Alcoholics Anonymous publishes several books, reports, pamphlets, and other media, including a periodical known as the AA Grapevine. Two books are used primarily: Alcoholics Anonymous (the "Big Book") and Twelve Steps and Twelve Traditions, the latter explaining AA's fundamental principles in depth. The full text of each of these two books is available on the AA website at no charge.
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.
Twelve-step programs approach alcoholism and drug addiction as diseases that can only be managed by surrendering one’s will to a higher power. In spite of their reliance on the disease model of addiction, 12-step groups offer rewarding experiences that reinforce healthy, sober behaviors. In this sense, the 12 steps reflect the principles of positive psychology, notes the Journal of Substance Abuse Treatment. Positive psychology is based on the belief that gratifying experiences will encourage the individual to repeat a healthy behavior, such as attending meetings or reading AA literature, rather than reverting to a self-destructive behavior, such as drinking or using drugs.
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With regard to pregnancy, fetal alcohol syndrome is the leading known cause of mental retardation (1 in 1000 births). More than 2000 infants annually are born with this condition in the United States. Alcohol-related birth defects and neurodevelopmental problems are estimated to be 3 times higher. Even small amounts of alcohol consumption may be risky in pregnancy. A 2001 study by Sood et al reported that children aged 6–7 years whose mothers consumed alcohol even in small amounts had more behavioral problems.  In a study from 2003, Baer et al showed that moderate alcohol consumption while pregnant resulted in a higher incidence of offspring problem drinking at age 21 years, even after controlling for family history and other environmental factors.  All women who are pregnant or planning to become pregnant should avoid alcohol.
Friends and family members are interconnected—suspended in delicate balance. When a loved one begins the arduous journey of recovery, the balance shifts. With work and understanding, relationships can be reshaped into something better and a healthier balance can be achieved. Recovery and support for the recovering person are reciprocal gifts that keep on giving.
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, 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.
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Prevention must begin at a young age since the first instance of intoxication usually occurs during the teenage years. It is particularly important that teenagers who are at high risk for alcoholism-those with a family history of alcoholism, early or frequent use of alcohol, a tendency to drink to drunkenness, alcohol use that interferes with school work, a poor family environment, or a history of domestic violence -receive education about alcohol and its long-term effects. How this is best achieved, without alienating these young people and thus losing their attention, is the subject of continuing debate and study.
These are all very different drinking patterns, but they have one thing in common. People who drink like this have lost some modicum of control over their consumption. The beverages drive their behaviors. It can seem like a subtle distinction, but it’s an important one to understand, as people who don’t amend troublesome drinking behaviors can become people who have symptoms of alcoholism.
Alcohol detoxification or 'detox' for alcoholics is an abrupt stop of alcohol drinking coupled with the substitution of drugs, such as benzodiazepines, that have similar effects to prevent alcohol withdrawal. Individuals who are only at risk of mild to moderate withdrawal symptoms can be detoxified as outpatients. Individuals at risk of a severe withdrawal syndrome as well as those who have significant or acute comorbid conditions are generally treated as inpatients. Detoxification does not actually treat alcoholism, and it is necessary to follow up detoxification with an appropriate treatment program for alcohol dependence or abuse to reduce the risk of relapse. Some symptoms of alcohol withdrawal such as depressed mood and anxiety typically take weeks or months to abate while other symptoms persist longer due to persisting neuroadaptations. Alcoholism has serious adverse effects on brain function; on average it takes one year of abstinence to recover from the cognitive deficits incurred by chronic alcohol abuse.
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Short-term effects of alcohol abuse can be just as dangerous as long-term effects. For instance, drinking can impact your reaction time, causing you to have slow reflexes and coordination. That’s why drinking and driving is extremely dangerous. Getting behind the wheel of a car can alter your perception of speed and distance, putting yourself and others at risk.
Women tend to be more sensitive to the effects of alcohol and may develop alcohol-related health problems sooner and after consuming less alcohol than men do. Alcohol use in pregnant women can lead to miscarriage, stillbirth, premature birth, low birth weight, and other problems in the baby, such as abnormal facial features, malformation of organs (such as the brain and heart), growth deficits, and hearing and vision problems. Brain damage due to a mother's alcohol use may result in behavioral problems, speech and language delays, and learning disabilities, according to the March of Dimes.
