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121-583: In September 2004, MusiCares acquired the Musicians Assistance Program , a similar program assisting musicians in need, including drug rehabilitation . MusiCares awards recording artists with the " Person of the Year Award ", to commend musicians for their artistic achievement in the music industry and dedication to philanthropy , and with the " Stevie Ray Vaughan Award ", to honor musicians on their commitment to helping others in

242-541: A Roman Catholic , joined in 1939. The first black AA group commenced in 1945 in Washington D.C., and was founded by Jim S., an African-American physician from Virginia. In 1938, Dr. Bob and Bill created The Alcoholic Foundation in New York, bringing in friends of John D. Rockefeller, Jr. as board members. Although they sought to raise significant funds, Rockefeller advised that large contributions might jeopardize

363-493: A "higher power". It offers guidance and strength through prayer and meditation from God or a higher power of their own understanding; take a moral inventory with care to include resentments; list and become ready to remove character defects; list and make amends to those harmed; continue to take a moral inventory, pray, meditate, and try to help other alcoholics recover. The second half of the book, "Personal Stories" (subject to additions, removal, and retitling in subsequent editions),

484-478: A "kinship of common suffering", Wilson attended his first group gathering, although he was drunk. 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 Dr. William Duncan Silkworth (an early benefactor of AA), Wilson's detox included the deliriant belladonna . At the hospital, a despairing Wilson experienced

605-440: A "searching and fearless moral inventory," and to thereby identify "character defects;" to share this moral inventory with one's AA sponsor or another trusted person; to make amends to people harmed; and to engage in regular prayer and meditation, seeking "conscious contact with God ... for knowledge of His will." The steps culminate in the 12th Step, which indicates that having had a "spiritual awakening" members continue to practice

726-470: A 28–30 day program length. The length is based solely upon providers' experience. During the 1940s, clients stayed about one week to get over the physical changes, another week to understand the program, and another week or two to become stable. 70% to 80% of American residential alcohol treatment programs provide 12-step support services. These include, but are not limited to AA, Narcotics Anonymous , Cocaine Anonymous and Al-Anon . One recent study suggests

847-489: A bright flash of light, which he felt to be God revealing himself. Following his hospital discharge, Wilson joined the Oxford Group and tried to recruit other alcoholics to the group. These early efforts to help others kept him sober, but were ineffective in getting anyone else to join the group and get sober. Dr. Silkworth suggested that Wilson place less stress on religion (as required by The Oxford Group) and more on

968-420: A declaration that cannot be questioned by other members. Speaker meetings feature one or more members who share their personal stories of recovery, fostering connection and understanding among participants. Big Book meetings focus on reading and discussing passages from AA's foundational text, while sharing meetings provide an open platform for members to speak freely and share their experiences, with or without

1089-514: A definition. The Recovery Model originates in the psychiatric survivor movement in the US, which argues that receiving a certain diagnoses can be stigmatizing and disempowering. Some characteristics of the Recovery Model are social inclusion, empowerment to overcome substance use, focusing on strengths of the client instead of their deficits and providing help living more fulfilling lives in

1210-474: A form of oxygen starvation called hypoxia , brain damage and a serious vitamin B12 deficiency that can lead to nerve damage. Although dangerous and addictive in its own right, nitrous oxide has been shown to be an effective treatment for a number of addictions. In-patient residential treatment for people with an alcohol use disorder is usually quite expensive without insurance. Most American programs follow

1331-608: A form of self-soothing. Such an approach lies in stark contrast to the approaches of social cognitive theory to addiction—and indeed, to behavior in general—which holds human beings to regulate and control their own environmental and cognitive environments, and are not merely driven by internal, driving impulses. Additionally, homosexual content is not implicated as a necessary feature in addiction. An influential cognitive-behavioral approach to addiction recovery and therapy has been Alan Marlatt's (1985) Relapse Prevention approach. Marlatt describes four psycho-social processes relevant to

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1452-438: A group setting and can include crisis counseling, weekly or daily counseling, and drop-in counseling supports. Counselors are trained to develop recovery programs that help to reestablish healthy behaviors and provide coping strategies whenever a situation of risk happens. It's very common to see them also work with family members who are affected by the addictions of the individual, or in a community to prevent addiction and educate

1573-567: A lack of willingness from the patients or fear to confront the true nature of the addiction and to take any action to improve their lives, instead of continuing the destructive behavior. Once this has been achieved, the counselor coordinates with the addict's family to support them in getting the individual to drug rehabilitation immediately, with concern and care for this person. Otherwise, this person will be asked to leave and expect no support of any kind until going into drug rehabilitation or alcoholism treatment. An intervention can also be conducted in

1694-699: A long process and the duration is dependent upon the patient's needs and history of substance use. Research has shown that most patients need at least three months of treatment and longer durations are associated with better outcomes. Prescription drug addiction does not discriminate. It affects people from all walks of life and can be a devastatingly destructive force. Certain opioid medications such as methadone and more buprenorphine are widely used to treat addiction and dependence on other opioids such as heroin, morphine or oxycodone . Methadone and buprenorphine are maintenance therapies intended to reduce cravings for opiates, thereby reducing illegal drug use , and

1815-454: A permissive set of beliefs have been activated, then the individual will activate drug-seeking and drug-ingesting behaviors. The cognitive therapist's job is to uncover this underlying system of beliefs, analyze it with the patient, and thereby demonstrate its dysfunction. As with any cognitive-behavioral therapy, homework assignments and behavioral exercises serve to solidify what is learned and discussed during treatment. A growing literature

