In addition, every federal court in the land that has examined the issue has held that 12-Step programs -- despite their claims to the contrary -- are sufficiently religious that coerced attendance (for example, when a court or probation officer orders mandatory attendance at AA meetings) violates the Establishment Clause of the First Amendment of the U.S. Constitution.  This is explicitly the law in the 2nd, 7th, and 9th federal circuits, as well as the states of New York and Tennessee.

When most people think about “alcoholism,” they assume the chronic severe group is the only group. However, adolescents and young adults, both with and without mental illnesses, can struggle with compulsive behaviors around alcohol, and many adults in the US are dependent on alcohol to stabilize their emotions. These conditions, too, indicate a potential AUD. If alcohol abuse remains unaddressed, it can lead to severe health consequences, both acute and chronic.
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If you are in need of immediate assistance, please call a counselor for immediate help 800-839-1686. Alcohol and Drug Rehab Counselors specializing in alcohol addiction drug treatment and substance abuse issues are standing by ready to listen and address any questions or concerns that you may have. Alcoholics Resource Center is supported by caring individuals with a genuine desire to help you achieve sobriety. Alcoholics Resource Center guides individuals struggling with alcohol addiction to AA meetings and recovery that helps prevent painful relapse. We offer many resources that can help individuals identify problematic behavioral patterns and help establish the best approach to fully overcome the challenging obstacles of alcohol addiction.
Sponsors share their experience, strength, and hope with their sponsees... A sponsor's role is not that of a legal adviser, a banker, a parent, a marriage counselor, or a social worker. Nor is a sponsor a therapist offering some sort of professional advice. A sponsor is simply another addict in recovery who is willing to share his or her journey through the Twelve Steps.[29]

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Alcohol, especially when consumed in excess, can affect teens, women, men, and the elderly quite differently. Women and the elderly tend to have higher blood concentrations of alcohol compared to men and younger individuals who drink the same amount. Alcoholic women are more at risk for developing physical health problems like cirrhosis of the liver and heart and nerve damage at a faster rate than alcohol-dependent men. Interestingly, men and women seem to have similar learning and memory problems as the result of excessive alcohol intake, but again, women tend to develop those problems twice as fast as men.

