Alcohol dependence is also known as alcoholism; however, health professionals tend not to use this term because of its potential to increase stigma and discrimination of the condition. Alcohol dependency is the most common substance use disorder in Australia. Individuals who are alcohol dependent tend to prioritise drinking alcohol over other activities (including seeing friends and going to work). However, alcohol dependency is not an all or nothing condition. It occurs on a continuum ranging from mild to severe. Individuals with a mild dependence on alcohol may crave an alcoholic drink when it is not available and find it difficult to stop drinking after a couple of drinks. Individuals with severe alcohol dependence suffer physical and/or psychological withdrawal symptoms (e.g. vomiting, anxiety) when they do not consume alcohol.
Five stages of alcohol and substance abuse disorders have been identified. The first stage is described as having access to alcohol rather than use of alcohol. In that stage, minimizing the risk factors that make a person more vulnerable to using alcohol are an issue. The second stage of alcohol use ranges from experimentation or occasional use to regular weekly use of alcohol. This or any of the more severe stages of alcoholism may involve binge drinking. The third stage is characterized by individuals further increasing the frequency of alcohol use and/or using the substance on a regular basis. This stage may also include either buying or stealing to get alcohol. In the fourth stage of alcohol use, users have established regular alcohol consumption, have become preoccupied with getting intoxicated ("high") and have developed problems in their social, educational, vocational, or family life as a result of using the substance. The final and most serious fifth stage of alcohol use is defined by the person only feeling normal when they are using alcohol. During this stage, risk-taking behaviors like stealing, engaging in physical fights, or driving while intoxicated increase, and they become most vulnerable to having suicidal thoughts.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has modified some of the criteria involved in the medical definition of an alcohol use disorder. There are 11 criteria listed to help clinicians determine if their patient has AUD and how serious the problem is. A mild AUD involves experiencing two or three of the 11 symptoms for one year; a moderate AUD involves four or five of the symptoms; and a severe AUD involves six or more of the listed criteria.
AA is the most widely available 12-Step program, and meeting times and locations are easily found on the Internet. Our Continuum of Care staff provides recommendations for solution-based meetings with a solid foundation of support. At Origins Behavioral HealthCare, we familiarize our patients with 12-Step meetings during their stay and connect them with 12-Step resources in their own communities.
"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."

The mental obsession is described as the cognitive processes that causes the individual to repeat the compulsive behavior after some period of abstinence, either knowing that the result will be an inability to stop or operating under the delusion that the result will be different. The description in the First Step of the life of the alcoholic or addict as "unmanageable" refers to the lack of choice that the mind of the addict or alcoholic affords concerning whether to drink or use again.[20]

Support groups provide people with understanding peers and ongoing support, in church basements, community centers, and public facilities scattered all across the country. Here, people can come together to discuss addiction’s difficulties, and they can meet with other addicted people to gain support and insight. Alumni groups are similar, in that they link peers together to discuss addiction, but these groups contain people who all worked within the same facility for help.
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.
If you think you have a problem with drinking, or know someone who does, we can help. The primary purpose of Alcoholics Anonymous is to help the alcoholic who is still suffering. If you are experiencing a medical emergency, please contact your local hospital or health care provider. To contact someone in Alcoholics Anonymous, please visit our Find A Meeting page, and click on the city or district nearest you. This will provide meeting locations, meeting times, and phone numbers to contact someone nearest you for help.
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.
FAS is the leading cause of mental retardation in the United States. One to two of every 1,000 infants born in the United States are afflicted with FAS. The incidence of FAS in children whose mothers drink heavily is 4% much higher than the rate in the general population. Research studies that have followed infants with FAS and FAEs across time have found that many of these children continue to have cognitive difficulties (e.g., lower IQ scores, more learning problems, poorer short-term memory functioning) and behavioral problems (e.g., high impulsivity, high activity level) into childhood and adolescence.
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Thank you for letting Los Angles Central Office serve and support you. LACO maintains this website and publishes both the online and print meeting directories, and it is the information hub for AA in the Los Angeles area. At Central Office volunteers are of service 365 days a year answering the phones and sharing experience, strength and hope. Let us know how we can help your group carry the message.
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]

