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The program’s emphasis on negative feelings of powerlessness and guilt. Continuing in that train of thought, while the idea behind the 12 Steps may have been revolutionary at the time, for many they can feel outdated and even counterproductive. The 12-Step program demands that those in it break themselves down to be built back up, focusing on the notion that you are incapable of taking responsibility not just for your alcoholism but for yourself as well, that there is something wrong with you, and instilling what can feel more like shame than motivation.
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.
Alcohol withdrawal can occur when alcohol use has been heavy and prolonged and is then stopped or greatly reduced. It can occur within several hours to four or five days later. Signs and symptoms include sweating, rapid heartbeat, hand tremors, problems sleeping, nausea and vomiting, hallucinations, restlessness and agitation, anxiety, and occasionally seizures. Symptoms can be severe enough to impair your ability to function at work or in social situations.
In the twelve-step program human structure is symbolically represented in three dimensions: physical, mental, and spiritual. The problems the groups deal with are understood to manifest themselves in each dimension. For addicts and alcoholics the physical dimension is best described by the allergy-like bodily reaction resulting in the compulsion to continue using substances after the initial use.[17][18] The statement in the First Step that the individual is "powerless" over the substance-abuse related behavior at issue refers to the lack of control over this compulsion, which persists despite any negative consequences that may be endured as a result.[19]

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.

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...

Average member sobriety is slightly under 10 years with 36% sober more than ten years, 13% sober from five to ten years, 24% sober from one to five years, and 27% sober less than one year.[64] Before coming to AA, 63% of members received some type of treatment or counseling, such as medical, psychological, or spiritual. After coming to AA, 59% received outside treatment or counseling. Of those members, 84% said that outside help played an important part in their recovery.[64]

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.
Misuse, problem use, abuse, and heavy use of alcohol refer to improper use of alcohol, which may cause physical, social, or moral harm to the drinker.[91] The Dietary Guidelines for Americans defines "moderate use" as no more than two alcoholic beverages a day for men and no more than one alcoholic beverage a day for women.[92] Some drinkers may drink more than 600 ml of alcohol per day during a heavy drinking period.[93] The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as the amount of alcohol leading to a blood alcohol content (BAC) of 0.08, which, for most adults, would be reached by consuming five drinks for men or four for women over a two-hour period. According to the NIAAA, men may be at risk for alcohol-related problems if their alcohol consumption exceeds 14 standard drinks per week or 4 drinks per day, and women may be at risk if they have more than 7 standard drinks per week or 3 drinks per day. It defines a standard drink as one 12-ounce bottle of beer, one 5-ounce glass of wine, or 1.5 ounces of distilled spirits.[94] Despite this risk, a 2014 report in the National Survey on Drug Use and Health found that only 10% of either "heavy drinkers" or "binge drinkers" defined according to the above criteria also met the criteria for alcohol dependence, while only 1.3% of non-binge drinkers met the criteria. An inference drawn from this study is that evidence-based policy strategies and clinical preventive services may effectively reduce binge drinking without requiring addiction treatment in most cases.[95]
Alcohol misuse and dependence are primarily diagnosed through the use of clinical screening surveys. Several hundred such surveys exist, and they vary in the number and nature of questions they ask. Some of the more common scientifically-validated questionnaires include the Michigan Alcohol Screening Test (MAST), a shorter version called the Brief MAST, the Alcohol Use Disorders Identification Test (AUDIT), and a commonly employed, quick survey called the CAGE questionnaire. These surveys ask a range of questions about frequency of drinking, problems that result, and ability to stop.

Alcoholics Anonymous (AA), founded in 1935, was the first twelve-step program ever created. The steps, which are very similar to ones already mentioned, were put in place at that time. In 1946, twelve traditions were created that governed how groups functioned and related to each other as membership was quickly growing. Traditions included the practice of anonymity by only using one’s first name and the tradition of “singleness of purpose.” The latter tradition meant that AA would have “but one primary purpose – to carry its message to the alcoholic who still suffers.” As such, this precluded attendance by anyone who did not suffer from alcohol misuse and resulted in the formation of other 12 step programs.
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