Parents may also inadvertently contribute to children’s alcohol problems, especially if they model bad drinking behaviors. Kids who grow up in homes with a great deal of drinking may come to see the behavior as normal. If their parents drink as a coping mechanism for stress or anxiety, kids may come to do the same. In this case, the genes aren’t at the root of the problem; it’s the behaviors parents model that causes concern.
Jump up ^ Sullivan, JT; Sykora, K; Schneiderman, J; Naranjo, CA; Sellers, EM (November 1989). "Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar)" (PDF). Br J Addict. 84 (11): 1353–7. CiteSeerX 10.1.1.489.341. doi:10.1111/j.1360-0443.1989.tb00737.x. PMID 2597811. Archived from the original (PDF) on 10 August 2013. Retrieved 25 October 2017.
Alcoholism, also known as alcohol use disorder (AUD), is a broad term for any drinking of alcohol that results in mental or physical health problems.[12] The disorder was previously divided into two types: alcohol abuse and alcohol dependence.[1][13] In a medical context, alcoholism is said to exist when two or more of the following conditions are present: a person drinks large amounts over a long time period, has difficulty cutting down, acquiring and drinking alcohol takes up a great deal of time, alcohol is strongly desired, usage results in not fulfilling responsibilities, usage results in social problems, usage results in health problems, usage results in risky situations, withdrawal occurs when stopping, and alcohol tolerance has occurred with use.[1] Risky situations include drinking and driving or having unsafe sex, among other things.[1] Alcohol use can affect all parts of the body, but it particularly affects the brain, heart, liver, pancreas and immune system.[3][4] This can result in mental illness, Wernicke–Korsakoff syndrome, irregular heartbeat, liver cirrhosis and increased cancer risk, among other diseases.[3][4] Drinking during pregnancy can cause damage to the baby resulting in fetal alcohol spectrum disorders.[2] Women are generally more sensitive than men to the harmful physical and mental effects of alcohol.[9]
Diagnosis is aided by administering specific psychological assessments that help to indicate what aspects of a person's life may be affected by alcohol use. Determining the exact quantity of alcohol that a person drinks is less important than determining how drinking affects relationships, jobs, educational goals, and family life. Because the metabolism (how the body breaks down and processes) of alcohol varies among individuals, the quantity of alcohol consumed is not part of the criteria list for diagnosing either alcohol dependence or alcohol abuse.
Of men aged 18–25 years, 60% binge drink. (Binge drinking is defined as 5 alcoholic drinks for men [4 for women] in a row.) Binge drinking significantly increases the risk of injury and contracting sexually transmitted diseases. Women who binge drink at this age are at higher risk of becoming pregnant and potentially harming an unborn child. (Any amount of alcohol consumption during pregnancy is risky.) Cohort data from the Prospective Epidemiological Study of Myocardial Infarction (PRIME) investigated alcohol use patterns on ischemic heart disease in Northern Ireland and France. Regular and moderate alcohol use throughout the week, a typical pattern in middle-aged men in France, was associated with a lower risk of ischemic heart disease, whereas the binge drinking pattern more prevalent in Northern Ireland was associated with a higher risk of ischemic heart disease. [17]
“Most of us have been unwilling to admit we were real alcoholics. No person likes to think he is bodily and mentally different from his fellows. Therefore, it is not surprising that our drinking careers have been characterized by countless vain attempts to prove we could drink like other people. The idea that somehow, someday he will control and enjoy his drinking is the great obsession of every abnormal drinker. The persistence of this illusion is astonishing. Many pursue it into the gates of insanity or death.
I am appalled that a book written by two extremely disturbed privileged white males who lived in 1930s Jim Crow era America is still the "treatment " standard for addiction. AA has been ruled a religious organization by several federal circuit courts, and it is impossible to work the program without a belief in a God who magically answers prayers for the addict who prays hard enough. It is not possible to turn one's will and life over to the care of Nature, or a Doorknob, or the Group of Drunks. One is guided through the steps by someone who is only qualified by the amount of sober time they claim to have. 12 step groups are especially dangerous for survivors of rape, abuse, and other trauma when they are tasked to examine "their part" in the crimes committed against them, not to mention having to defend themselves against the unethical yet joked about 13th Step.
alcohol dependence = alcohol abuse combined with tolerance, withdrawal, and an uncontrollable drive to drink.[99] The term "alcoholism" was split into "alcohol abuse" and "alcohol dependence" in 1980's DSM-III, and in 1987's DSM-III-R behavioral symptoms were moved from "abuse" to "dependence".[100] It has been suggested that DSM-V merge alcohol abuse and alcohol dependence into a single new entry,[101] named "alcohol-use disorder".[102]
In a closed AA meeting, the only people who may attend are those who are recovering addicts (or those interested in learning more about overcoming their addiction). Open meetings allow the attendance of friends, spouses and family members. Whether you decide to go to a closed or open meeting depends exclusively on what you’re comfortable with. Some people would rather keep their recovery separate from the rest of their life. Others thrive on the support that loved ones can provide during meetings.

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People who struggle with AUD may begin drinking because of social situations or anxiety about being around people; however, signs of a potential AUD include changes in friend groups, especially geared toward friends who drink versus those who don’t, and avoiding social situations to drink instead. Those who have a family member who struggles with AUD are more likely to suffer from high stress, emotional and physical abuse, and mental health or substance abuse problems later in life.
More than a quarter (27%) of all 15- to 19-year-olds worldwide consume alcohol. Rates are highest in Europe (44%), followed by the Americas (38%) and the Western Pacific (38%). Total alcohol consumption per capita among those older than 15 years around the world rose from 5.5 liters of pure alcohol in 2005 to 6.4 liters in 2010 and remained at that level in 2016. [1, 2]
The World Health Organization estimates that as of 2010 there are 208 million people with alcoholism worldwide (4.1% of the population over 15 years of age).[9][10] Substance use disorders are a major public health problem facing many countries. "The most common substance of abuse/dependence in patients presenting for treatment is alcohol."[125] In the United Kingdom, the number of 'dependent drinkers' was calculated as over 2.8 million in 2001.[148] About 12% of American adults have had an alcohol dependence problem at some time in their life.[149] In the United States and Western Europe, 10 to 20 percent of men and 5 to 10 percent of women at some point in their lives will meet criteria for alcoholism.[150] Estonia had the highest death rate from alcohol in Europe in 2015 at 8.8 per 100,000 population.[151] In the United States, 30% of people admitted to hospital have a problem related to alcohol.[152]
Codependency is the tendency to interact with another person in an excessively passive or caretaking manner that negatively affects the quality of the codependent individual's life. The codependent person has a pattern of putting their own needs below those of others, likely has low self-esteem, and tends to engage in denial, excessive compliance, and control. Individuals who are codependent are at risk for engaging in addictive behaviors, including alcoholism, drug or sexual addiction, as well as eating disorders or self-destructive or other self-defeating behaviors. Psychotherapy and participation in support groups are the usual treatments for codependency.
Risk factors for developing a drinking problem include depression, anxiety, or another mood problem in the individual, as well as having parents with addiction. Low self-esteem and feeling out of place are other risk factors for developing alcohol dependence. In women, antisocial behaviors and impulsivity are associated with the development of severe alcohol use disorder. Both men and women are more likely to develop alcoholism if they have a childhood history of being physically or sexually abused. Children and teens who have their first drink of alcohol between 11 and 14 years of age are more at risk for developing a drinking alcohol problems than those who do so when either younger or older.