1936-1104: A precursor to addiction. Many rehabilitation centers treat "co-occurring" disorders, which refer to substance abuse disorder paired with a mental health diagnosis. Barriers to accessing drug treatment may worsen negative health outcomes and further exacerbate health inequalities in the United States. Stigmatization of drug use , the War on Drugs and criminalization, and the social determinants of health should all be considered when discussing access to drug treatment and potential barriers. Broad categories of barriers to drug treatment are: absences of problem, negative social support, fear of treatment, privacy concerns, time conflict, poor treatment availability, and admission difficulty. Other barriers to treatment include high costs, lack of tailored programs to address specific needs, and prerequisites that require participants to be house, abstinent from all substances, and/or employed. (See low-threshold treatment and housing first for more context on

2057-552: A predetermined topic. AA meetings are gatherings where recovery from alcoholism is discussed. One perspective sees them as "quasi-ritualized therapeutic sessions run by and for, alcoholics". In recent years, online meetings have become popular, allowing members to connect virtually through platforms like Zoom. Offline or in-person meetings, often referred to as “brick and mortar” meetings, take place in physical locations, and some groups even host hybrid meetings, enabling participants to attend either in person or virtually. Inclusivity

2178-452: A psychotherapeutic approach to behavior change developed by Sigmund Freud and modified by his followers, has also explained substance use. This orientation suggests the main cause of the addiction syndrome is the unconscious need to entertain and to enact various kinds of homosexual and perverse fantasies, and at the same time to avoid taking responsibility for this. It is hypothesized specific drugs facilitate specific fantasies and using drugs

2299-773: A resource for alcoholics worldwide, the Grapevine evolved into a unifying publication for the AA community, chronicling the Fellowship's growth, including the creation of the General Service Structure and publication of later editions of the Big Book. The Twelve Traditions were introduced to AA by Bill W. in April 1946 through an article titled "Twelve Suggested Points for A.A. Tradition." The AA Preamble, inspired by

2420-702: A small hole in the skull to insert a tiny 1mm electrode in the specific area of the brain that regulates impulses such as addiction and self-control. This treatment is for those who have failed every other treatment, whether that is medicine, behavioral therapy, and/or social interventions. It is a very rigorous trial with oversight from ethicists and regulators and many other governing bodies. The definition of recovery remains divided and subjective in drug rehabilitation, as there are no set standards for measuring recovery. The Betty Ford Institute defined recovery as achieving complete abstinence as well as personal well-being while other studies have considered "near abstinence" as

2541-582: A spiritual conversion" with the help of the Group and began to experience the liberation from drink he was seeking. He became converted to a lifetime of sobriety while on a train ride from New York to Detroit after reading For Sinners Only by Oxford Group member AJ Russell. Members of the group introduced Hazard to Ebby Thacher . Hazard brought Thacher to the Calvary Rescue Mission, led by Oxford Group leader Sam Shoemaker . In keeping with

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2662-480: A supportive social network that can help them remain sober. Such approaches are the quintessential features of Twelve-step programs, originally published in the book Alcoholics Anonymous in 1939. These approaches have met considerable amounts of criticism, coming from opponents who disapprove of the spiritual-religious orientation on both psychological and legal grounds. Opponents also contend that it lacks valid scientific evidence for claims of efficacy. However, there

2783-565: A surge in inquires, and AA membership tripled over the next year. Interviews on American radio and favorable articles in US magazines led to increased big book sales and membership. As the growing Fellowship faced disputes over structure, purpose, authority, and publicity, Wilson began promoting the Twelve Traditions. Bill W. first introduced his ideas on the Twelve Traditions in an April 1946 article for The Grapevine , titled “Twelve Suggested Points for A.A. Tradition.” Recognizing

2904-532: A unique approach—no logos, phone numbers, or links—focusing on subtle messaging like "You Are not Alone" and "Alcohol isn't the Answer." The campaign, created by The Raised Eyebrow Society, aims to attract people struggling with alcohol without violating AA's principles of anonymity and non-promotion. AA will celebrate its 100th anniversary meeting in Indianapolis, Indiana in 2035. The international convention

3025-479: A very unpleasant reaction when drinking alcohol that includes flushing, nausea and palpitations. It is more effective for patients with high motivation and some addicts use it only for high-risk situations. Patients who wish to continue drinking or may be likely to relapse should not take disulfiram as it can result in the disulfiram-alcohol reaction mentioned previously, which is very serious and can even be fatal. Nitrous oxide , also sometimes known as laughing gas,

3146-413: A whole. Despite cultural differences influencing certain rituals, many elements of AA meetings remain consistent worldwide. AA meetings encompass a variety of formats, each designed to serve different needs. Open meetings are accessible to anyone, including non-alcoholics who can attend as observers. In contrast, closed meetings are reserved for individuals who identify as having a desire to stop drinking,

3267-661: A year, and came back to the US, he soon resumed drinking, and returned to Jung in Zurich for further treatment. Jung told Hazard that his case was nearly hopeless (as with other alcoholics) and that his only hope might be a "spiritual conversion" with a "religious group". Back in America, Hazard went to the Oxford Group, whose teachings were eventually the source of such AA concepts as "meetings" and "sharing" (public confession), making "restitution", "rigorous honesty" and "surrendering one's will and life to God's care". Hazard underwent

3388-451: A “disease’’), and out of control—for which on going divining and following the will an unspecified 'higher power' (“God, as we understood Him”) could restore them to “sanity”. In the steps members acknowledge and make amends and seek to correct personal character defects aided by their higher power for guidance. Those “having achieved a spiritual awakening as a result of these steps” are suggested to carry AA's message to other alcoholics. This

3509-496: Is a hallucinogenic drug promoted by certain fringe groups to interrupt both physical dependence and psychological craving to a broad range of drugs including narcotics, stimulants, alcohol, and nicotine. To date, there have never been any controlled studies showing it to be effective, and it is not accepted as a treatment by physicians, pharmacists, or addictionologist. There have also been several deaths related to ibogaine use, which causes tachycardia and long QT syndrome . The drug

