For every addiction, there are recovery programs and support groups to help those looking to kick their habits. Generally speaking, these programs can be grouped into one of two big buckets: those following a 12-step approach, and those that do not. Which you choose will be a matter of personal preference and – to some – whether you believe in a higher power, which 12-step programs typically promote. Either way, these resources can help you stay happy, healthy and social after your course of recovery from drug addiction or alcoholism treatment.
"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)          

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. [3]


interventions Extreme caution should be used in administering drugs to alcoholic patients because of the possibility of additive central nervous system depression and toxicity caused by inability of the liver to metabolize the drugs. Treatment consists of psychotherapy (especially group therapy by organizations such as Alcoholics Anonymous), or administration of drugs such as disulfiram that cause an aversion to alcohol. See also acute alcoholism, chronic alcoholism.
Since Alcoholics Anonymous was founded in the 1930s, 12-step treatment models have gained widespread acceptance among psychologists, therapists, social workers and medical doctors. Twelve-step groups like AA have also become a gold standard of recovery for many members of the general public. What makes the 12 steps such an effective model for drug and alcohol rehab? The psychology behind these principles indicates that these non-profit, mutual self-help groups fulfill several important needs, such as:
There are few medications that are considered effective in treating moderate to severe alcohol use disorder. Naltrexone (Trexan, Revia, or Vivitrol) has been found effective in managing this illness. It is the most frequently used medication in treating alcohol use disorder . It decreases the alcoholic's cravings for alcohol by blocking the body's euphoric ("high") response to it. Naltrexone is either taken by mouth on a daily basis or through monthly injections. Disulfiram (Antabuse) is prescribed for about 9% of alcoholics. It decreases the alcoholic's craving for the substance by producing a negative reaction to drinking. Acamprosate (Campral) works by decreasing cravings for alcohol in those who have stopped drinking. Ondansetron (Zofran) has been found to be effective in treating alcohol use disorder in people whose problem drinking began before they were 25 years old. None of these medications have been specifically approved to treat alcoholism in people less than 18 years of age. Baclofen (Lioresal) has been found to be a potentially effective treatment to decrease alcohol cravings and withdrawal symptoms. Some research indicates that psychiatric medications like lithium (Eskalith, Lithobid) and sertraline (Zoloft) may be useful in decreasing alcohol use in people who have another mental health disorder in addition to alcohol use disorder.

Serious social problems arise from alcoholism; these dilemmas are caused by the pathological changes in the brain and the intoxicating effects of alcohol.[40][55] Alcohol abuse is associated with an increased risk of committing criminal offences, including child abuse, domestic violence, rape, burglary and assault.[56] Alcoholism is associated with loss of employment,[57] which can lead to financial problems. Drinking at inappropriate times and behavior caused by reduced judgment can lead to legal consequences, such as criminal charges for drunk driving[58] or public disorder, or civil penalties for tortious behavior, and may lead to a criminal sentence. An alcoholic's behavior and mental impairment while drunk can profoundly affect those surrounding him and lead to isolation from family and friends. This isolation can lead to marital conflict and divorce, or contribute to domestic violence. Alcoholism can also lead to child neglect, with subsequent lasting damage to the emotional development of the alcoholic's children.[59] For this reason, children of alcoholic parents can develop a number of emotional problems. For example, they can become afraid of their parents, because of their unstable mood behaviors. In addition, they can develop considerable amount of shame over their inadequacy to liberate their parents from alcoholism. As a result of this failure, they develop wretched self-images, which can lead to depression.[60]
Because of the growing population of older Americans, the number of heavy drinkers will increase from 1 million currently to 2 million by 2060. [20] The 2012—2013 National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC III) found that 55.2% of adults age 65 and over drink alcohol. Most of them don’t have a drinking problem, but some of them drink above the recommended daily limits. [21]
"I discovered how good relationships get better and how unhealthy relationships get exposed when you work your program," said Cathy. "I've been friends with Hannah for years, but we had been partying friends. So when I entered recovery, we were really careful around each other. Then we began talking—really talking. Now our friendship is deeper and more honest. Recovery has been good for both of us."
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.
While this provides a blanket of comfort and security to the many thousands of people it helps, the secrecy has not gone over well with the more scientifically minded in the treatment community. The success and acceptance of the program has clashed with the desire for evidence and statistics, leading to Pacific Standard saying that AA is not a form of professional treatment, and it offers mixed results; but as a “mutual aid organization,” the 12-Step method comes into its own. Similarly, The Atlantic goes so far as to call Alcoholics Anonymous a pseudoscientific organization, one that dictated the treatment conversation for generations (to the point where its claimed success rate of 75 percent went unquestioned for decades), but has overstayed its privileged place in American culture.
When most people think about “alcoholism,” they assume the chronic severe group is the only group. However, adolescents and young adults, both with and without mental illnesses, can struggle with compulsive behaviors around alcohol, and many adults in the US are dependent on alcohol to stabilize their emotions. These conditions, too, indicate a potential AUD. If alcohol abuse remains unaddressed, it can lead to severe health consequences, both acute and chronic.

