Risk factors for developing problems with alcohol arise from many interconnected factors, including your genetics, how you were raised, your social environment, and your emotional health. Some racial groups, such as American Indians and Native Alaskans, are more at risk than others of developing drinking problems or alcohol addiction. People who have a family history of alcoholism or who associate closely with heavy drinkers are more likely to develop drinking problems. Finally, those who suffer from a mental health problem such as anxiety, depression, or bipolar disorder are also particularly at risk, because alcohol is often used to self-medicate.
Relapse can be avoided by getting sufficient aftercare. Oftentimes, aftercare involves a peer support group, ongoing therapy, and even a maintenance medication like naltrexone, which reduces or eliminates cravings. Support from family and friends is also a very important part of sustained recovery, so finding a supportive home environment – through a sober home, moving to a new house, or clearing drugs and alcohol out of one’s existing home – is very important. Working with an evidence-based treatment program can help one gather resources about nearby or online support groups and therapists.
We AAs have never called alcoholism a disease because, technically speaking, it is not a disease entity. For example, there is no such thing as heart disease. Instead there are many separate heart ailments or combinations of them. It is something like that with alcoholism. Therefore, we did not wish to get in wrong with the medical profession by pronouncing alcoholism a disease entity. Hence, we have always called it an illness or a malady—a far safer term for us to use.[63]
This inventory of self is meant to be comprehensive, searching, and fearless. This does not mean that it is without fear, but that individuals are encouraged to push past their fears and be honest with listing their shortcomings. Writing lists is often an important part of Step 4 as individuals are called to cite incidents, thoughts, feelings, and past experiences that may be difficult to think about.
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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]
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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]
Prevention must begin at a young age since the first instance of intoxication usually occurs during the teenage years. It is particularly important that teenagers who are at high risk for alcoholism-those with a family history of alcoholism, early or frequent use of alcohol, a tendency to drink to drunkenness, alcohol use that interferes with school work, a poor family environment, or a history of domestic violence -receive education about alcohol and its long-term effects. How this is best achieved, without alienating these young people and thus losing their attention, is the subject of continuing debate and study.
I'm sober since 1999, with AA and by the grace of my Higher Power. No religion for me. Meetings, sponsor, litterature and 12 steps every day if possible. I live a wonderful life, quiet and stable. My only enemy is my ego. He often try to bring me back to the "Old Me"... but AA, my sponsor, my sponsees and other members are always there to help me. And I'm there for them.
The World Health Organization estimates that as of 2010 there were 208 million people with alcoholism worldwide (4.1% of the population over 15 years of age).[9][10] In the United States, about 17 million (7%) of adults and 0.7 million (2.8%) of those age 12 to 17 years of age are affected.[11] It is more common among males and young adults, becoming less common in middle and old age.[3] It is the least common in Africa, at 1.1%, and has the highest rates in Eastern Europe, at 11%.[3] Alcoholism directly resulted in 139,000 deaths in 2013, up from 112,000 deaths in 1990.[21] A total of 3.3 million deaths (5.9% of all deaths) are believed to be due to alcohol.[11] It often reduces a person's life expectancy by around ten years.[22] In the United States, it resulted in economic costs of $224 billion USD in 2006.[11] Many terms, some insulting and others informal, have been used to refer to people affected by alcoholism; the expressions include tippler, drunkard, dipsomaniac and souse.[23] In 1979, the World Health Organization discouraged the use of "alcoholism" due to its inexact meaning, preferring "alcohol dependence syndrome".[24]

There are three oral medications that have been FDA-approved to help people remain sober: disulfiram, naltrexone, and acamprosate. They are prescribed for those who have indicated their intention to abstain from alcohol but require some reinforcement. Disulfiram causes unpleasant symptoms such as nausea, vomiting, and flushing with any amount of drinking. Naltrexone limits the cravings a person may get from drinking but can cause severe withdrawal symptoms in people who are also dependent on opiates. Acamprosate helps reduce the craving for alcohol. An injectable, long-acting form of naltrexone is also available. All of these medications are meant to be used in combination with counseling.
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.