3630-621: Is a biennial international forum where AA delegates from around the world exchange ideas and experiences on carrying the message of recovery. Held in various global cities, the WSM focuses on sharing strategies to help alcoholics in different countries and languages. Today, A.A. is present in approximately 180 nations worldwide. By 2018, AA had 2,087,840 members and 120,300 AA groups worldwide. There are AA meetings in Beijing , China. In July 2024, AA launched its first UK-wide advertising campaign with

3751-468: Is a book published in 1953 that serves as a key text for AA. Written by AA co-founder Bill W., it provides detailed explanations of the Twelve Steps and the Twelve Traditions. The book is commonly used in AA meetings and individual study, offering a framework for understanding the organization's approach to recovery and community. The story of Eddie Rickenbacker "and his courageous company" appears in

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3872-481: Is a core principle of AA meetings, which welcome all alcoholics, though some are tailored to specific demographics such as gender, age, profession, or cultural background. Since the mid-1970s, several 'agnostic' or 'no-prayer' AA groups have begun across the US, 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

3993-514: Is a legally available gas used for anesthesia during certain dental and surgical procedures, in food preparation, and for the fueling of rocket and racing engines. People who use substances also sometimes use gas as an inhalant. Like all other inhalants, it is popular because it provides consciousness-altering effects while allowing users to avoid some of the legal issues surrounding illicit substances. Misuse of nitrous oxide can produce significant short-term and long-term damage to human health, including

4114-524: Is a long-acting opioid antagonist with few side effects. It is usually prescribed in outpatient medical conditions. Naltrexone blocks the euphoric effects of alcohol and opiates. Naltrexone cuts relapse risk in the first three months by about 36%. However, it is far less effective in helping patients maintain abstinence or retaining them in the drug-treatment system (retention rates average 12% at 90 days for naltrexone, average 57% at 90 days for buprenorphine, average 61% at 90 days for methadone). Ibogaine

4235-554: Is a result of internal, or rather external, transient causes (e.g., allowing oneself to make exceptions when faced with what are judged to be unusual circumstances). Finally, decision-making processes are implicated in the relapse process as well. Substance use is the result of multiple decisions whose collective effects result in the consumption of the intoxicant. Furthermore, Marlatt stresses some decisions—referred to as apparently irrelevant decisions—may seem inconsequential to relapse, but may actually have downstream implications that place

4356-466: Is addressed in many drug rehabilitation programs by attempting to teach patients new methods of interacting in a drug-free environment. In particular, patients are generally encouraged, or possibly even required, to not associate with peers who still use addictive substances. Twelve-step programs encourage addicts not only to stop using alcohol or other drugs but to examine and change habits related to their addictions . Many programs emphasize that recovery

4477-508: Is also fully self-supporting through the sale of literature and member contributions. The Eighth Tradition permits AA to employ "special workers" for roles that require specific expertise or full-time responsibilities, such as administrative tasks. However, these paid roles do not involve working directly with alcoholics in need of help, a function known as the "12th Step." Calls from alcoholics seeking assistance are always passed on to sober AA members who have volunteered to handle them, ensuring

4598-456: Is also the origin of AA's name. AA offers a suggested, but not required, program of ongoing self-improvement and recovery in its Twelve Steps , a central element of which involves divining and following the will of a self-defined “God as we understood Him.” The Twelve Steps begin with admitting to powerlessness over alcohol and recognizing the unmanageability of one's life due to alcoholism. Subsequent steps require "rigorous honesty" to undertake

4719-413: Is an illegal Schedule I controlled substance in the United States, and the foreign facilities in which it is administered tend to have little oversight and range from motel rooms to one moderately-sized rehabilitation center. A few antidepressants have been proven to be helpful in the context of smoking cessation/nicotine addiction. These medications include bupropion and nortriptyline. Bupropion inhibits

4840-512: Is an ongoing process without culmination. For legal drugs such as alcohol, complete abstention—rather than attempts at moderation , which may lead to relapse —is also emphasized ("One is too many, and a thousand is never enough.") Whether moderation is achievable by those with a history of misuse remains a controversial point. The brain's chemical structure is altered by addictive substances and these changes are present long after an individual stops using. This change in brain structure increases

4961-590: Is anticipated to attract tens of thousands of attendees to the Indiana Convention Center and Lucas Oil Stadium . 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, expounding on the big book in regard to its subject, Twelve Steps and Twelve Traditions . As with all AA literature,

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5082-478: Is believed to have originated in 1942 in Indianapolis, gaining popularity as various AA groups adopted the practice. Typically, different colored chips represent milestones of sobriety within the first year, with tokens awarded for 24 hours, 30 days, 60 days, 90 days, and beyond, culminating in a bronze chip for one year of sobriety. AA members celebrate Founders Day on the weekend closest to June 10, marking

5203-423: Is commonly used in AA meetings as a tool for reflection and guidance. It was called the AA prayer in the 1940s. Often recited at meetings, it emphasizes the concepts of acceptance, courage, and wisdom, which align with the principles of the AA program. The prayer encourages individuals to accept things they cannot change, to find the courage to make changes where possible, and to seek the wisdom to distinguish between

5324-413: Is considered to be a displacement from, and a concomitant of, the compulsion to masturbate while entertaining homosexual and perverse fantasies. The addiction syndrome is also hypothesized to be associated with life trajectories that have occurred within the context of teratogenic processes, the phases of which include social, cultural, and political factors, encapsulation, traumatophobia, and masturbation as

5445-466: Is demonstrating the importance of emotion regulation in the treatment of substance use. Considering that nicotine and other psychoactive substances such as cocaine activate similar psycho-pharmacological pathways, an emotion regulation approach may be applicable to a wide array of substance use. Proposed models of affect-driven tobacco use have focused on negative reinforcement as the primary driving force for addiction; according to such theories, tobacco