Monitor your teen’s activity: Know where your teen goes and who they hang out with. Remove or lock away alcohol from your home and routinely check potential hiding places for alcohol—in backpacks, under the bed, between clothes in a drawer, for example. Explain to your teen that this lack of privacy is a consequence of having been caught using alcohol.
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]
This final step is the service aspect, and it asks individuals to give back to others who are also struggling with addiction. After coming to God or a higher power, individuals are then taught to share this spirituality with others and support them in recovery. During Step 12, individuals are often asked to share their stories, testimonies, and struggles with others in order to provide hope and encouragement.
Before you do anything, it’s important to know whether your friend or loved one has an alcohol addiction. Alcohol use disorder, or alcoholism, is more than just drinking too much from time to time. Sometimes alcohol as coping mechanism or social habit may look like alcoholism, but it’s not the same. People with alcohol use disorder don’t drink in moderation, even if they say they’re only having one drink. To learn more, read about alcoholism and its symptoms.
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]
People going through mild withdrawal are monitored to make sure that more severe symptoms do not develop. Medications usually are unnecessary. Treatment of a patient suffering more severe effects of withdrawal may require sedative medications to relieve the discomfort of withdrawal and to avoid the potentially life-threatening complications of high blood pressure, fast heart rate, and seizures. Benzodiazepine drugs may be helpful in those patients experiencing hallucinations. If the patient vomits for an extended period, fluids may need to be given through a vein (intravenously, IV). Thiamine (a vitamin) is often included in the fluids, because thiamine levels are often very low in alcohol-dependent patients, and deficiency of thiamine is responsible for the Wernicke-Korsakoff syndrome.
SMART Recovery: (Self Management for Addiction Recovery): SMART Recovery is a 4-point program based on cognitive behavioral therapy and seeks to empower the individual through education and practical techniques. It is present-focused and does not use the term “disease” when referring to addiction. Attendees may use medications, which are not encouraged in AA.
The program is available for patients who are otherwise healthy; specifically, specifically, those who do not have acute or significant heart disease, insulin dependent diabetes that is well controlled with an A1C at or above 7, sleep apnea not controlled or a Body Mass Index (BMI) over 42, as individuals with these conditions are best suited recovering in a hospital setting.
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A condition characterised by a pathologic pattern of alcohol use causing a serious impairment in social or occupational functioning; also defined by the Joint Committee of the National Council on Alcoholism and Drug Dependence & the American Society of Addiction Medicine as a “primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterised by … distortions in thinking, most notably denial.” A simpler, operational definition is persistent drinking that interferes with the person’s health, legal position, interpersonal relationships, or means of livelihood. Alcoholism is characterised by the regular intake of ≥75 g/day of alcohol.
AA's program extends beyond abstaining from alcohol.[33] Its goal is to effect enough change in the alcoholic's thinking "to bring about recovery from alcoholism"[34] through "an entire psychic change," or spiritual awakening.[35] A spiritual awakening is meant to be achieved by taking the Twelve Steps,[36] and sobriety is furthered by volunteering for AA[37] and regular AA meeting attendance[38] or contact with AA members.[36] Members are encouraged to find an experienced fellow alcoholic, called a sponsor, to help them understand and follow the AA program. The sponsor should preferably have experience of all twelve of the steps, be the same sex as the sponsored person, and refrain from imposing personal views on the sponsored person.[37] Following the helper therapy principle, sponsors in AA may benefit from their relationship with their charges, as "helping behaviors" correlate with increased abstinence and lower probabilities of binge drinking.[39]
There are no dues or fees for members of AA. Prohibitive cost can be a major hurdle when it comes to sticking with a treatment program. Even if it’s working, someone might drop out if it becomes too expensive for them to stay with it. While a group might do a collection to cover expenses like rent or refreshments, there is no mandatory cost required to join AA.

