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. 
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Prioritizing coping over healing. While AA obviously wants its members to avoid relapse and maintain sobriety, the means of doing so is heavily focused on using skills to cope with addictive behaviors rather than addressing the underlying issues that are causing them. Because of this, many people find the 12-Step program might help them stay sober, but leave them still struggling with the problems that led to becoming alcoholics in the first place.
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.
AA meetings do not exclude other alcoholics, though some meetings cater to specific demographics such as gender, profession, age, sexual orientation, or culture. Meetings in the United States are held in a variety of languages including Armenian, English, Farsi, Finnish, French, Japanese, Korean, Russian, and Spanish. While AA has pamphlets that suggest meeting formats, groups have the autonomy to hold and conduct meetings as they wish "except in matters affecting other groups or AA as a whole". Different cultures affect ritual aspects of meetings, but around the world "many particularities of the AA meeting format can be observed at almost any AA gathering".
Meditation, prayer, and journaling make up Step 11 as individuals use these tools to form a spiritual connection with God or the higher power. Quiet time and solitude provide for self-reflection, and meditation can be helpful to increase the connection between the body, mind, and soul. When a person is in tune with themselves physically and emotionally, the spiritual aspect is also strengthened. Journaling during Step 11 can be a beneficial way to explore thoughts and emotions more fully as well.
The Serenity Prayer is learned, which is meant to be used whenever individuals need a reminder in their lives. The Serenity Prayer is as follows: “God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference.” This prayer is considered a cornerstone of many 12-Step programs as it embodies the idea that individuals need to accept the control that alcohol and drugs have over them, gain strength to work at remaining sober, and know when things are changeable and when they are not. Step 3 asks individuals to be willing to let God, in whatever form that is for each person, fully into their lives.
Below are the statistically significant relative risks from a study by the American Cancer Society for men and women who consume 4 or more drinks daily. A drink is defined as one 12-oz beer, one 4- to 5-oz glass of wine, or one mixed drink containing 1.5 oz of spirits (80 proof). The relative risk for the noted maladies with consumption of 4 or more drinks daily is as follows:
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Stanton Peele argued that some AA groups apply the disease model to all problem drinkers, whether or not they are "full-blown" alcoholics. Along with Nancy Shute, Peele has advocated that besides AA, other options should be readily available to those problem drinkers who are able to manage their drinking with the right treatment. The Big Book says "moderate drinkers" and "a certain type of hard drinker" are able to stop or moderate their drinking. The Big Book suggests no program for these drinkers, but instead seeks to help drinkers without "power of choice in drink."
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Alcoholics Anonymous is the largest of all the twelve-step programs (from which all other twelve-steps programs are derived), followed by Narcotics Anonymous; the majority of twelve-step members are recovering from addiction to alcohol or other drugs. The majority of twelve-step programs, however, address illnesses other than substance addiction. For example, the third-largest twelve-step program, Al-Anon, assists family members and friends of people who have alcoholism and other addictions. About twenty percent of twelve-step programs are for substance addiction recovery, the other eighty percent address a variety of problems from debt to depression. It would be an error to assume the effectiveness of twelve-step methods at treating problems in one domain translates to all or to another domain, therefore readers are directed to relevant sections in each group's article.
Because of the growing population of older Americans, the number of heavy drinkers will increase from 1 million currently to 2 million by 2060.  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. 
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Added fat and scar tissue on the liver due to excessive alcohol consumption can lead to all sorts of problems, but most often either cirrhosis or alcohol-induced hepatitis. Liver failure among those who drink heavily for many years is likely. Pancreatitis, or the consistent inflammation of the pancreas, can also cause damage to the body, including high blood sugar leading to diabetes.
Around a third of individuals with alcohol dependence resolve their alcohol consumption problems without professional intervention. Others need the support of a health professional who can recommend a range of treatments. While there are many effective treatments, people who overcome alcohol dependence often relapse (i.e. develop alcohol dependency once again).