Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism. The only requirement for membership is a desire to stop drinking. There are no dues or fees for AA membership; we are self-supporting through our own contributions. AA is not allied with any sect, denomination, 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 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]
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.
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]
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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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]
United States courts have ruled that inmates, parolees, and probationers cannot be ordered to attend AA. Though AA itself was not deemed a religion, it was ruled that it contained enough religious components (variously described in Griffin v. Coughlin below as, inter alia, "religion", "religious activity", "religious exercise") to make coerced attendance at AA meetings a violation of the Establishment Clause of the First Amendment of the constitution.[82][83] In 2007, the Ninth Circuit of the U.S. Court of Appeals stated that a parolee who was ordered to attend AA had standing to sue his parole office.[84][85]
Excessive alcohol consumption is correlated with increased risk of stroke, liver disease, and decreased life expectancy. In fact, binge drinking during only the weekends is still enough to damage the liver, studies show, and moderate drinking interferes with sleep quality by interrupting circadian rhythms and REM sleep. However, a number of different treatment options are available to address alcoholic dysfunction.
If you are still having issues with activation after trying the above mentioned items, please click on the “Gear” icon located on the lower left of the SRS window when it first opens. Next, click on “About” and then click on the check box to “Enable Log For Debugging”. This will turn on the logging feature for Customer Support to be able to further help you solve your issue. Once you have enabled logging, try to activate your license again, then call Customer Support and they will instruct you how to send the log files to them.
One review warned of detrimental iatrogenic effects of twelve-step philosophy and labeled the organizations as cults,[41] while another review asserts that these programs bore little semblance to religious cults and that the techniques used appeared beneficial to some.[42] Another study found that a twelve-step program's focus on self-admission of having a problem increases deviant stigma and strips members of their previous cultural identity, replacing it with the deviant identity.[43] Another study asserts that the prior cultural identity may not be replaced entirely, but rather members found adapted a bicultural identity.[44]
The Big Book was originally written as a guide for people who couldn’t attend AA fellowship meetings, but it soon became a model for the program in general. It has since been adopted as a model for a wide range of addiction peer-support and self-help programs designed to help drive behavioral change. In addition to the original Alcoholics Anonymous (AA) group, various offshoots now exist, such as Narcotics Anonymous (NA), Heroin Anonymous (HA), and Gamblers Anonymous (GA).

Treating underlying problems: There may be problems with self-esteem, stress, anxiety, depression, or other aspects of mental health. It is important to treat these problems, too, as they can increase the risks posed by alcohol. Common alcohol-related issues, such as hypertension, liver diseases, and possibly heart diseases, will need to be treated too.
There are many kinds of counseling and psychotherapy that can be helpful for the person with addiction, beyond non-specific “supportive psychotherapy” that can be offered in any setting, along with medication management or apart from such an approach. Cognitive Behavioral Therapy is arguably the most widespread ‘evidence based practice’ offered to persons with addiction. This approach challenges irrational thoughts, understands automatic thoughts and thought chains, understands the thoughts and feelings that can lead to relapse behaviors and seeks to minimize relapse by specifying unhealthy cognitions and providing practice in decoupling an unhealthy thought (“stinking thinking,” as some people say) from an unhealthy action. Dialectical Behavioral Therapy and Mindfulness Meditation are two approaches that have enjoyed increased popularity in addiction treatment in this century.
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.

Copyright © 2018 by Alcoholics Anonymous World Services, Inc. All rights reserved. This is the official Website of the General Service Office (G.S.O.) of Alcoholics Anonymous. Videos or graphic images may not be downloaded, copied or duplicated without the express written permission of Alcoholics Anonymous World Services, Inc. The “Blue People” graphic is a trademark of Alcoholics Anonymous World Services, Inc. All rights reserved.

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Other options include inpatient and outpatient rehab centers, which offer professional addiction treatment and medical care. These programs can also offer a medically supervised detox, which is important in the early stages of alcohol withdrawal. People who have been drinking heavily for long periods of time and stop are at risk of symptoms such as insomnia, nausea, vomiting, tremors, fever, seizures, hallucinations, and severe confusion. Some of these symptoms can be dangerous or even fatal. A medical detox can reduce these symptoms and prevent complications.7


The 12-Step philosophy pioneered by Alcoholics Anonymous is used by about 74 percent of treatment centers. The basic premise of this model is that people can help one another achieve and maintain abstinence from substances of abuse, but that healing cannot come about unless people with addictions surrender to a higher power. The 12-Step movement can be a force for good for many people, but some struggle with what they interpret as a strong religious element of the program. Many addiction treatment programs offer alternatives to 12-Step methodology for those who prefer a more secular foundation for treatment.

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).
Genetic differences that exist between different racial groups affect the risk of developing alcohol dependence. For example, there are differences between African, East Asian and Indo-racial groups in how they metabolize alcohol. These genetic factors partially explain the differing rates of alcohol dependence among racial groups.[84][85] The alcohol dehydrogenase allele ADH1 B*3 causes a more rapid metabolism of alcohol. The allele ADH1 B*3 is only found in those of African descent and certain Native American tribes. African Americans and Native Americans with this allele have a reduced risk of developing alcoholism.[86] Native Americans, however, have a significantly higher rate of alcoholism than average; it is unclear why this is the case.[87] Other risk factors such as cultural environmental effects e.g. trauma have been proposed to explain the higher rates of alcoholism among Native Americans compared to alcoholism levels in caucasians.[88][89]

