Prevention of alcoholism may be attempted by regulating and limiting the sale of alcohol, taxing alcohol to increase its cost, and providing inexpensive treatment.[17] Treatment may take several steps.[7] Due to medical problems that can occur during withdrawal, alcohol detoxification should be carefully controlled.[7] One common method involves the use of benzodiazepine medications, such as diazepam.[7] These can be either given while admitted to a health care institution or occasionally while a person remains in the community with close supervision.[7] Mental illness or other addictions may complicate treatment.[18] After detoxification, support such as group therapy or support groups are used to help keep a person from returning to drinking.[6][19] One commonly used form of support is the group Alcoholics Anonymous.[20] The medications acamprosate, disulfiram or naltrexone may also be used to help prevent further drinking.[8]
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.

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.

Prevention of alcoholism may be attempted by regulating and limiting the sale of alcohol, taxing alcohol to increase its cost, and providing inexpensive treatment.[17] Treatment may take several steps.[7] Due to medical problems that can occur during withdrawal, alcohol detoxification should be carefully controlled.[7] One common method involves the use of benzodiazepine medications, such as diazepam.[7] These can be either given while admitted to a health care institution or occasionally while a person remains in the community with close supervision.[7] Mental illness or other addictions may complicate treatment.[18] After detoxification, support such as group therapy or support groups are used to help keep a person from returning to drinking.[6][19] One commonly used form of support is the group Alcoholics Anonymous.[20] The medications acamprosate, disulfiram or naltrexone may also be used to help prevent further drinking.[8]

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People have been brewing and fermenting alcoholic drinks since the dawn of civilization. Consumed in moderate amounts, alcoholic beverages are relaxing and in some cases may even have beneficial effects on heart health. Consumed in excess, alcohol is poisonous and is considered a drug. It is estimated that between 18 million -- or one in 12 adults -- in the U.S. abuse alcohol or are chronic alcoholics. Nearly 100,000 Americans die each year as a result of alcohol abuse, and alcohol is a factor in more than half of the country's homicides, suicides, and traffic accidents. Alcohol abuse also plays a role in many social and domestic problems, from job absenteeism and crimes against property to spousal and child abuse.
But not everyone in the treatment community is as skeptical toward Alcoholics Anonymous. Scientific American grants that it’s not a perfect solution, but claims that criticisms of the group are often unfair or based on false assumptions. For many alcoholics, AA’s wide availability of meetings and lack of expense make it a worthy consideration. The Recent Developments in Alcoholism journal said 12-Step programs are “an ideal recovery recourse,” and the Alcoholic Research & Health journal notes that the rise of other treatment methods have not displaced the model of mutual health groups, which are still the most widely sought-after source of help for alcoholism and other substance abuse problems.
Fact: Alcoholism is NOT defined by what you drink, when you drink it, or even how much you drink. It’s the EFFECTS of your drinking that define a problem. If your drinking is causing problems in your home or work life, you have a drinking problem—whether you drink daily or only on the weekends, down shots of tequila or stick to wine, drink three bottles of beers a day or three bottles of whiskey.
Step 6 is about letting go of negativity and the past, and moving forward with the help of the higher power. Individuals pray, asking their higher power to remove their moral failings. People may go back to their lists of wrongdoings during Step 6 or choose to write a whole new list of specific character flaws. Individuals then choose something positive to replace these defects with. For example, lying and secrecy can be replaced with transparency and honesty. During Step 6, it may be helpful to write down several positive affirmations next to personal character issues, thus providing new and healthy methods for living in recovery.
The first book written to cover the 12 step program was titled "Alcoholics Anonymous", affectionately known as the Big Book by program members. Following the subsequent extensive growth of twelve step programs for other addictive and dysfunctional behaviors, many additional books were written and recordings and videos were produced. These cover the steps in greater detail and how people have specifically applied the steps in their lives. An extensive chronology and background about the history of A.A. has been put together at Dick B.'s website.