5566-409: Is emphasized, particularly in media, with no prescribed consequences for breaches. AA meetings serve as a space where individuals discuss recovery from alcoholism, with flexibility in how meetings are conducted. While AA offers pamphlets suggesting formats, groups have the autonomy to organize their meetings according to their preferences, as long as their decisions do not impact other groups or AA as

5687-581: Is entirely self-supporting, relying on voluntary contributions from its members to cover expenses. Contributions to the General Service Office (GSO) are limited to $ 5,000 per member per year. In addition to these contributions, more than 50% of AA's income comes from the sale of AA literature, such as books and pamphlets. This practice aligns with AA's Seventh Tradition, which emphasizes financial independence by not accepting donations from outside individuals or organizations. The Central Office

5808-458: Is made of AA members' redemptive autobiographical sketches. AA's Big Book calls alcoholism "an illness which only a spiritual experience will conquer." Ernest Kurtz says this is "The closest the book Alcoholics Anonymous comes to a definition of alcoholism." Somewhat divergently in his introduction to The Big Book, non-member and early benefactor William Silkworth said those unable to moderate their drinking suffer from an allergy . In presenting

5929-476: Is meant to be achieved by taking the Twelve Steps , and sobriety is furthered by volunteering for AA and regular AA meeting attendance or contact with AA members. Taking AA's 12 steps are a “suggested”, but not required, “program of recovery”—also called a “spiritual solution”. They start with members admitting to being “powerless over alcohol” (which the Big Book calls an “Illness” or “malady”, but never

6050-409: Is often done through meetings of AA groups as well as with members taking on sponsees, although the Big Book makes no mention of the latter term. While taking care to avoid becoming affiliated, some AA members perform outreach to hospitals, treatment centers and correctional facilities. Members are encouraged to find an experienced fellow alcoholic, called a sponsor, to help them understand and follow

6171-573: Is preferable, with very high rates (79–100%) of relapse within three months of detoxification from levo-α-acetylmethadol ( LAAM ), buprenorphine, and methadone. According to the National Institute on Drug Abuse (NIDA), patients stabilized on adequate, sustained doses of methadone or buprenorphine can keep their jobs, avoid crime and violence, and reduce their exposure to HIV and Hepatitis C by stopping or reducing injection drug use and drug-related high risk sexual behavior . Naltrexone

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6292-475: Is self-supporting, with donations from members covering expenses, and it operates through an "inverted pyramid" structure, where individual groups function autonomously. The organization does not accept outside contributions and relies heavily on literature sales. A 2020 Cochrane review found that, compared to other treatments like cognitive-behavioral therapy, manualized AA and Twelve-Step Facilitation (TSF) therapy showed superior continuous abstinence rates in

6413-420: Is survey-based research that suggests there is a correlation between attendance and alcohol sobriety. Different results have been reached for other drugs, with the twelve steps being less beneficial for addicts to illicit substances, and least beneficial to those addicted to the physiologically and psychologically addicting opioids , for which maintenance therapies are the gold standard of care. SMART Recovery

6534-611: Is the process of medical or psychotherapeutic treatment for dependency on psychoactive substances such as alcohol , prescription drugs , and street drugs such as cannabis , cocaine , heroin , and amphetamines . The general intent is to enable the patient to confront substance dependence , if present, and stop substance misuse to avoid the psychological , legal, financial, social, and medical consequences that can be caused. Treatment includes medication for comorbidities , counseling by experts, and sharing of experience with other recovering individuals. Psychological dependency

6655-485: Is the sole fault of the person for becoming addicted. Supporters of the Moral Model view drug use as a choice, even for those who are addicted, and addicts as people of bad character. Disease Model of addiction frames substance abuse as 'a chronic relapsing disease that changes the structure and function of the brain'. Research conducted on the neurobiological factors of addiction has proven to have mixed results, and

6776-568: Is used because it helps one escape from the undesirable effects of nicotine withdrawal or other negative moods. Acceptance and commitment therapy (ACT), is showing evidence that it is effective in treating substance use, including the treatment of polysubstance use disorder and tobacco smoking . Mindfulness programs that encourage patients to be aware of their own experiences in the present moment and of emotions that arise from thoughts, appear to prevent impulsive/compulsive responses. Research also indicates that mindfulness programs can reduce

6897-830: The Betty Ford Center . Susan Ford Bales accepted the MusiCares MAP Fund award on behalf of her mother. Awards given after the MusiCares/MAP merger... The MusiCares From the Heart Award is given to artists for their unconditional friendship and dedication to the mission and goals of the organization during the MusiCares MAP Fund Benefit Concert. The first recipient was Goldenvoice in memory of Rick Van Santen. Drug rehabilitation Drug rehabilitation

7018-464: The Christian revivalist Oxford Group , they and other alcoholics helped each other until forming what became AA. In 1939, the new fellowship published Alcoholics Anonymous: The Story of How More than One Hundred Men Have Recovered from Alcoholism . The amended sub-title in later editions referred to “ Thousands of Men and Women”. Debuting AA's 12 steps, it is informally known as the “Big Book”. It

7139-499: The criminal justice system . People convicted of minor drug offenses may be sentenced to rehabilitation instead of prison, and those convicted of driving while intoxicated are sometimes required to attend Alcoholics Anonymous meetings. There are a great number of ways to address an alternative sentence in a drug possession or DUI case; increasingly, American courts are willing to explore outside-the-box methods for delivering this service. There have been lawsuits filed, and won, regarding

7260-407: The "eroded relationships" caused by active addiction. Quadrant Four often involves facing the harsh consequences of drug use such as unemployment, legal discrepancies, or eviction. The use of integral theory aims to break the dichotomy of "using" or "not using" and focuses instead on emotional, spiritual, and intellectual growth, along with physical wellness. Drug rehabilitation is sometimes part of

7381-550: The AA program. The sponsor should preferably have experienced all twelve of the steps, be the same sex as the sponsored person, and refrain from imposing personal views on the sponsored person. 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. The Twelve Traditions provide essential guidelines—not rules—that help A.A. groups navigate their relationships both internally and with