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Friends and family members of alcoholic individuals have often developed a codependent relationship with the substance abuser. Specifically, they often feel compelled to either help their loved one secure alcohol or to repair situations caused by the alcoholic's alcohol use. Social control involves family members and other significant others of the alcoholic in treatment.
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The path to getting sober and drug-free is never exactly the same for any two people. However, anyone looking to find out more about rehab and recovery - either for themselves or their loved ones - will recognize some common steps, particularly when it comes to inpatient residential treatment programs. These steps are usually similar whether you’re looking for private alcoholism treatment or a drug addiction recovery center.
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In the early and mild stages of alcohol dependence individuals may find it difficult to stop drinking or feel anxious when they are unable to drink. At this stage, the health and social consequences of alcohol dependence are largely absent. Mild alcohol dependency often gradually leads to more frequent consumption of larger quantities of alcohol, which increases alcohol dependence.
The effects of alcoholism are far reaching. Alcohol affects every body system, causing a wide range of health problems. Problems include poor nutrition, memory disorders, difficulty with balance and walking, liver disease (including cirrhosis and hepatitis), high blood pressure, muscle weakness (including the heart), heart rhythm disturbances, anemia, clotting disorders, decreased immunity to infections, gastrointestinal inflammation and irritation, acute and chronic problems with the pancreas, low blood sugar, high blood fat content, interference with reproductive fertility, increased risk of cancer of the liver, esophagus, and breast, weakened bones, sleep disturbances, anxiety, and depression. About 20% of adults admitted to the hospital (for any reason) are alcohol dependent. Men are more than twice as likely to be alcohol dependent than women, and smokers who are alcohol dependent are much more likely to develop serious or fatal health problems associated with alcoholism.
Many AA meetings take place in treatment facilities. Carrying the message of AA into hospitals was how the co-founders of AA first remained sober. They discovered great value of working with alcoholics who are still suffering, and that even if the alcoholic they were working with did not stay sober, they did.[74][75][76] Bill Wilson wrote, "Practical experience shows that nothing will so much insure immunity from drinking as intensive work with other alcoholics".[77] Bill Wilson visited Towns Hospital in New York City in an attempt to help the alcoholics who were patients there in 1934. At St. Thomas Hospital in Akron, Ohio, Smith worked with still more alcoholics. In 1939, a New York mental institution, Rockland State Hospital, was one of the first institutions to allow AA hospital groups. Service to corrections and treatment facilities used to be combined until the General Service Conference, in 1977, voted to dissolve its Institutions Committee and form two separate committees, one for treatment facilities, and one for correctional facilities.[78]
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:
One review of AA warned of detrimental iatrogenic effects of twelve-step philosophy and concluded that AA uses many methods that are also used by cults.[93] A subsequent study concluded, however, that AA's program bore little resemblance to religious cults because the techniques used appeared beneficial.[94] Another study found that the AA program's focus on admission of having a problem increases deviant stigma and strips members of their previous cultural identity, replacing it with the deviant identity.[95] A survey of group members, however, found they had a bicultural identity and saw AA's program as a complement to their other national, ethnic, and religious cultures.[96]

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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.


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.
Our Mission: To provide evidenced-based, compassionate care in a professional and collaborative manner which creates an atmosphere of hope that not only promotes recovery from alcohol or drug addiction, but provides a space where patients can discover their highest human potential and be inspired to make recovery-oriented changes medically, socially, emotionally and/or spiritually.
Smith and Wilson left the Oxford Group in 1937 to focus on developing Alcoholics Anonymous, and by 1938, they had successfully brought the message to almost a hundred alcoholics in the Ohio and New York areas. Looking to capitalize on their momentum, they decided to document the group in a book. Wilson took the lead on the project, naming the resulting publication, Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism. He included 12 guidelines that, if followed, would grow the individual’s spirit to the point of overcoming the temptation to drink, and help the person make reparations for all the damage done during the days of drinking. These became known as the 12 Steps, and the book’s popularity led to Wilson’s group adopting the name of the book itself.