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This inventory of self is meant to be comprehensive, searching, and fearless. This does not mean that it is without fear, but that individuals are encouraged to push past their fears and be honest with listing their shortcomings. Writing lists is often an important part of Step 4 as individuals are called to cite incidents, thoughts, feelings, and past experiences that may be difficult to think about.
In the case of expectant mothers who drink, future healthcare costs double, now including both the mother and child. For example, a child born with fetal alcohol syndrome could require special schooling. Not only is this a personal and unnecessary family tragedy but also it stands to impact the social system financially in the form of healthcare and education for years.
At the end of an intervention, the stage is set for entry into addiction treatment programs. There are many different options out there. Some facilities, for example, offer inpatient treatment for addiction. These programs allow people to step away from their day-to-day concerns and tackle an addiction around the clock, every single day. For some people, that tight focus is an ideal setup for healing. But outpatient centers can be ideal for those who want to stay at home, surrounded by family, while they work on addictions to alcohol. It’s a personal decision that families can make in consultation with the person who needs help.
Medications also are available that may help a recovering alcoholic avoid returning to drinking. These have been used with variable success; different medications may be more or less successful for different individuals. Disulfiram (Antabuse) is a drug which, when mixed with alcohol, causes unpleasant reactions including nausea, vomiting, diarrhea, and trembling. It was estimated that in 2008, 200,000 recovering alcoholics in the United States were taking disulfiram. Naltrexone (Depade, ReVia) helps to reduce the brain's craving for alcohol. Acamprosate (Campral) works by reducing anxiety and insomnia that often occur when habitual drinkers become abstinent. Drugs alone will not prevent relapse. They are most effective when used in conjunction with a self-help program and/or psychotherapy aimed at changing behavior.
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Not all alcohol abusers become full-blown alcoholics, but it is a big risk factor. Sometimes alcoholism develops suddenly in response to a stressful change, such as a breakup, retirement, or another loss. Other times, it gradually creeps up on you as your tolerance to alcohol increases. If you’re a binge drinker or you drink every day, the risks of developing alcoholism are greater.
According to Vaillant's research, inner-city men began problem drinking approximately 10 years earlier than college graduates (age 25–30 y vs age 40–45 y). Inner-city men were more likely to be abstinent from alcohol consumption than college graduates (30% vs 10%) but more likely to die from drinking (30% vs 15%). A large percentage of college graduates alternated between controlled drinking and alcohol abuse for many years. Returning to controlled drinking from alcohol abuse is uncommon, no more than 10%; however, this figure is likely to be high because it was obtained from self-reported data. Mortality in both groups was related strongly to smoking. Abstinence for less than 5–6 years did not predict continued abstinence (41% of men abstinent for 2 y relapsed).
The co-occurrence of major depressive disorder and alcoholism is well documented. 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). Additional use of other drugs may increase the risk of depression. 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). Women with alcoholism are more likely to experience physical or sexual assault, abuse and domestic violence than women in the general population, which can lead to higher instances of psychiatric disorders and greater dependence on alcohol.
As an addiction professional who has worked in the field for 21 years I would be negligent in my duties if I did not inform my clients about the availability of AA as a potential avenue for recovery. I also let them know of other options such as SMART, rational recovery, etc. They invariable return to me saying "all I can find around town is AA". I encourage them to use what is available if they choose to do so. I educate them about the program of AA, the fellowship (which is not the program) and what AA's official stance is on medications (there is none other than it's between the alcoholic and their doctor). I educate and encourage them on all of these things so they are not at the mercy of any uninformed alcoholic in AA.
The personal nature of the behavioral issues that lead to seeking help in twelve-step fellowships results in a strong relationship between sponsee and sponsor. As the relationship is based on spiritual principles, it is unique and not generally characterized as "friendship". Fundamentally, the sponsor has the single purpose of helping the sponsee recover from the behavioral problem that brought the sufferer into twelve-step work, which reflexively helps the sponsor recover.