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7502-539: The Abstinence Violation Effect, characterized by guilt for having gotten intoxicated and low efficacy for future abstinence in similar tempting situations. This is a dangerous pathway, Marlatt proposes, to full-blown relapse. An additional cognitively-based model of substance use recovery has been offered by Aaron Beck , the father of cognitive therapy and championed in his 1993 book Cognitive Therapy of Substance Abuse . This therapy rests upon

7623-598: The CA Department of Health Care Services investigating over 2,000 licensed rehab centers. In Afghanistan since the Taliban took power in 2021, they have forced drug addicts into compulsory drug rehab. Alcoholics Anonymous Alcoholics Anonymous ( AA ) is a global, peer-led mutual-aid fellowship dedicated to abstinence-based recovery from alcoholism through its spiritually inclined twelve-step program . AA's Twelve Traditions stress anonymity and

7744-669: The California Insurance Fraud Prevention Act (IFPA) which declares it unlawful to unknowingly conduct such businesses. Under the Affordable Care Act and the Mental Health Parity Act, rehabilitation centers are able to bill insurance companies for substance use treatment. With long wait lists in limited state-funded rehabilitation centers, controversial private centers rapidly emerged. One popular model, known as

7865-515: The Fellowship. The foundation opened a small office in New York, primarily funded by A.A. members, to handle inquiries and distribute the Alcoholics Anonymous book. In 1940, Rockefeller organized a dinner to promote A.A., which further increased the number of inquiries. The office became effective. Each request received a personal reply and a pamphlet, enhancing interest in the book. Consequently, many new groups were established, and by

7986-805: The Florida Model for rehabilitation centers, is often criticized for fraudulent billing to insurance companies. Under the guise of helping patients with opioid addiction, these centers would offer addicts free rent or up to $ 500 per month to stay in their "sober homes", then charge insurance companies as high as $ 5,000 to $ 10,000 per test for simple urine tests. Little attention is paid to patients in terms of addiction intervention as these patients have often been known to continue drug use during their stay in these centers. Since 2015, these centers have been under federal and state criminal investigation. As of 2017 in California, there are only 16 investigators in

8107-679: The Foreword of the book Alcoholics Anonymous , was written by one of the Grapevine's early editors Tom. Y. and first appeared in the June 1947 issue. In 1986, it was reaffirmed as AA's international journal by the General Service Conference. AA's program extends beyond abstaining from alcohol. Its goal is to effect enough change in the alcoholic's thinking "to bring about recovery from alcoholism" through "an entire psychic change," or spiritual awakening. A spiritual awakening

8228-536: The Oxford Group stressed the possibility of complete victory over sin. In 1935, AA began in Akron, Ohio, as the outcome of a meeting between Bill W., and Dr. Bob , an Akron surgeon. Wilson's first success came during a business trip to Akron, Ohio, where he was introduced to Dr. Robert Smith , a surgeon, who was unable to stay sober. Dr. Bob's participation in the Oxford Group had not been enough to enable him to stop drinking. Bill W. explained that alcoholism affects

8349-420: The Oxford Group teaching that a new convert must win other converts to preserve his own conversion experience, Thacher contacted his old friend Bill Wilson , whom he knew had a drinking problem. Thacher approached Wilson saying that he had "got religion", was sober, and that Wilson could do the same if he set aside objections and instead formed a personal idea of God, "another power" or "higher power". Feeling

8470-521: The SMART Recovery programs are: This is considered to be similar to other self-help groups who work within mutual aid concepts. In his influential book, Client-Centered Therapy , in which he presented the client-centered approach to therapeutic change, psychologist Carl Rogers proposed there are three necessary and sufficient conditions for personal change: unconditional positive regard, accurate empathy, and genuineness. Rogers believed

8591-684: The Society of Psychologists in Addictive Behaviors) measuring treatment responses on the Spiritual Belief Scale (a scale measuring belief in the four spiritual characteristics Alcoholics Anonymous identified by Ernest Kurtz); the scores were found to explain 41% of the variance in the treatment provider's responses on the Addiction Belief Scale (a scale measuring adherence to the disease model or

8712-626: The Twelve Concepts for World Service outline how the organization operates on a global scale. Each AA group is self-governing, with AA World Services acting only in an advisory capacity. This "inverted pyramid" style of governance has been key to the organization's resilience and adaptability. In Ireland, Shane Butler noted that AA's lack of top-level leadership might make it seem unsustainable, but its structure has proven extremely robust since its establishment there in 1946. AA's 21-member Board of Trustees includes seven "nonalcoholic friends of

8833-478: The Twelve Steps. This book also included case histories of thirty individuals who had achieved recovery, marking a significant milestone in A.A.'s development. The Twelve Steps were influenced by the Oxford Group's 6 steps and various readings, including William James 's The Varieties of Religious Experience . The first female member, Florence Rankin, joined AA in March 1937, and the first non-Protestant member,

8954-464: The addiction and relapse processes: self-efficacy , outcome expectancy, attributions of causality, and decision-making processes. Self-efficacy refers to one's ability to deal competently and effectively with high-risk, relapse-provoking situations. Outcome expectancy refers to an individual's expectations about the psychoactive effects of an addictive substance. Attributions of causality refer to an individual's pattern of beliefs that relapse to drug use

9075-526: The addiction recovery process. To help raise funding for the program, a MusiCares MAP Fund Benefit Concert is held annually since 2005. Among the awards given at the event is the Stevie Ray Vaughan Award , named after the late guitarist Stevie Ray Vaughan , which recognizes musicians for their devotion to helping other addicts struggling with the recovery process. Founded by longtime musician and addiction recovery activist Buddy Arnold ,