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]
Signs of a drinking problem include behaviors like drinking for the purpose of getting drunk, drinking alone or keeping it secret, drinking to escape problems, hiding alcohol in odd places, getting irritated when you are unable to obtain alcohol to drink, and having problems at work, school, home, or legally as a result of your drinking. Other warning signs of alcohol use disorder include losing interest in activities you used to enjoy, having blackouts because of heavy drinking, and getting annoyed when loved ones say you may have a drinking problem. Behaviors that may indicate that a person is suffering from alcoholism include being able to drink more and more alcohol, trouble stopping once you start drinking, powerful urges to drink, and having withdrawal symptoms like nervousness, nausea, shaking, or having cold sweats, and even hallucinations when you don't have a drink.

Functional subtype: Representing about 19 percent of those struggling with AUD in the study, this group is typically middle aged and, on the surface, appears to have their lives together. They have higher income, more education, and stable relationships compared to other adults struggling with AUD. They drink, on average, every other day, and tend to binge drink on those days.

Jump up ^ Alcoholics Anonymous (2001-06-01). "Chapter 2: There Is a Solution". Alcoholics Anonymous (PDF) (4th ed.). Alcoholics Anonymous World Services. p. 21. ISBN 1893007162. OCLC 32014950. These observations would be academic and pointless if [he] never took the first drink, thereby setting the terrible cycle in motion. Therefore, the main problem...centers in his mind....The fact is that most alcoholics...have lost the power of choice in drink...unable, at certain times, to bring into [his] consciousness with sufficient force the memory of the suffering and humiliation of a month or even a week ago. [He] is without defense against the first drink.
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Chemically, alcohol tends to decrease the chemical activity of substances that affect the nervous system, to inhibit behavior (gamma aminobutyric acid, also called GABA signaling) and increase the activity of pleasure-seeking processes (glutamate). That can result in people being less inhibited in their words and actions and more likely to engage in immediately pleasurable activities even if they are unsafe. Even light drinkers can experience shrinking of parts of the brain. Intoxication with alcohol can be characterized by slurred speech, clumsiness, sleepiness, headaches, distorted senses, lapses in memory, nausea, vomiting, and loss of consciousness.

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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]
Benzodiazepines, while useful in the management of acute alcohol withdrawal, if used long-term can cause a worse outcome in alcoholism. Alcoholics on chronic benzodiazepines have a lower rate of achieving abstinence from alcohol than those not taking benzodiazepines. This class of drugs is commonly prescribed to alcoholics for insomnia or anxiety management.[139] Initiating prescriptions of benzodiazepines or sedative-hypnotics in individuals in recovery has a high rate of relapse with one author reporting more than a quarter of people relapsed after being prescribed sedative-hypnotics. Those who are long-term users of benzodiazepines should not be withdrawn rapidly, as severe anxiety and panic may develop, which are known risk factors for relapse into alcohol abuse. Taper regimes of 6–12 months have been found to be the most successful, with reduced intensity of withdrawal.[140][141]

As defined by the American Society of Addiction Medicine (ASAM), addiction is a disease that disrupts brain chemistry and circuitry, which in turn impacts willpower, reward, memory, and motivation. The first step calls for individuals to accept that they are unable to control their drinking and/or drug use and that their willpower and motivation have been compromised. When someone struggles with addiction, they are no longer able to manage how much and how often drugs and/or alcohol are abused. Recognition of this loss of control and admission of being powerless over addiction is the first step toward recovery.
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.
Like individual groups, the GSO is self-supporting. AA receives proceeds from books and literature that constitute more than 50% of the income for its General Service Office.[30] In keeping with AA's Seventh Tradition, the Central Office is fully self-supporting through the sale of literature and related products, and through the voluntary donations of AA members and groups. It does not accept donations from people or organizations outside of AA.
Chemically, alcohol tends to decrease the chemical activity of substances that affect the nervous system, to inhibit behavior (gamma aminobutyric acid, also called GABA signaling) and increase the activity of pleasure-seeking processes (glutamate). That can result in people being less inhibited in their words and actions and more likely to engage in immediately pleasurable activities even if they are unsafe. Even light drinkers can experience shrinking of parts of the brain. Intoxication with alcohol can be characterized by slurred speech, clumsiness, sleepiness, headaches, distorted senses, lapses in memory, nausea, vomiting, and loss of consciousness.