To start with, getting sober and drug-free requires the desire and determination to get clean, and having both of these is crucial. If you’re looking for help for a loved one or a friend, know that they’ll need to be “on board" with the idea of recovery if they are going to have a solid chance of getting clean. If they have not yet recognized their own problem, an addiction intervention may be necessary. During the beginning phases of recovery, an alcohol and drug detox is always necessary to remove any unwanted chemicals from the body, followed by intensive addiction recovery therapy. The latter may take 28-90 days (sometimes more), but completing the program provides all the tools needed to stay substance-free. It is highly beneficial for those leaving rehab to join a recovery support group and even consider spending time in a recovery home.
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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.
The program’s emphasis on negative feelings of powerlessness and guilt. Continuing in that train of thought, while the idea behind the 12 Steps may have been revolutionary at the time, for many they can feel outdated and even counterproductive. The 12-Step program demands that those in it break themselves down to be built back up, focusing on the notion that you are incapable of taking responsibility not just for your alcoholism but for yourself as well, that there is something wrong with you, and instilling what can feel more like shame than motivation.
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.
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.
Alcohol misuse and dependence are primarily diagnosed through the use of clinical screening surveys. Several hundred such surveys exist, and they vary in the number and nature of questions they ask. Some of the more common scientifically-validated questionnaires include the Michigan Alcohol Screening Test (MAST), a shorter version called the Brief MAST, the Alcohol Use Disorders Identification Test (AUDIT), and a commonly employed, quick survey called the CAGE questionnaire. These surveys ask a range of questions about frequency of drinking, problems that result, and ability to stop.
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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.
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The twelve steps of alcoholics anonymous do not come from the Oxford Groups because there were twelve apostles the  Oxford Groups practised six steps all of which AA adopted but also added six which had to do specifically with a non denominational or religious numinous power and the specific effects of alcohol addiction on the character on the afflicted.  As many addicts -- probably many more -- have been harmed by the ignorant prescription or pharmaceuticals to people in recovery for AA as have been harmed by a lay AA sponsor telling a member that all prescriptions are bad. .   
Jump up ^ Agrawal, A; Sartor, CE; Lynskey, MT; Grant, JD; Pergadia, ML; Grucza, R; Bucholz, KK; Nelson, EC; Madden, PA; Martin, NG; Heath, AC (2009). "Evidence for an Interaction Between Age at 1st Drink and Genetic Influences on DSM-IV Alcohol Dependence Symptoms". Alcoholism: Clinical and Experimental Research. 33 (12): 2047–56. doi:10.1111/j.1530-0277.2009.01044.x. PMC 2883563. PMID 19764935.
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.
Recovery from alcoholism is a life-long process. The potential for relapse remains present and must be acknowledged and respected. Many individuals stop drinking and then relapse multiple times before attaining extended periods of sobriety. Statistics suggest that, among middle-class alcohol-dependent individuals in stable financial and family situations who have undergone treatment, 60% or more successfully stop drinking for at least one year.
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The diagnosis of an alcohol problem is best made by the history. Screening instruments for alcohol problems include the CAGE ([need to] cut down [on drinking], annoyance, guilt [about drinking], [need for] eye-opener) questionnaire and the AUDIT (alcohol use disorders identification test). The CAGE questions should be given face-to-face, whereas AUDIT can be given as a paper-and-pencil test.
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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.
Even if you do go to the trouble of backing up data, there’s plenty of potential for files to slip through the cracks. You may have neglected to include an important folder in the backup job, or your hard drive may fail the day before your weekly backup is due to be updated. This is where data recovery tools can save the day, and here we take a look at five of the very best free options that are available.
Photodynamic therapy (PDT) is a procedure that treats precancerous cells, in addition to other types of cancer cells. The medical treatment does this with the help of a photosensitizing drug and a light source that activates the applied drug, destroying cancer cells. PDT is approved to treat non-small cell lung cancer, esophageal cancer, and Barrett's esophagus. It's used to treat actinic keratosis, as well as acne, rosacea, skin cancer, sun damage, oily skin, wrinkles, warts, psoriasis, and enlarged sebaceous glands.
Another important point about 12 Step programs is their cost and accessibility.  What other chronic lifelong disease has an equally accessible and cost effective (free) intervention?    Like any disease, part of our job as physicians is to recommend effective treatment which our patients can both access and afford.  I'd like for my patients to be able to access and afford all useful modalities of addiction treatment, but here at least is one they can all use.   
While both alcohol abuse and alcoholism are included in the alcohol use disorder diagnosis and involve engaging in maladaptive behaviors in the use of alcohol, abuse of this substance does not include the person having withdrawal symptoms or needing more and more amounts to achieve intoxication (tolerance) unless the person has developed alcoholism.
A study found an association between an increase in attendance to AA meetings with increased spirituality and a decrease in the frequency and intensity of alcohol use. The research also found that AA was effective at helping agnostics and atheists become sober. The authors concluded that though spirituality was an important mechanism of behavioral change for some alcoholics, it was not the only effective mechanism.[54] Since the mid-1970s, a number of 'agnostic' or 'no-prayer' AA groups have begun across the U.S., Canada, and other parts of the world, which hold meetings that adhere to a tradition allowing alcoholics to freely express their doubts or disbelief that spirituality will help their recovery, and these meetings forgo use of opening or closing prayers.[55][56] There are online resources listing AA meetings for atheists and agnostics.[57]
Alcohol inhibits the receptor for glutamate. Long-term ingestion results in the synthesis of more glutamate receptors. When alcohol is withdrawn, the central nervous system experiences increased excitability. Persons who abuse alcohol over the long term are more prone to alcohol withdrawal syndrome than persons who have been drinking for only short periods. Brain excitability caused by long-term alcohol ingestion can lead to cell death and cerebellar degeneration, Wernicke-Korsakoff syndrome, tremors, alcoholic hallucinosis, delirium tremens, and withdrawal seizures. Opiate receptors are increased in the brains of recently abstinent alcoholic patients, and the number of receptors correlates with cravings for alcohol.
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.
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