9196-443: The anniversary of the organization with thousands of attendees engaging in tours of historical sites, sharing recovery stories, and participating in related activities in Akron, Ohio. AA describes itself as "not organized in the formal or political sense" and has been referred to as a "benign anarchy," borrowing a phrase from anarchy theorist Peter Kropotkin. The Twelve Traditions guide the functioning of individual AA groups, while

9317-454: The assumption addicted individuals possess core beliefs, often not accessible to immediate consciousness (unless the patient is also depressed). These core beliefs, such as "I am undesirable," activate a system of addictive beliefs that result in imagined anticipatory benefits of substance use and, consequentially, craving. Once craving has been activated, permissive beliefs ("I can handle getting high just this one more time") are facilitated. Once

9438-458: The authors expected the two-factor theory to be the most effective, it actually proved to be deleterious in the outcome. Surprisingly, client-centered therapy proved most effective. It has been argued, however, these findings may be attributable to the profound difference in therapist outlook between the two-factor and client-centered approaches, rather than to client-centered techniques. The authors note two-factor theory involves stark disapproval of

9559-585: The book. It pertains to when his plane crashed in the Pacific and is used in the closing remarks of Tradition One: "Our common welfare should come first; personal recovery depends upon A.A. unity." The Grapevine , established in June 1944 by six AA members in New York, became AA's national journal by 1945 and later its international journal. Supported by Bill W., the magazine featured first-person stories, AA news, and discussions on key topics like women in AA and veterans returning from war. Initially intended as

9680-458: The clients' "irrational behavior" (p. 350); this notably negative outlook could explain the results. A variation of Rogers' approach has been developed in which clients are directly responsible for determining the goals and objectives of the treatment. Known as Client-Directed Outcome-Informed therapy (CDOI), this approach has been utilized by several drug treatment programs, such as Arizona's Department of Health Services . Psychoanalysis ,

9801-410: The consumption of substances such as alcohol, cocaine, amphetamines, marijuana, cigarettes and opiates. People who are diagnosed with a mental health disorder and a simultaneous substance use disorder are known as having a dual diagnosis. For example, someone with bipolar disorder who also has an alcohol use disorder would have dual diagnosis . On such occasions, two treatment plans are needed with

9922-452: The doctor's postulate, AA said "The doctor's theory that we have an allergy to alcohol interests us. As laymen, our opinion as to its soundness may, of course, mean little. But as ex-problem drinkers, we can say that his explanation makes good sense. It explains many things for which we cannot otherwise account." AA later acknowledged that "alcoholism is not a true allergy, the experts now inform us." The " Twelve Steps and Twelve Traditions "

10043-622: The end of 1940, A.A. membership had grown to 2,000. In 1939, media coverage, particularly from The Cleveland Plain Dealer , generated a surge of interest and requests for help. The Cleveland group, although small, successfully assisted many alcoholics, quickly growing from twenty to around 500 members. A subsequent article in Liberty magazine resulted in a flood of requests for assistance, further expanding A.A.'s reach. In 1941 The Saturday Evening Post published an article about AA, sparking

10164-532: The event was originally called Musicians' Assistance Program (MAP) Awards . Eric Clapton was honored with the Musicians' Assistance Program's (MAP) first Stevie Ray Vaughan Award on November 2, 1999. In 2004, MusiCares acquired MAP and merged the two programs under the MusiCares banner. The 2010 Musicares MAP Fund benefit concert celebrated Women In Recovery and honored former U.S. first lady Betty Ford and

10285-442: The fellowship," though the organization is primarily served and run by alcoholics. Members who accept service positions, termed "trusted servants," hold these roles for limited terms, typically ranging from three months to two years, depending on the position and group vote. This approach ensures regular rotation and participation from a broad spectrum of members, maintaining AA's commitment to shared responsibility and leadership. AA

10406-403: The field of alcoholism. The headquarters also published standard A.A. literature and oversaw translations, while the AA Grapevine gained substantial circulation. Despite these essential services, they were managed by a disconnected board of trustees, primarily linked to Bill and Dr. Bob. Recognizing the need for accountability, delegates from across the U.S. and Canada were convened, leading to

10527-498: The first meeting of the A.A. General Service Conference in 1951. This successful gathering established direct oversight of A.A.'s trusteeship by the Fellowship itself, ensuring the organization's future governance. At the 1955 conference in St. Louis, Missouri, Wilson relinquished stewardship of AA to the General Service Conference, as AA had grown to millions of members internationally. The World Service Meeting (WSM), established in 1969,

10648-635: The free-will model addiction). Effective treatment addresses the multiple needs of the patient rather than treating addiction alone. In addition, medically assisted drug detoxification or alcohol detoxification alone is ineffective as a treatment for addiction. The National Institute on Drug Abuse (NIDA) recommends detoxification followed by both medication (where applicable) and behavioral therapy , followed by relapse prevention . According to NIDA, effective treatment must address medical and mental health services as well as follow-up options, such as community or family-based recovery support systems. Whatever

10769-642: The geographical location, gender, race, socioeconomic status, and status of past or current criminal justice system involvement of the person seeking treatment. Despite ongoing efforts to combat addiction, there has been evidence of clinics billing patients for treatments that may not guarantee their recovery. This is a major problem as there are numerous claims of fraud in drug rehabilitation centers, where these centers are billing insurance companies for under-delivering much-needed medical treatment while exhausting patients' insurance benefits. In California, there are movements and laws regarding this matter, particularly

10890-448: The importance of family participation in residential treatment patient retention , finding "increased program completion rate for those with a family member or significant other involved in a seven-day family program". Patients with severe opioid addiction are being given brain implants to help reduce their cravings, in the first trial of its kind in the US. Treatment starts with a series of brain scans. Surgery follows with doctors making

11011-468: The individual, the collective society, along with individual and external factors. The four quadrants corresponding with each in Integral Theory are Consciousness, Behavior, Culture and Systems. Quadrant One deals with the neurological aspect of addiction. Quadrant Two focuses on building self-esteem and a feeling of connectedness, sometimes through spirituality . Quadrant three works on mending