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:


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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.
Within the medical and scientific communities, there is a broad consensus regarding alcoholism as a disease state. For example, the American Medical Association considers alcohol a drug and states that "drug addiction is a chronic, relapsing brain disease characterized by compulsive drug seeking and use despite often devastating consequences. It results from a complex interplay of biological vulnerability, environmental exposure, and developmental factors (e.g., stage of brain maturity)."[111] Alcoholism has a higher prevalence among men, though, in recent decades, the proportion of female alcoholics has increased.[36] Current evidence indicates that in both men and women, alcoholism is 50–60 percent genetically determined, leaving 40–50 percent for environmental influences.[153] Most alcoholics develop alcoholism during adolescence or young adulthood.[69] 31 percent of college students show signs of alcohol abuse, while six percent are dependent on alcohol. Under the DSM's new definition of alcoholics, that means about 37 percent of college students may meet the criteria.[154]
Blood. Alcohol may cause changes to all the types of blood cells. Red blood cells become abnormally large. White blood cells (important for fighting infections) decrease in number, resulting in a weakened immune system. This places alcohol-dependent individuals at increased risk for infections and may account in part for the increased risk of cancer faced by people with alcoholism. Platelets and blood clotting factors are affected, causing an increased risk of bleeding.
At least two thirds of all alcohol consumed by Australians is consumed at levels which present either long or short term health risks. Some 10% of Australian men and women consume more than the average number of drinks recommended in the Australian guidelines. While a smaller proportion of Indigenous Australians drink than non-Indigenous Australians, a higher proportion of Indigenous Australians (20%) exceed the recommended average daily drinking limits than non-Indigenous Australians.

AA has remained mostly unchanged since it was founded. Obviously, the world is not the same as it was in 1935, as well as addiction, how we see it, and how we treat it. While newer sober support programs like SMART Recovery make it a point to keep up with the latest in the science of recovery treatment, AA and its 12 Steps have relied on the same “one-size-fits-all” techniques for almost 80 years, techniques that may no longer be as effective in today’s world.
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]
The only requirement for membership is a desire to stop drinking. There are no dues or fees for A.A. membership; we are self-supporting through our own contributions. A.A. is not allied with any sect, denomination, politics, organization or institution; does not wish to engage in any controversy; neither endorses nor opposes any causes. Our primary purpose is to stay sober and help other alcoholics to achieve sobriety.
A lot of people get wrapped up in abusing psychoactive substances that make them feel good.  Physical and psychological dependence ensue.  Both states of withdrawal may ensue.  There are people who just need motivation and life change to get away from their addiction.  There is another class of people who cannot stop.  The 12-steps are being attacked because they can't do anything for you.  You have to use the 12-steps for them to help you.  I have the disease, nothing else could help me. 
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Given the malnutrition that many alcoholics suffer from, gradual correction of that condition is also important, both to prevent or correct the consequences of malnutrition (like low thiamine level) and to prevent the potential results of correcting nutrition problems too rapidly. One example of the latter is that people with chronic alcohol-induced low sodium levels in the bloodstream (hyponatremia) are at risk for severe neurological problems due to a loss of the outer, insulating covering of nerve cells in parts of the brain (central pontine myelinolysis) if low sodium levels are corrected too rapidly.
"We will comprehend the word serenity and we will know peace." (Alcoholics Anonymous, p. 84)          Just For Today          Life takes on new meaning in A.A. To watch people recover, to see them help others, to watch loneliness vanish, to see a fellowship grow up about you, to have a host of friends - this is an experience not to be missed. (from the 12&12 and Alcoholics Anonymous)          
Like many chronic diseases, alcoholism cannot be cured; however, effective treatment is available to help individuals who suffer from alcoholism remain sober. Treatment usually consists primarily of group therapy, one or more types of counseling, and alcohol education. Participants must acknowledge that they have a drinking problem and have a strong desire to stop drinking. Once the decision has been made, they may check into a treatment center for a brief period of time to rehabilitate as they stop drinking. The treatment center (and/or doctor) counsels patients, gives them support, and helps them get through their initial symptoms and safely withdraw from the alcohol. In some cases, short-term medications such as benzodiazepines (Valium or similar drugs) are used to help alleviate some of the symptoms of alcohol dependence.
Herbal treatments include milk thistle (Silybum marianum), which is thought to protect the liver against damage. Other herbs are thought to be helpful for the patient suffering through withdrawal. Some of these include lavender (Lavandula officinalis), skullcap (Scutellaria lateriflora), chamomile (Matricaria recutita), peppermint (Mentha piperita) yarrow (Achillea millefolium), and valerian (Valeriana officinalis).