Please encourage Spanish-speaking women members in your area to write their personal stories for possible inclusion in this new pamphlet. Submissions can be emailed to [email protected] with "Spanish-speaking women in A.A." in the subject line of the message. Alternatively, submissions can be mailed to: Literature Coordinator, General Service Office, Box 459, Grand Central Station, New York, NY 10163.
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The co-occurrence of major depressive disorder and alcoholism is well documented.[47][48][49] Among those with comorbid occurrences, a distinction is commonly made between depressive episodes that remit with alcohol abstinence ("substance-induced"), and depressive episodes that are primary and do not remit with abstinence ("independent" episodes).[50][51][52] Additional use of other drugs may increase the risk of depression.[53] Psychiatric disorders differ depending on gender. Women who have alcohol-use disorders often have a co-occurring psychiatric diagnosis such as major depression, anxiety, panic disorder, bulimia, post-traumatic stress disorder (PTSD), or borderline personality disorder. Men with alcohol-use disorders more often have a co-occurring diagnosis of narcissistic or antisocial personality disorder, bipolar disorder, schizophrenia, impulse disorders or attention deficit/hyperactivity disorder (ADHD).[54] Women with alcoholism are more likely to experience physical or sexual assault, abuse and domestic violence than women in the general population,[54] which can lead to higher instances of psychiatric disorders and greater dependence on alcohol.
The 12-step approach to rehabilitation treatment is embraced throughout the world, so it’s always easy to find support where you are or wherever you go. Accordingly, we advise patients to keep in contact with ‘sober supports’ they make during treatment at one of our locations. We also encourage them to continue attending 12-step groups on a regular basis after discharge. Being able to discuss mistakes or relapses, as needed, in a supportive environment helps to keep patients accountable for their actions.
Denial is one of the biggest obstacles to getting help for alcohol abuse and alcoholism. The desire to drink is so strong that the mind finds many ways to rationalize drinking, even when the consequences are obvious. By keeping you from looking honestly at your behavior and its negative effects, denial also exacerbates alcohol-related problems with work, finances, and relationships.
Feeling a "kinship of common suffering" and, though drunk, Wilson attended his first Group gathering. Within days, Wilson admitted himself to the Charles B. Towns Hospital after drinking four beers on the way—the last alcohol he ever drank. Under the care of William Duncan Silkworth (an early benefactor of AA), Wilson's detox included the deliriant belladonna.[16] At the hospital a despairing Wilson experienced a bright flash of light, which he felt to be God revealing himself.[17] Following his hospital discharge Wilson joined the Oxford Group and recruited other alcoholics to the Group. Wilson's early efforts to help others become sober were ineffective, prompting Silkworth to suggest that Wilson place less stress on religion and more on "the science" of treating alcoholism. Wilson's first success came during a business trip to Akron, Ohio, where he was introduced to Robert Smith, a surgeon and Oxford Group member who was unable to stay sober. After thirty days of working with Wilson, Smith drank his last drink on 10 June 1935, the date marked by AA for its anniversaries.[18]

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.


When you opt for the increased success rates common to some of the top residential recovery centers, you give yourself or your loved one the best chance of achieving and maintaining sobriety. However, you'll still need to consider whether to seek addiction treatment locally or take it out-of-state, putting distance between you and any abuse triggers. If you know someone who has gone through an alcoholic recovery program or has received drug treatment, ask them their opinion on the program they attended! For everyone else, calling a toll-free recovery hotline - whether it’s ours or another reputable service's - is an excellent way to start. You can discuss your local drug and alcohol recovery program options and have any questions answered that you might have about substance abuse insurance coverage.
n the continued extreme dependence on excessive amounts of alcohol, accompanied by a cumulative pattern of deviant behaviors. The most frequent consequences are chronic gastritis, central nervous system depression, and cirrhosis of the liver, each of which can compromise the delivery of dental care. Oral cancer and increased levels of periodontal disease are also risks.
WHO's ICD-10	"alcohol harmful use" and "alcohol dependence syndrome"	Definitions are similar to that of the DSM-IV. The World Health Organization uses the term "alcohol dependence syndrome" rather than alcoholism.[24] The concept of "harmful use" (as opposed to "abuse") was introduced in 1992's ICD-10 to minimize underreporting of damage in the absence of dependence.[100] The term "alcoholism" was removed from ICD between ICD-8/ICDA-8 and ICD-9.[103]