11132-439: The lack of a governing hierarchy, and establish AA as free to all, non-promotional, non-professional, unaffiliated, non-denominational, and apolitical. In 2021, AA reported a presence in approximately 180 countries with nearly two million members—73% in the United States and Canada. AA dates its beginning to Bill Wilson's (Bill W.) and Bob Smith's (Dr. Bob) first commiseration alcoholic-to-alcoholic in 1935. Meeting through

11253-472: The latter point.) In certain states, providers due to mandatory reporting methods and guidelines inform Child Protective Services of substance abusing parents for Schedule 1 substances including cannabis/marijuana. If a mother tests positive for using the substance during pregnancy in South Carolina she may be required to forfeit her child. Further, barriers to treatment can vary depending on

11374-664: The mental health disorder requiring treatment first. According to the National Survey on Drug Use and Health (NSDUH), 45 percent of people with addiction have a co-occurring mental health disorder. Behavioral models make use of principles of functional analysis of drinking behavior. Behavior models exist for both working with the person using the substance (community reinforcement approach) and their family ( community reinforcement approach and family training ). Both these models have had considerable research success for both efficacy and effectiveness. This model lays much emphasis on

11495-511: The methodology, patient motivation is an important factor in treatment success. For individuals addicted to prescription drugs, treatments tend to be similar to those who are addicted to drugs affecting the same brain systems. Medication like methadone and buprenorphine can be used to treat addiction to prescription opiates, and behavioral therapies can be used to treat addiction to prescription stimulants, benzodiazepines, and other drugs. Types of behavioral therapy include: Treatment can be

11616-423: The mind, emotions, and body, a concept he learned from Dr. Silkworth at Towns Hospital in New York, where he had been a patient multiple times. Convinced by Bill's insights, Dr. Bob soon achieved sobriety and never drank again, marking the inception of A.A., on 10 June 1935. Bill W. and Dr. Bob started working with alcoholics at Akron's City Hospital . One patient, who soon achieved sobriety, joined them. Together,

11737-426: The months and years after treatment, and with greater healthcare cost savings. AA has faced criticism for various reasons. Critics have questioned its overall success rate, and others have criticized the religious or what they see as cult-like aspects of its program. There have also been concerns about "thirteenth-stepping," where older members pursue new members romantically, as well as lawsuits regarding safety and

11858-806: The need for guidance as A.A. expanded, he aimed to preserve the organization's unity and purpose. Bill described the input he received as a "welter of exciting and fearsome experience," which greatly influenced the development of the Traditions. From December 1947 to November 1948, The Grapevine published the Traditions individually, and in 1950, the First International Convention in Cleveland officially adopted them. In 1951, A.A.'s New York office expanded its activities, including public relations, support for new groups, services to hospitals and prisons, and cooperation with agencies in

11979-419: The only treatment idea it offers is abstinence. The Socio-Cultural Model tries to provide an explanation of how certain populations are more susceptible to substance abuse than others. It focuses on how discrimination, poor quality of life, lack of opportunity and other problems common in marginalized communities can make them vulnerable to addiction. The Psycho-Dynamic Model looks at trauma and mental illness as

12100-567: The outside world. These traditions ensure that membership is open to anyone seeking to stop drinking, with no dues or fees required. These Traditions foster an altruistic, unaffiliated, non-coercive, and non-hierarchical organization, limiting A.A.'s mission to helping alcoholics at a non-professional level while avoiding publicity. To prioritize recovery, the traditions discourage hierarchies, dogma, public controversies, property acquisition, and outside contributions. Members are advised against using A.A. for personal gain or public prestige, and anonymity

12221-431: The presence of symptoms of addiction. Another key component of the Recovery Model is the collaborative relationship between client and provider in developing the client's path to abstinence. Under the Recovery Model a program is personally designed to meet an individual clients needs, and does not include a standard set of steps one must go through. The Recovery Model uses integral theory: a four-part approach focusing on

12342-470: The presence of these three items, in the therapeutic relationship , could help an individual overcome any troublesome issue, including but not limited to alcohol use disorder . To this end, a 1957 study compared the relative effectiveness of three different psychotherapies in treating alcoholics who had been committed to a state hospital for sixty days: a therapy based on two-factor learning theory, client-centered therapy , and psychoanalytic therapy . Though

12463-519: The principles articulated in the previous 11 steps, and to carry AA's message of recovery to other alcoholics. Such "12th Step work" includes peer-to-peer sponsorship of alcoholics, forming AA groups, holding meetings, and through outreach to hospitals, prisons and other institutions. AA meetings vary in format, with some focusing on personal stories, readings from the Big Book, or open discussion. Meetings may cater to specific demographics, but they generally welcome anyone who desires to stop drinking. AA

12584-490: The program, has remained largely intact since the 1939 edition, with minor statistical updates and edits. The second part contains personal stories that are updated with every edition to reflect current AA membership, resulting in earlier stories being removed – these were published separately in 2003 in the book Experience, Strength, and Hope . The Big Book suggests a twelve-step program in which members admit that they are powerless over alcohol and need help from

12705-421: The public. Counselors should be able to recognize how addiction affects the whole person and those around him or her. Counseling is also related to "Intervention"; a process in which the addict's family and loved ones request help from a professional to get an individual into drug treatment. This process begins with a professionals' first goal: breaking down denial of the person with the addiction. Denial implies

12826-543: The re-uptake of nor-epinephrine and dopamine and has been FDA approved for smoking cessation, while nortriptyline is a tricyclic antidepressant which has been used to aid in smoking cessation it has not been FDA approved for this indication. Acamprosate , disulfiram and topiramate (a novel anticonvulsant sulphonated sugar) are also used to treat alcohol addiction. Acamprosate has shown effectiveness for patients with severe dependence, helping them to maintain abstinence for several weeks, even months. Disulfiram produces