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.


An analysis in the United Kingdom in 2010 found that overall, alcohol was found to be the most harmful drug to the person consuming and to others. However, this study does not mean that substances other than alcohol have no harmful consequences; heroin, cocaine, and methamphetamine were found to be the most harmful drugs to individuals themselves. In addition, this study did not address the issue of polydrug abuse, which is a common phenomenon in individuals abusing substances. The combination of alcohol and other substances can lead to serious adverse effects, and such combinations were not explored in this study. [12]
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Successful long-term recovery is more likely with longer involvement in the treatment process. Wyoming Recovery offers weekly continuing care sessions for the months after completion of residential or Intensive Outpatient levels of care. In these groups, graduates address various issues of sober living in the real world setting, helping to reduce the risk of relapse.
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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Environmental factors and genetics are two components associated with alcoholism, with about half the risk attributed to each.[3] Someone with a parent or sibling with alcoholism is three to four times more likely to become an alcoholic themselves.[3] Environmental factors include social, cultural and behavioral influences.[14] High stress levels and anxiety, as well as alcohol's inexpensive cost and easy accessibility, increase the risk.[3][5] People may continue to drink partly to prevent or improve symptoms of withdrawal.[3] After a person stops drinking alcohol, they may experience a low level of withdrawal lasting for months.[3] Medically, alcoholism is considered both a physical and mental illness.[15][16] Questionnaires and certain blood tests may both detect people with possible alcoholism.[3] Further information is then collected to confirm the diagnosis.[3]
Moderate alcohol consumption appears to increase the risk of breast cancer in women. Total mortality is reduced with moderate alcohol consumption but not with heavy alcohol consumption; the cardiovascular benefit is offset by cirrhosis, cancer, and injuries. The amount of alcohol associated with the lowest mortality appears to be 2 drinks per day in men and 1 drink or fewer per day in women. Moderate alcohol consumption reduces the risk of developing diabetes, but heavy alcohol consumption may increase the risk. The cardiovascular benefit becomes important in men older than 40 years and in women older than 50 years. The risk of hypertension is increased with 3 or more drinks daily.
Babies who are born to mothers who are heavy drinkers are more at risk for being born with significant medical, developmental, behavioral, and emotional problems, including fetal alcohol syndrome (FAS). However, many babies whose mothers consumed even minimal amounts of alcohol during pregnancy have been born with such problems. Therefore, there is no amount of alcohol intake that has been proven to be safe during pregnancy.
If you have ever found your drinking to interfere with your career or your life at home, then chances are you’re either an alcoholic or on your way. Those who drink responsibly tend to use alcohol as a treat, something to be consumed once the day’s work is done, or at special social occasions. Those who are alcoholics tend to use alcohol for really no reason at all.
No laboratory tests exist that can screen for alcoholism with a high level of accuracy. Most alcoholism is diagnosed through patient and family history. However, alcoholism can be difficult to diagnose until late-stage physical symptoms become apparent because alcohol-dependent people often lie or about underestimate their alcohol use. In addition, many physicians do not routinely screen their patients using standardized questionnaires that may reveal alcohol problems.
The twelve steps of the program are listed above and on the steps page in generic form. Other groups who have adopted the 12 steps to address their own particular addictive or dysfunctional behavior have similar ideas, usually with only minor variations. These steps are meant to be worked sequentially as a process of getting rid of addictive behaviors and should result in a growth in freedom and happiness, as outlined in the Promises. The general governing approach for A.A. groups was originally laid out in the Twelve Traditions, and they remain the guiding principles for most 12 step groups today.
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