Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

"When I first told my family I was going into treatment, they were stunned," said Cathy, a recovering alcoholic. "I wanted to talk, needed to talk, but none of us had the right words yet. Now, five years later, I realize that it doesn't really matter how perfectly you say something. You have to risk saying the wrong thing and just start communicating.

An initial step in detecting liver damage is a simple blood test to determine the presence of certain liver enzymes in the blood. Under normal circumstances, these enzymes reside within the cells of the liver. But when the liver is injured, these enzymes are spilled into the blood stream, and can lead to diseases like fatty liver, type 2 diabetes, obesity, and hepatitis. Several medications also can increase liver enzyme test results.

Some people don’t like or are not interested in the 12-Step model, even with the variations above or through organizations that facilitate the 12-Step model. Some people don’t like basing their recovery on the idea that they cannot control their addiction, when there is evidence that there are ways of practicing internal control over the recovery process.
AA meetings do not exclude other alcoholics, though some meetings cater to specific demographics such as gender, profession, age, sexual orientation,[44][45] or culture.[46][47] Meetings in the United States are held in a variety of languages including Armenian, English, Farsi, Finnish, French, Japanese, Korean, Russian, and Spanish.[48][45] While AA has pamphlets that suggest meeting formats,[49][50] groups have the autonomy to hold and conduct meetings as they wish "except in matters affecting other groups or AA as a whole".[4] Different cultures affect ritual aspects of meetings, but around the world "many particularities of the AA meeting format can be observed at almost any AA gathering".[51]
AA meetings do not exclude other alcoholics, though some meetings cater to specific demographics such as gender, profession, age, sexual orientation,[44][45] or culture.[46][47] Meetings in the United States are held in a variety of languages including Armenian, English, Farsi, Finnish, French, Japanese, Korean, Russian, and Spanish.[48][45] While AA has pamphlets that suggest meeting formats,[49][50] groups have the autonomy to hold and conduct meetings as they wish "except in matters affecting other groups or AA as a whole".[4] Different cultures affect ritual aspects of meetings, but around the world "many particularities of the AA meeting format can be observed at almost any AA gathering".[51]
Other tests are sometimes used for the detection of alcohol dependence, such as the Alcohol Dependence Data Questionnaire, which is a more sensitive diagnostic test than the CAGE questionnaire. It helps distinguish a diagnosis of alcohol dependence from one of heavy alcohol use.[116] The Michigan Alcohol Screening Test (MAST) is a screening tool for alcoholism widely used by courts to determine the appropriate sentencing for people convicted of alcohol-related offenses,[117] driving under the influence being the most common. The Alcohol Use Disorders Identification Test (AUDIT), a screening questionnaire developed by the World Health Organization, is unique in that it has been validated in six countries and is used internationally. Like the CAGE questionnaire, it uses a simple set of questions – a high score earning a deeper investigation.[118] The Paddington Alcohol Test (PAT) was designed to screen for alcohol-related problems amongst those attending Accident and Emergency departments. It concords well with the AUDIT questionnaire but is administered in a fifth of the time.[119] Certain blood tests may also indicate possible alcoholism.[3]
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]
Alcohol exerts a depressive effect on the brain. The blood-brain barrier does not prevent alcohol from entering the brain, so the brain alcohol level will quickly become equivalent to the blood alcohol level. In the brain, alcohol interacts with various neurotransmitters to alter nerve function. Alcohol's depressive effects result in difficulty walking, poor balance, slurring of speech, and generally poor coordination (accounting in part for the increased likelihood of injury). The affected person also may have impairment of peripheral vision. At higher alcohol levels, a person's breathing and heart rates may be slowed and vomiting may occur (with a high risk of the vomit being breathed into the lungs, potentially resulting in aspiration pneumonia.) Still higher alcohol levels may result in coma and death.
Alcoholism is common, serious, and expensive. Physicians encounter alcohol-related cirrhosis, cardiomyopathy, pancreatitis, and gastrointestinal bleeding, as well as intoxication and alcohol addiction, on a daily basis. Alcoholism is also associated with many cancers. Wernicke encephalopathy and Korsakoff psychosis are also important causes of chronic disability as well as dementia. Fetal alcohol syndrome is a leading cause of mental retardation. In addition, accidents (especially automobile), depression, dementia, suicide, and homicide are important consequences of alcoholism.
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.