12947-400: The relapse risk (PATH 1) and heighten his efficacy for future abstinence. If, however, he lacks coping mechanisms—for instance, he may begin ruminating on his cravings (PATH 2)—then his efficacy for abstinence will decrease, his expectations of positive outcomes will increase, and he may experience a lapse—an isolated return to substance intoxication. So doing results in what Marlatt refers to as

13068-452: The religious nature of AA in court-mandated treatment. Rowland Hazard ’s journey from Carl Jung ’s psychiatric treatment to spiritual conversion through the Oxford Group played a pivotal role in shaping the foundations of Alcoholics Anonymous, influencing its principles of recovery. In 1926, Hazard went to Zurich , Switzerland , to seek treatment for alcoholism with psychiatrist Carl Jung . When Hazard ended treatment with Jung after about

13189-794: The requirement of attending Alcoholics Anonymous and other twelve-step meetings as being inconsistent with the Establishment Clause of the First Amendment of the U.S. Constitution, mandating separation of church and state. In some cases, individuals can be court-ordered to drug rehabilitation by the state through legislation like the Marchman Act . Traditional addiction treatment is based primarily on counseling. Counselors help individuals with identifying behaviors and problems related to their addiction. It can be done on an individual basis, but it's more common to find it in

13310-509: The result of a lifelong disease that is biological in origin and exacerbated by environmental contingencies. This conceptualization renders the individual essentially powerless over his or her problematic behaviors and unable to remain sober by himself or herself, much as individuals with a terminal illness are unable to fight the disease by themselves without medication. Behavioral treatment, therefore, necessarily requires individuals to admit their addiction, renounce their former lifestyle, and seek

13431-626: The risk of relapse, making treatment an important part of the rehabilitation process. Various types of programs offer help in drug rehabilitation, including residential treatment (in-patient/out-patient), local support groups , extended care centers, recovery or sober houses , addiction counselling, mental health, and medical care. Some rehab centers offer age- and gender-specific programs. In an American survey by three separate institutions (the National Association of Alcoholism and Drug Abuse Counselors, Rational Recovery Systems and

13552-409: The risks associated with it, such as disease, arrest, incarceration , and death, in line with the philosophy of harm reduction . Both drugs may be used as maintenance medications (taken for an indefinite period of time), or used as detoxification aids. All available studies collected in the 2005 Australian National Evaluation of Pharmacotherapies for Opioid Dependence suggest that maintenance treatment

13673-490: The science of treating alcoholism. Bill W. would later write: "The early AA got its ideas of self-examination, acknowledgment of character defects, restitution for harm done, and working with others straight from the Oxford Group and directly from Sam Shoemaker , their former leader in America, and from nowhere else." According to Mercadante, however, the AA concept of powerlessness over alcohol departs significantly from Oxford Group belief. In AA, alcoholism cannot be cured, and

13794-417: The texts are freely available on AA.org. In 1939, Wilson and other members wrote the book initially titled Alcoholics Anonymous: The Story of How More than One Hundred Men Have Recovered from Alcoholism , from which AA drew its name. Informally known as "The Big Book." The second edition of the Big Book was released in 1955, the third in 1976, and the fourth in 2001. The first part of the book, which details

13915-501: The three men formed the foundation of what would later become Alcoholics Anonymous, although the name "Alcoholics Anonymous" had not yet been adopted. In late 1935, a new group of alcoholics began forming in New York, followed by another in Cleveland in 1939. Over the course of four years, these three initial groups helped around 100 people achieve sobriety. In early 1939, the Fellowship published its foundational text, Alcoholics Anonymous , which outlined A.A.’s philosophy and introduced

14036-404: The two. Sobriety coins , also known as sobriety chips, are tokens given to members of AA to signify the duration of their sobriety. While the chip system is common, it is not universally adopted across all AA groups. The tradition began with Sister Ignatia in Akron, Ohio who distributed medallions to newly released patients as reminders to avoid drinking. The actual sobriety chip as known today

14157-417: The use of opening or closing prayers. Meetings in the United States are held in a variety of languages including Armenian , English, Farsi , Finnish , French, Japanese, Korean , Russian, and Spanish. At some point during the meeting a basket is passed around for voluntary donations. AA's 7th tradition requires that groups be self-supporting, "declining outside contributions". The Serenity Prayer

14278-473: The use of problem-solving techniques as a means of helping the addict to overcome his/her addiction. The way researchers think about how addictions are formed shapes the models we have. Four main Behavioral Models of addiction exist: the Moral Model, Disease Model , Socio-Cultural Model and Psycho-dynamic Model. The Moral Model of addiction theorizes that addiction is a moral weakness and that it

14399-463: The user in a high-risk situation. For example: As a result of heavy traffic, a recovering alcoholic may decide one afternoon to exit the highway and travel on side roads. This will result in the creation of a high-risk situation when he realizes he is inadvertently driving by his old favorite bar. If this individual can employ successful coping strategies , such as distracting himself from his cravings by turning on his favorite music, then he will avoid

14520-474: The workplace environment with colleagues instead of family. One approach with limited applicability is the sober coach . In this approach, the client is serviced by the provider(s) in his or her home and workplace—for any efficacy, around-the-clock—who functions much like a nanny to guide or control the patient's behavior. The disease model of addiction has long contended the maladaptive patterns of alcohol and substance use displays addicted individuals are

14641-519: Was founded by Joe Gerstein in 1994 by basing REBT as a foundation. It gives importance to the human agency in overcoming addiction and focuses on self-empowerment and self-reliance. It does not subscribe to disease theory and powerlessness. The group meetings involve open discussions, questioning decisions and forming corrective measures through assertive exercises. It does not involve a lifetime membership concept, but people can opt to attend meetings, and choose not to after gaining recovery. Objectives of

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