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.
Most outpatient rehabilitation programs work with teens primarily in a group setting, with less individualized treatment. Children’s Health is different. Our intensive outpatient program starts with individual and family sessions, allowing your teen to build up to the second phase of treatment, which then incorporates their new found motivation and education into our group setting. We also offer a comprehensive follow-up program after treatment, where your teen will receive support from the same caring staff they have grown to trust throughout their therapy.

The basic premise of the 12-Step model is that people can help one another achieve and maintain abstinence from the substances or behaviors to which they are addicted. They can do this through meetings in which they share their experiences with one another and support each other in the ongoing effort of maintaining abstinence. In research, as seen in a recent article from the journal Addiction Research and Theory, abstinence practices (as supported by 12-Step programs) can account for high levels of what experts call flourishing, which is positive mental health and can contribute to longer-term recovery. In the study, those who maintained abstinence were more likely to flourish in the long-term, with 40.7 percent flourishing after three months (as compared to 9.3 percent languishing) and nearly 40 percent flourishing after 12 months (compared to 12.4 percent languishing).
People who struggle with AUD may begin drinking because of social situations or anxiety about being around people; however, signs of a potential AUD include changes in friend groups, especially geared toward friends who drink versus those who don’t, and avoiding social situations to drink instead. Those who have a family member who struggles with AUD are more likely to suffer from high stress, emotional and physical abuse, and mental health or substance abuse problems later in life.
A cross-sectional survey of substance-misuse treatment providers in the West Midlands found fewer than 10% integrated twelve-step methods in their practice and only a third felt their consumers were suited for Alcoholics Anonymous or Narcotics Anonymous membership. Less than half were likely to recommend self-help groups to their clients. Providers with nursing qualifications were more likely to make such referrals than those without them. A statistically significant correlation was found between providers' self-reported level of spirituality and their likelihood of recommending AA or NA.[87]

AA says it is "not organized in the formal or political sense",[25] and Bill Wilson called it a "benign anarchy".[26] In Ireland, Shane Butler said that AA “looks like it couldn’t survive as there’s no leadership or top-level telling local cumanns what to do, but it has worked and proved itself extremely robust.” Butler explained that "AA’s 'inverted pyramid' style of governance has helped it to avoid many of the pitfalls that political and religious institutions have encountered since it was established here in 1946."[27]

Humility is the key of Step 7, as individuals are asked to seek God’s will in how their life is to be lived. Humility is defined as the state of being humble or thinking less of oneself than of others. Humility is an important concept in recovery. Meditation is often useful during Step 7 as a method of self-introspection and learning how to apply humility to one’s life. During Step 7, individuals work to remain humble.

It's interesting to read the comments, pro and con about AA and other 12 step programs. Much of which I agree with. What I did not see mentioned is that AA doesn't enter into this debate about how 'successful or effective' their program is; because they aren't selling or promoting anything. Period. AA offers a spiritually based program to help one find a connection with a higher power that many have found helpful in staying sober. Period. All this other chatter and debate is not what AA is about or even pretends to offer. This debate about the success of a program that is a voluntary offering of a chance to live sober is, frankly, ridiculous. It's truly a take it or leave it kind of deal. If the court orders you to go to AA and you feel you're rights are being violated then you might be better served taking that up with the court then blaming AA. There are three facts that are not legitimately debatable: 1) Many people have gone to AA, got sober and remain that way. 2) Many people have gone to AA and decided they didn't want to go back. 3) Addiction will kill some people who are afflicted regardless of the best efforts of the best of us.


