Chuck Lorre's Mom (2013-), follows dysfunctional daughter/mother duo Christy and Bonnie Plunkett, who are estranged for years while simultaneously struggling with addiction. They attempt to pull their lives and relationships together by trying to stay sober and visiting Alcoholics Anonymous. The show also explores themes of alcoholism, drug addiction and relapse.
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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.
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AA's program extends beyond abstaining from alcohol. Its goal is to effect enough change in the alcoholic's thinking "to bring about recovery from alcoholism" through "an entire psychic change," or spiritual awakening. A spiritual awakening is meant to be achieved by taking the Twelve Steps, and sobriety is furthered by volunteering for AA and regular AA meeting attendance or contact with AA members. Members are encouraged to find an experienced fellow alcoholic, called a sponsor, to help them understand and follow the AA program. The sponsor should preferably have experience of all twelve of the steps, be the same sex as the sponsored person, and refrain from imposing personal views on the sponsored person. Following the helper therapy principle, sponsors in AA may benefit from their relationship with their charges, as "helping behaviors" correlate with increased abstinence and lower probabilities of binge drinking.
During addiction recovery, individuals in treatment may also undergo various types of therapy and participate in support groups as they work to address and heal the attitudes, thoughts, emotions and behaviors that led to substance abuse in the first place. Ongoing participation in therapy and support groups may continue long after the initial period of treatment as they may continue to provide lasting recovery benefit for many individuals.
Young antisocial subtype: This group represents about 21 percent of people struggling with AUD, according to the NIAAA study. On average, this group is about 26 years old – so still young, but not as young as the young adult group. They are defined by having antisocial personality disorder; this mental health condition leads them to begin drinking in adolescence, around age 15 on average, and they display symptoms of AUD by age 18. They are also more likely to struggle with polydrug abuse, especially abuse of tobacco and marijuana. There is no overlap between the young adult and young antisocial subtypes.
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.
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.
Below are the statistically significant relative risks from a study by the American Cancer Society for men and women who consume 4 or more drinks daily. A drink is defined as one 12-oz beer, one 4- to 5-oz glass of wine, or one mixed drink containing 1.5 oz of spirits (80 proof). The relative risk for the noted maladies with consumption of 4 or more drinks daily is as follows:
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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.
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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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. 
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While Wilson and Smith credited their sobriety to working with alcoholics under the auspices of the Oxford Group, a Group associate pastor sermonized against Wilson and his alcoholic Groupers for forming a "secret, ashamed sub-group" engaged in "divergent works". By 1937, Wilson separated from the Oxford Group. AA Historian Ernest Kurtz described the split:
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During Step 9, individuals will attempt to make amends for wrongdoings done to specific individuals. People are encouraged to reach out to these individuals and let them know that they would like to approach them to make amends. It can be very humbling to do so. In some cases, it is not possible to have these conversations directly, or doing so would be more harmful, so indirect methods may be ideal. Individuals can write a letter to the person (even if it will never actually be delivered), or they may choose to donate to a charity in their honor or help someone else in need.
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Not all alcohol abusers become full-blown alcoholics, but it is a big risk factor. Sometimes alcoholism develops suddenly in response to a stressful change, such as a breakup, retirement, or another loss. Other times, it gradually creeps up on you as your tolerance to alcohol increases. If you’re a binge drinker or you drink every day, the risks of developing alcoholism are greater.
Alcohol intoxication results as the amount of alcohol in your bloodstream increases. The higher the blood alcohol concentration is, the more impaired you become. Alcohol intoxication causes behavior problems and mental changes. These may include inappropriate behavior, unstable moods, impaired judgment, slurred speech, impaired attention or memory, and poor coordination. You can also have periods called "blackouts," where you don't remember events. Very high blood alcohol levels can lead to coma or even death.
If you are in need of immediate assistance, please call a counselor for immediate help 800-839-1686. Alcohol and Drug Rehab Counselors specializing in alcohol addiction drug treatment and substance abuse issues are standing by ready to listen and address any questions or concerns that you may have. Alcoholics Resource Center is supported by caring individuals with a genuine desire to help you achieve sobriety. Alcoholics Resource Center guides individuals struggling with alcohol addiction to AA meetings and recovery that helps prevent painful relapse. We offer many resources that can help individuals identify problematic behavioral patterns and help establish the best approach to fully overcome the challenging obstacles of alcohol addiction.
Alcoholism can also lead to impotence in men, damage to the fetus in pregnant women, and an elevated risk of cancer of the larynx, esophagus, liver, breast, stomach, pancreas, and upper gastrointestinal tract. Because heavy drinkers seldom have adequate diets, they may have nutritional deficiencies. Heavy drinkers typically have impaired liver function, and up to one in five develops cirrhosis.
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Morgan and his colleagues used data from the National Epidemiological Survey on Alcohol and Related Conditions, xamining the gender-specific prevalence of Axis I (clinical disorders such as depression, schizophrenia, social phobia) and Axis II (personality disorders such as paranoia, antisocial and borderline personality) disorders in 40,374 respondents (23,006 males, 17,368 females) with and without a history of paternal or maternal alcoholism.
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.
Twelve-step programs approach alcoholism and drug addiction as diseases that can only be managed by surrendering one’s will to a higher power. In spite of their reliance on the disease model of addiction, 12-step groups offer rewarding experiences that reinforce healthy, sober behaviors. In this sense, the 12 steps reflect the principles of positive psychology, notes the Journal of Substance Abuse Treatment. Positive psychology is based on the belief that gratifying experiences will encourage the individual to repeat a healthy behavior, such as attending meetings or reading AA literature, rather than reverting to a self-destructive behavior, such as drinking or using drugs.
Feeling a "kinship of common suffering" and, though drunk, Wilson attended his first Group gathering. Within days, Wilson admitted himself to the Charles B. Towns Hospital after drinking four beers on the way—the last alcohol he ever drank. Under the care of William Duncan Silkworth (an early benefactor of AA), Wilson's detox included the deliriant belladonna. At the hospital a despairing Wilson experienced a bright flash of light, which he felt to be God revealing himself. Following his hospital discharge Wilson joined the Oxford Group and recruited other alcoholics to the Group. Wilson's early efforts to help others become sober were ineffective, prompting Silkworth to suggest that Wilson place less stress on religion and more on "the science" of treating alcoholism. Wilson's first success came during a business trip to Akron, Ohio, where he was introduced to Robert Smith, a surgeon and Oxford Group member who was unable to stay sober. After thirty days of working with Wilson, Smith drank his last drink on 10 June 1935, the date marked by AA for its anniversaries.
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. 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.