery is a network of support groups that advocate the use of scientific research in addiction recovery. SMART Recovery supports the use of prescription medications and behavioral therapies in the treatment of substance abuse. Since scientific knowledge is constantly evolving, the SMART Recovery program is also constantly evolving. The organization has face-to-face meetings across the United States and daily online meetings.
The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) study suggests the transition from use to dependence was highest for nicotine users, followed by cocaine, alcohol, and cannabis users. [10] An increased risk of transition to dependence among minorities and those with psychiatric or dependence comorbidity highlights the importance of promoting outreach and treatment of these populations.

When it comes to behavior disorders, the notion of causality (cause and effect) can be a major factor between one disorder and another. Drug abuse is often linked to depression, alcoholism is often linked to PTSD and so on. But what about eating disorders? Can THEY be related to alcoholism? They certainly can be. This relationship between substance abuse and a mental health disorder is what’s referred to as a co-occurring disorder. For some people, the substance abuse disorder causes the mental health disorder, while for others, it’s the other way around. The reasons for the co-occurrence of alcoholism and eating disorders vary for each person, but there are certain common denominators involved. These include low self-esteem, poor self-image and depression, which often lead to self-medicating behaviors. Many people who abuse alcohol consume it in place of food, becoming “drunkorexic” as a result. Drunkorexia can also involve combining binge eating and purging in addition with alcohol abuse. The good news is, there are many treatment facilities in the country that can treat alcoholism AND co-occurring disorders like bulimia, anorexia and binge eating. If you or someone you know is struggling with both alcoholism and an eating disorder, help is just a phone call away.
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.
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There are numerous individual psychotherapeutic treatments for alcohol addiction. Relapse prevention uses methods for recognizing and amending problem behaviors. Individualized drug counseling specifically emphasizes short-term behavioral goals in an attempt to help the individual reduce or stop the use of alcohol altogether. Cognitive-behavioral therapy techniques, like helping the individual with alcohol use disorder recognize what tends to precede and follow their episodes of alcohol use, are often used to address alcohol abuse. Some treatment programs include drug testing. Twelve-step recovery programs like Alcoholics Anonymous are individualized drug-counseling methods. Motivational enhancement therapy encourages the person suffering from alcohol use disorder to increase their desire to participate in therapy. Stimulus control refers to an intervention that teaches the alcohol-use disordered person to stay away from situations that are associated with alcohol use and to replace those situations with activities that are alcohol-free and otherwise contrary to using alcohol. Urge control is an approach to changing patterns that lead to drug or alcohol use.
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]
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.

Up to 30% of children are offered drugs before graduating high school, and for alcohol, it’s three out of every four kids who are offered. Peer pressure is a beast. Fitting-in is extremely important in high school, and unfortunately drinking alcohol is a common marker of ‘being cool.’ Peer pressure does not end after 12th grade, though. Oftentimes adults are pressured into drinking at social events when they don’t want to. Over time, this can be habit-forming.

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).
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 illness of the spiritual dimension, or "spiritual malady," is considered in all twelve-step groups to be self-centeredness.[17][18] The process of working the steps is intended to replace self-centeredness with a growing moral consciousness and a willingness for self-sacrifice and unselfish constructive action.[18] In twelve-step groups, this is known as a spiritual awakening not a religious experience.[21] This should not be confused with abreaction, which produces dramatic, but ephemeral, changes.[22] In twelve-step fellowships, "spiritual awakening" is believed to develop, most frequently, slowly over a period of time.[23]
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