Using “I” statements reduces accusation and lets you be an active participant in the discussion. It may be helpful to bring up a specific concern. You may mention when alcohol caused an unwanted effect, such as violent behavior or economic problems. Rather than saying, “You’re an alcoholic — you need to get help now,” you can say, “I love you and you’re very important to me. I’m concerned about how much you’re drinking, and it may be harming your health.”
AA sprang from The Oxford Group, a non-denominational movement modeled after first-century Christianity.[13] Some members founded the Group to help in maintaining sobriety. "Grouper" Ebby Thacher was Wilson's former drinking buddy who approached Wilson saying that he had "got religion", was sober, and that Wilson could do the same if he set aside objections to religion and instead formed a personal idea of God, "another power" or "higher power".[14][15]
Alcohol use disorder (which includes a level that's sometimes called alcoholism) is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking.
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.
A complex mixture of genetic and environmental factors influences the risk of the development of alcoholism.[69] Genes that influence the metabolism of alcohol also influence the risk of alcoholism, and may be indicated by a family history of alcoholism.[70] One paper has found that alcohol use at an early age may influence the expression of genes which increase the risk of alcohol dependence.[71] Individuals who have a genetic disposition to alcoholism are also more likely to begin drinking at an earlier age than average.[72] Also, a younger age of onset of drinking is associated with an increased risk of the development of alcoholism,[72] and about 40 percent of alcoholics will drink excessively by their late adolescence. It is not entirely clear whether this association is causal, and some researchers have been known to disagree with this view.[73]

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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]
Sponsors and sponsees participate in activities that lead to spiritual growth. Experiences in the program are often shared by outgoing members with incoming members. This rotation of experience is often considered to have a great spiritual reward.[30] These may include practices such as literature discussion and study, meditation, and writing. Completing the program usually implies competency to guide newcomers which is often encouraged.[31] Sponsees typically do their Fifth Step, review their moral inventory written as part of the Fourth Step, with their sponsor. The Fifth Step, as well as the Ninth Step, have been compared to confession and penitence.[32] Michel Foucault, a French philosopher, noted such practices produce intrinsic modifications in the person—exonerating, redeeming and purifying them; relieves them of their burden of wrong, liberating them and promising salvation.[32][33]

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:
Alcoholism is characterised by an increased tolerance to alcohol–which means that an individual can consume more alcohol–and physical dependence on alcohol, which makes it hard for an individual to control their consumption. The physical dependency caused by alcohol can lead to an affected individual having a very strong urge to drink alcohol. These characteristics play a role decreasing an alcoholic's ability to stop drinking.[25] Alcoholism can have adverse effects on mental health, causing psychiatric disorders and increasing the risk of suicide. A depressed mood is a common symptom of heavy alcohol drinkers.[26][27]
There are many clues which can lead a doctor to suspect a patient is alcohol dependent, and will not usually require a physical examination. For example, a doctor may suspect alcohol dependence if a patient often asks for a medical certificate for time off work, has a mental health problem (e.g. depression) or physical conditions associated with alcohol consumption (especially liver cirrhosis). In such cases, a good doctor will ask the patient questions about their alcohol consumption patterns, or ask them to complete a questionnaire about alcohol, to assess whether or not their alcohol consumption is presenting a health risk.

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Though it can feel as if you are hiding a unique or embarrassing problem, the fact is that families across the country are experiencing the exact same thing you are. You are not alone with the disease, and you will not be alone as you seek the treatment necessary to begin to heal and start a new life in recovery. Alcohol.org is available to provide education and support all along the way.
There is a group of physicians within ASAM who are concerned that twelve-step recovery is not being taught to new physicians entering this field (most physicians currently enter addiction practice in mid-career, rather than straight out of residency training). Referring to themselves as “Like Minded Docs,” they communicate regularly among each other, leaning on each other via email for support and guidance, and occasionally reaching out to ASAM regarding policies of the Society. One of their stated concerns is that continuing education programs for physicians newly involved with addiction or considering a mid-career switch into addiction medicine have more content on pharmacotherapies and less content on psychosocial therapies, and that Twelve-Step Facilitation therapy and twelve-step recovery overall are at risk of becoming ‘dying arts.’
Most Twelve Step participants view addiction as a lifelong disease and see the Twelve Steps as their new design for living. When people whose lives have been affected by addiction work the Twelve Steps, they can better sort out the things which they have no control over, and the things for which they are responsible. Group meetings offer a safe place to share one's experience, strength and hope, and to receive support and fellowship.
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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.
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While group therapy can help teens stay sober, groups that include a number of teens who also engage in disordered behaviors can actually tend to increased alcohol use in this age group. Family interventions for alcoholism that tend to be effective for teens include multidimensional family therapy (MDFT), group therapy, and multifamily educational intervention (MFE). MDFT has been found to be quite effective. Longer-term residential treatment, often called rehab, of three to five months that addresses peer relationships, educational problems, and family issues is often used in treating alcohol use disorder in teens.
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.
An alcohol use disorder can range from mild to severe. Mild patterns may develop into more serious complications. Early treatment and intervention can help people with alcohol use disorder. While it’s up to the person to willingly start their sobriety journey, you can also help. Read on for some steps you can take to help your friend, family member, or loved one.
Warning signs of alcoholism include the consumption of increasing amounts of alcohol and frequent intoxication, preoccupation with drinking to the exclusion of other activities, promises to quit drinking and failure to keep those promises, the inability to remember what was said or done while drinking (colloquially known as "blackouts"), personality changes associated with drinking, denial or the making of excuses for drinking, the refusal to admit excessive drinking, dysfunction or other problems at work or school, the loss of interest in personal appearance or hygiene, marital and economic problems, and the complaint of poor health, with loss of appetite, respiratory infections, or increased anxiety.[28]
Steps 1-9 set up a strong spiritual foundation and a new way of life without drugs and alcohol. With Step 10, individuals are seeking daily accountability for their actions. Recovery is ongoing, and individuals continue to examine how their thoughts, words, behaviors, and actions impact daily life and how to keep themselves in line with their faith and God’s will. Individuals are asked to take inventory every day and immediately correct any wrongs that are apparent. This may be accomplished by keeping a journal or devising another method of self-examination each evening, for instance. By understanding how certain things may make a person feel and therefore act, individuals can become more aware of themselves and their behaviors. Step 10 involves personal reflections and a kind of spot-checking to keep oneself balanced emotionally.
Since the 1950s, alcohol addiction has been treated as a separate addiction from that of other illicit drugs under the AA program, meaning that drug abuse disorders are considered to be a different struggle, so a separate 12-step program is recommended. Chemical dependency is considered the most life-threatening addiction disorder and addicts are advised to address this addiction first and prior to other addictions such as gambling or sexual addiction, until abstinence is established and recovery has begun. Drug dependency is sometimes considered the root addiction, causing the individual to develop other addictive tendencies and therefore should be addressed first.

The first book written to cover the 12 step program was titled "Alcoholics Anonymous", affectionately known as the Big Book by program members. Following the subsequent extensive growth of twelve step programs for other addictive and dysfunctional behaviors, many additional books were written and recordings and videos were produced. These cover the steps in greater detail and how people have specifically applied the steps in their lives. An extensive chronology and background about the history of A.A. has been put together at Dick B.'s website.
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