Issues with retention and completion rates. Despite how ingrained the 12-Step program is as the standard for alcoholism recovery, the hard numbers tell a different story. According to several studies, the 12-Step Program has been found to be effective for about 20 percent of those that try it, with the other 80 percent usually stopping after just one month. At any given time, only five percent of those still attending AA has been there for a year.
Young adult subtype: These individuals account for, per the study, about 32 percent of people struggling with AUD. This group generally begins to experience compulsive behaviors around alcohol associated with addiction when they are around 20 years old. While they have fewer occasions during an average week in which they drink, they tend to binge drink on those occasions.
There are countless ways to lose your data. Power failure, failed boot drives, partition damage, an accidentally emptied Recycle Bin, a virus attack… these are only the most common. Data loss can be a frustrating, infuriating or downright terrifying experience. For fast, reliable file recovery software, download Disk Drill for Windows to recover your lost data no matter what the cause.
Naltrexone is a competitive antagonist for opioid receptors, effectively blocking the effects of endorphins and opioids. Naltrexone is used to decrease cravings for alcohol and encourage abstinence. Alcohol causes the body to release endorphins, which in turn release dopamine and activate the reward pathways; hence in the body reduces the pleasurable effects from consuming alcohol.[136] Evidence supports a reduced risk of relapse among alcohol-dependent persons and a decrease in excessive drinking.[135] Nalmefene also appears effective and works in a similar manner.[135]
Some data recovery apps also include the opposite of file recovery—permanent file deletion. When you want to make sure that no one can retrieve your data, you can tell these apps to overwrite the data with enough random bytes to make the original data unreadable. Keep in mind that government agencies have tools that can retrieve data from almost anything, but these apps make it impractical even for expert thieves to recover private information from stolen or discarded disk drives.