In most parts of the world, alcohol is legal for adults to both purchase and consume. As a result, beverages that contain alcohol are available almost everywhere, and clearly, many adults partake. Since use is so common, it might seem hard to determine who is drinking alcohol in an appropriate manner and who is drinking in a manner that could lead to alcohol abuse or alcoholism. Experts suggest there are key signs to look for.


Twelve-step recovery programs aren’t the answer for every addict. But these principles of behavior have helped a lot of people face their addiction honestly and rebuilt their lives on a more solid, stable foundation. At Axis, our approach to recovery is based on the guidelines of the 12 steps. We use these principles as a framework for developing personalized treatment plans that address each client’s individual needs. If you’re struggling with a drug or alcohol problem, we encourage you to call our intake counselors to find out how our philosophy of care can make positive changes in your life.
Once the person has safely detoxed from alcohol, a comprehensive rehabilitation program is the best step. These programs offer intensive therapy to help clients understand the root causes of their addiction and change their behaviors toward intoxicating substances. The National Institute on Drug Abuse (NIDA) recommends remaining in a rehabilitation program for 90 days, or three months.

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.
AA's program extends beyond abstaining from alcohol.[33] Its goal is to effect enough change in the alcoholic's thinking "to bring about recovery from alcoholism"[34] through "an entire psychic change," or spiritual awakening.[35] A spiritual awakening is meant to be achieved by taking the Twelve Steps,[36] and sobriety is furthered by volunteering for AA[37] and regular AA meeting attendance[38] or contact with AA members.[36] 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.[37] 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.[39]
While some people with alcohol use disorder can cut back or stop drinking without help, most are only able to do so temporarily unless they get treatment. Individuals who consume alcohol in lower amounts and tend to cope with problems more directly are more likely to be successful in their efforts to cut back or stop drinking without the benefit of treatment.
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.
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n the continued extreme dependence on excessive amounts of alcohol, accompanied by a cumulative pattern of deviant behaviors. The most frequent consequences are chronic gastritis, central nervous system depression, and cirrhosis of the liver, each of which can compromise the delivery of dental care. Oral cancer and increased levels of periodontal disease are also risks.
At secular meetings there is generally much more acceptance of medication-assisted recovery, much less emphasis on deficits in "moral character," and no prayer.  The focus is present-centered, avoiding "war stories," and pragmatic:  "how am I staying sober today?  What tools am I using?" Participants are also generally not required to label themselves as addicts or alcoholics, which can be refreshing for many people new to recovery.  In LifeRing, "crosstalk" is a key element of meetings, so folks in recovery are sharing their strategies for success.
A disorder characterized by a persistent pattern of alcohol use that causes harm or distress. It typically involves cravings for alcohol, inability to control the amount consumed, withdrawal symptoms in its absence, and the need to consume greater quantities in order to feel the same effects, and often results in impaired social functioning and significant damage to physical health.

Most of the warning signs and symptoms of alcoholism are not difficult to pinpoint. However, there are some that are obvious. Often, an alcoholic will not admit that there is a problem. This could be due to denial, or a true belief no problem exists. Generally speaking, the last person to realize that there is a problem is the alcoholic. He or she will likely deny the existence of a problem until irreparable damage is done. This is why the symptoms of alcoholism are important to recognize.


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.
Treatment of alcoholism often is a combination of inpatient and outpatient therapy depending on the individual's alcohol history and physical condition. The person with alcoholism often resists the idea that he or she has an alcohol problem and needs to stop drinking. Treatment cannot be forced on adults unless it is a condition imposed by a court of law. However, if the person is a danger to him- or herself or to others, immediate hospitalization may be possible without the individual's consent.

In order to effectively recover from an addiction, professional help in the field of substance abuse is only part of the equation. Often times, recovering individuals additionally need the support of others who are also recovering from addiction. This is where support groups can provide a critical element needed to bring success to an individual's recovery process.

Demographic preferences related to the addicts' drug of choice has led to the creation of Cocaine Anonymous, Crystal Meth Anonymous and Marijuana Anonymous. Behavioral issues such as compulsion for, and/or addiction to, gambling, crime, food, sex, hoarding, debting and work are addressed in fellowships such as Gamblers Anonymous, Overeaters Anonymous, Sexaholics Anonymous and Debtors Anonymous.
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