Prior to entering any inpatient or outpatient rehabilitation program for alcohol use disorder, the possibility that the person with this disorder could suffer from physical symptoms of alcohol withdrawal needs to be addressed. People who have a pattern of extensive alcohol abuse are at risk for developing a potentially fatal set of withdrawal symptoms (delirium tremens or DTs) that may include irregular heartbeat, sweating, high fever, shaking/tremors, hallucinations, and even fatal seizures, three days after withdrawal symptoms begin. Those individuals will need to enter a detoxification (detox) program that includes the use of close medical support, monitoring, and prescription of medications like chlordiazepoxide (Librium) or clonazepam (Klonopin) to help prevent and ease the symptoms of alcohol withdrawal.
In Step 4, individuals are asked to be thorough and honest in their personal inventory, writing down anything that comes to mind, and then to explore the effects and particulars of each incident. Self-reflection and introspection into how each event may have impacted family and loved ones as well as individual feelings are delved into during this step. People may wish to start a personal journal. This inventory during Step 4 can take some time to complete. Individuals may therefore spend a lot of time on Step 4, writing, praying, and receiving encouragement from others in their support group.
After the individual is no longer drinking and has passed through withdrawal, the next steps involve helping the individual avoid relapsing and a return to drinking. This phase of treatment is referred to as rehabilitation. It can continue for a lifetime. Many programs incorporate the family into rehabilitation therapy, because the family has likely been severely affected by the patient's drinking. Some therapists believe that family members, in an effort to deal with their loved one's drinking problem, develop patterns of behavior that unintentionally support or enable the patient's drinking. This situation is referred to as co-dependence. These patterns should addressed in order to help successfully treat a person's alcoholism.
Elevated homocysteine levels in the blood called hyperhomocysteinemia, is a sign that the body isn't producing enough of the amino acid homocysteine. is a rare and serious condition that may be inherited (genetic). People with homocystinuria die at an early age. Symptoms of hyperhomocysteinemia include developmental delays, osteoporosis, blood clots, heart attack, heart disease, stroke, and visual abnormalities.
AA's program is an inheritor of Counter-Enlightenment philosophy. AA shares the view that acceptance of one's inherent limitations is critical to finding one's proper place among other humans and God. Such ideas are described as "Counter-Enlightenment" because they are contrary to the Enlightenment's ideal that humans have the capacity to make their lives and societies a heaven on earth using their own power and reason.[33] After evaluating AA's literature and observing AA meetings for sixteen months, sociologists David R. Rudy and Arthur L. Greil found that for an AA member to remain sober a high level of commitment is necessary. This commitment is facilitated by a change in the member's worldview. To help members stay sober AA must, they argue, provide an all-encompassing worldview while creating and sustaining an atmosphere of transcendence in the organization. To be all-encompassing AA's ideology places an emphasis on tolerance rather than on a narrow religious worldview that could make the organization unpalatable to potential members and thereby limit its effectiveness. AA's emphasis on the spiritual nature of its program, however, is necessary to institutionalize a feeling of transcendence. A tension results from the risk that the necessity of transcendence, if taken too literally, would compromise AA's efforts to maintain a broad appeal. As this tension is an integral part of AA, Rudy and Greil argue that AA is best described as a quasi-religious organization.[40]
There are a number of secular (non-religious) self-help organizations besides SMART recovery, like LifeRing Secular Recovery and Women for Sobriety.  I serve on the Board of Directors for LifeRing.  Women for Sobriety is a women's only group that keeps its meeting times and locations private to ensure the safety of its participants, some of whom are the victims of domestic violence and stalking.
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An intervention can be held in the immediate aftermath of a terrible alcoholism consequence. Those openings are easy to find. For example, research published in Addiction suggests that people who drink before heading out on the town are 2.5 times more likely to get in a fight while out, compared to people who don’t drink. When people come home from a night of drinking with bruises and cuts, an intervention may be in order, and it may be well received.
The World Health Organization, the European Union and other regional bodies, national governments and parliaments have formed alcohol policies in order to reduce the harm of alcoholism.[122][123] Targeting adolescents and young adults is regarded as an important step to reduce the harm of alcohol abuse. Increasing the age at which licit drugs of abuse such as alcohol can be purchased, the banning or restricting advertising of alcohol has been recommended as additional ways of reducing the harm of alcohol dependence and abuse. Credible, evidence based educational campaigns in the mass media about the consequences of alcohol abuse have been recommended. Guidelines for parents to prevent alcohol abuse amongst adolescents, and for helping young people with mental health problems have also been suggested.[124]
Twelve-Step Recovery addresses the psychology of the person with addiction as well as the individual’s spirituality--his/her values, his/her connectedness to others, and his/her willingness to engage with others and humbly ask for help. The process of change in Twelve-Step Recovery starts with an acceptance that when friends or loved ones point out that things are amiss in one’s life, they are likely correct, and things have likely become unmanageable. And while taking personal responsibility and accepting accountability for one’s actions are considered key steps, Twelve-Step Recovery outlines that excessive self-reliance and the firm stance that “I can get myself out of this,” and “I know what to do about this,” will be roadblocks to recovery from addiction. “Getting out of oneself” and recognizing that one doesn’t have all the answers, and humbly asking for help from another human being—from a health professional or from a lay person—are behaviors and behavioral styles that are promoted by Alcoholics Anonymous and related “Twelve-Step” programs of peer support.
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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.
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.

Since Alcoholics Anonymous was founded in the 1930s, 12-step treatment models have gained widespread acceptance among psychologists, therapists, social workers and medical doctors. Twelve-step groups like AA have also become a gold standard of recovery for many members of the general public. What makes the 12 steps such an effective model for drug and alcohol rehab? The psychology behind these principles indicates that these non-profit, mutual self-help groups fulfill several important needs, such as:


A sponsor is a more experienced person in recovery who guides the less-experienced aspirant ("sponsee") through the program's twelve steps. New members in twelve-step programs are encouraged to secure a relationship with at least one sponsor who both has a sponsor and has taken the twelves steps themselves.[25] Publications from twelve-step fellowships emphasize that sponsorship is a "one on one" nonhierarchical relationship of shared experiences focused on working the Twelve Steps.[26][27][28] According to Narcotics Anonymous:
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