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Added fat and scar tissue on the liver due to excessive alcohol consumption can lead to all sorts of problems, but most often either cirrhosis or alcohol-induced hepatitis. Liver failure among those who drink heavily for many years is likely. Pancreatitis, or the consistent inflammation of the pancreas, can also cause damage to the body, including high blood sugar leading to diabetes.
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 female member, Florence Rankin, joined AA in March 1937,[6][7] and the first non-Protestant member, a Roman Catholic, joined in 1939.[8] The first Black AA group was established in 1945 in Washington DC by Jim S., an African-American physician from Virginia.[9][10] AA membership has since spread internationally "across diverse cultures holding different beliefs and values", including geopolitical areas resistant to grassroots movements.[11] Close to 2 million people worldwide are members of AA as of 2016.[12]
Over 6% of the Australian population meet the criteria for having alcohol consumption disorders, either alcohol dependence or intoxication disorder. Alcohol dependence is the most common disorder, occurring in about 4.1% of Australians. A greater proportion of men (6.1%) suffer from alcohol dependence than women (2.3%). 18–24 years olds (of whom 9.3% meet the criteria for alcohol dependence) are the age group most likely to be alcohol dependent in Australia. There is a higher rate of alcohol consumption disorders amongst Indigenous Australians, compared to non-Indigenous Australians.
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:
Statistics (US) Alcohol causes half a million hospital admissions/year, 17,000 psychiatric admissions, 80% of all fire-related deaths, 65% of serious head injuries, 50% of homicides, 40% of RTAs/MVAs, 33% of divorces, 33% child abuse cases, 30% of fatal accidents, 30% of domestic accidents, 8 million working days lost, £1.6 billion annual cost to society.
Dr.Miller, if it were that simple, we wouldn't be discussing the issue at all. I have experienced both sides of the fence so to speak. I've been the guy in the back of the room who couldn't put 24 hours of sobriety together, life in shambles, family gone, and without the ability to function in society.   On the other hand I have worked in the treatment field, worked the program in every aspect of my life, as well as sponsored countless people.  The sponsorship is where I have the "BEGINNING" of difficulty, not that it's all bad. Especially when it comes to forth step.  A person who has resentments should be made to see their part in their resentment. All to often though the addict is made to blame.  A sponsee of mine was raped in jail and he had put it on his forth step.  So he had sexual issues, self worth issues, ECT.  I deferred to my sponsor on how to deal with such a resentment. He and his sponsor both told me to tell the kid, yea, it was bad, but you put yourself In jail, so it your fault. I've taken enough psychology to know you never under any circumstances  tell a rape victim it's their fault that they were raped. I told him to defer to a mental health professional, and for a time he improved. Later after being forced back into AA by the legal system he was again told on a fourth step that it was his fault for being raped. But this crazy "tough love", "it's your fault"  "now learn some humility and fix it", kind of thinking permeates AA to it's core.  The kid did stay sober, his determination was so strong the police found him with both barrels of a shotgun in his mouth and the back of his head splattered against the wall. Next to him they found and unopened bottle of wiskey and a note saying "this is how bad I don't want to drink". You see, he had floundered in AA and so of course the finger was pointed  at him for failure, by his family, by the program, and most people he knew. This is just one of countless horror stories. If you look at the founder. I realize that most believe AA  was co founded by Dr. Robert Smith M.D.  In reality, Dr. Bob was the first person to have tried the program and had any success. Everyone Bill Wilson tried his program on previously failed miserably. But looking at the heart of the origins of the program, and I dont mean the Oxford groups of whom Bill Wilson would derive his 12 steps from their 6 step program, I mean at the thinking of Bill Wilson himself. He says in his biography that he had a literal disease that left him virtually powerless over every vice and compulsion he indulged in.  AND I don't say this to degrade In anyway the hardworking and caring people of AA. Heaven knows, the vast overwhelming majority of AA's have their hearts in the right place, but the whole thing is based on an excuse. The idea of having a disease took the heat off of Bill.  The program  slowly built up around that notion that there's a disease to blame. After 20 years of life experience, and a lot of academia,  I believe the problem lies in unintentional conditioning. Really a learning disorder to put it in other terms. Susceptible individuals, usually because of one form of trauma or another seek out relief. By repeated chemical administration the brain slowly starts to think that chemical is necessary for survival. Probably because the instinctual systems become involved. When a compulsion is more powerful than a individuals desire for oxygen, and food ECT.  Words are useless, consequences will have no effect. Mostly because a person can't directly access the sub conscience.  But you can unlearn something. Email me for the real solution
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.
Q. Alcoholism Steve 26 yr old suffered with bi-polar and the related drugs that eventually lead to his over dose. He died in where he felt a connection to the intellectual environment. After suffering with Steve for so many years, I am convinced that this disease is genetic; his grandmother also suffered with drug addiction and a mental disorder, but had that gene that must have been inherited by Steve. Any one in the area of mental health and genetic engineering Research? We want to set up or get involved with public awareness on the devastation of this disease which kills 100+ thousands in this country each year; yet society treats it as a social problem -- The advancement of mental research has been slow almost medieval -- Please help. No one, no family should have to suffer the way my beautiful son suffered and who had so much to give to humanity.
Sponsors share their experience, strength, and hope with their sponsees... A sponsor's role is not that of a legal adviser, a banker, a parent, a marriage counselor, or a social worker. Nor is a sponsor a therapist offering some sort of professional advice. A sponsor is simply another addict in recovery who is willing to share his or her journey through the Twelve Steps.[29]
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