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In the United States and Canada, AA meetings are held in hundreds of correctional facilities. The AA General Service Office has published a workbook with detailed recommendations for methods of approaching correctional-facility officials with the intent of developing an in-prison AA program.[79] In addition, AA publishes a variety of pamphlets specifically for the incarcerated alcoholic.[80] Additionally, the AA General Service Office provides a pamphlet with guidelines for members working with incarcerated alcoholics.[81]
The term alcoholism is commonly used amongst laypeople, but the word is poorly defined. The WHO calls alcoholism "a term of long-standing use and variable meaning", and use of the term was disfavored by a 1979 WHO expert committee. The Big Book (from Alcoholics Anonymous) states that once a person is an alcoholic, they are always an alcoholic, but does not define what is meant by the term alcoholic in this context. In 1960, Bill W., co-founder of Alcoholics Anonymous (AA), said:
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.
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.

Many newcomers who attend 12-step meetings find personal validation in the stories of other addicts. Substance abusers who have been isolated by their disease have the opportunity to relieve their pain by sharing their experiences with others. Alcoholics who have lost their jobs, families, and dignity can recover their self-respect and restore broken relationships with the help of the fellowship and the 12 steps.
Jump up ^ Littrell, Jill (2014). Understanding and Treating Alcoholism Volume I: An Empirically Based Clinician's Handbook for the Treatment of Alcoholism: Volume Ii: Biological, Psychological, and Social Aspects of Alcohol Consumption and Abuse. Hoboken: Taylor and Francis. p. 55. ISBN 9781317783145. Archived from the original on 20 July 2017. The World Health Organization defines alcoholism as any drinking which results in problems
Recently some researchers have suggested that there are two distinct types of alcoholism. According to these researchers, type 1 alcoholism develops in adulthood, often in the early twenties. It is most often associated with the desire to relieve stress and anxiety and is not associated with any criminal or antisocial behavior. Type 2 alcoholism develops earlier, usually during the teenage years. Drinking is done primarily to get high. Type 2 alcoholism is associated with violence, destructiveness, and other criminal and antisocial behavior. Those who study alcoholism do not universally accept the distinction between these two types of alcoholism. Research continues in this area.

Following detoxification, social support to abstain from or moderate drinking is needed for an extended period of time. It is useful for individuals who are recovering from alcohol dependence to identify people who can support them through the process, as it can still be very difficult not to drink alcohol, or to drink in moderation following detoxification. People who have difficulty may wish to investigate whether there is medication which can help them stay away from alcohol. There are range of prescription medicines which might assist some people. Talk to a doctor before taking any medication.


Standing by your friend or family member’s progress during and after treatment is important, too. For example, alcohol is everywhere. Even after recovery, your person will be in situations they can’t predict. Ways you can help include avoiding alcohol when you’re together or opting out of drinking in social situations. Ask about new strategies that they learned in treatment or meetings. Stay invested in their long-term recovery.

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.


Many start their addiction recovery process with a period of detoxification (detox), where the body rids itself of the toxic influence of drugs and/or alcohol. Detox allows the body to restore itself to a stable starting point from which substance abuse treatment efforts may more effectively begin. While detox programs vary, medical detox programs may utilize certain medications to manage withdrawal, when applicable, and otherwise facilitate this early recovery step.1
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.
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