In 1939, Alcoholics Anonymous published its original 12-step method of recovery from alcoholism in the book Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism. Many programs have started as offshoots of the original Alcoholics Anonymous program. Likewise, these problems include drug addiction, compulsion, and depression.
Alcoholism often reduces a person's life expectancy by around ten years.[22] The most common cause of death in alcoholics is from cardiovascular complications.[155] There is a high rate of suicide in chronic alcoholics, which increases the longer a person drinks. Approximately 3–15 percent of alcoholics commit suicide,[156] and research has found that over 50 percent of all suicides are associated with alcohol or drug dependence. This is believed to be due to alcohol causing physiological distortion of brain chemistry, as well as social isolation. Suicide is also very common in adolescent alcohol abusers, with 25 percent of suicides in adolescents being related to alcohol abuse.[157] Among those with alcohol dependence after one year, some met the criteria for low-risk drinking, even though only 25.5 percent of the group received any treatment, with the breakdown as follows: 25 percent were found to be still dependent, 27.3 percent were in partial remission (some symptoms persist), 11.8 percent asymptomatic drinkers (consumption increases chances of relapse) and 35.9 percent were fully recovered—made up of 17.7 percent low-risk drinkers plus 18.2 percent abstainers.[158] In contrast, however, the results of a long-term (60-year) follow-up of two groups of alcoholic men indicated that "return to controlled drinking rarely persisted for much more than a decade without relapse or evolution into abstinence."[159] There was also "return-to-controlled drinking, as reported in short-term studies, is often a mirage."

An analysis in the United Kingdom in 2010 found that overall, alcohol was found to be the most harmful drug to the person consuming and to others. However, this study does not mean that substances other than alcohol have no harmful consequences; heroin, cocaine, and methamphetamine were found to be the most harmful drugs to individuals themselves. In addition, this study did not address the issue of polydrug abuse, which is a common phenomenon in individuals abusing substances. The combination of alcohol and other substances can lead to serious adverse effects, and such combinations were not explored in this study. [12]
Withdrawal symptoms can range from mild to life threatening. Mild withdrawal symptoms include nausea, achiness, diarrhea, difficulty sleeping, sweatiness, anxiety, and trembling. This phase usually lasts no more than three to five days. More severe effects of withdrawal can include hallucinations in which a patient sees, hears, or feels something that is not actually present, seizures, an unbearable craving for more alcohol, confusion, fever, fast heart rate (tachycardia), high blood pressure (hypertension), and delirium (a fluctuating level of consciousness). Patients at highest risk for the most severe symptoms of withdrawal are those with other medical problems, including malnutrition, liver disease, or Wernicke's syndrome. Severe withdrawal symptoms usually begin about three days after the individual's last drink, and may last a variable number of days.
An analysis in the United Kingdom in 2010 found that overall, alcohol was found to be the most harmful drug to the person consuming and to others. However, this study does not mean that substances other than alcohol have no harmful consequences; heroin, cocaine, and methamphetamine were found to be the most harmful drugs to individuals themselves. In addition, this study did not address the issue of polydrug abuse, which is a common phenomenon in individuals abusing substances. The combination of alcohol and other substances can lead to serious adverse effects, and such combinations were not explored in this study. [12]
Research from NIAAA also suggests that alcoholism can stem from genes. While the specific “alcoholism gene” hasn’t yet been identified, there are known genes that can boost the power of alcohol and reduce the impact of a hangover. People with these gene combinations may get a bigger high from drinking, and they may not feel ill or sick after a long day of drinking. Their bodies just seem primed for alcohol abuse, and that can make them more likely to develop alcoholism.

Another important point about 12 Step programs is their cost and accessibility.  What other chronic lifelong disease has an equally accessible and cost effective (free) intervention?    Like any disease, part of our job as physicians is to recommend effective treatment which our patients can both access and afford.  I'd like for my patients to be able to access and afford all useful modalities of addiction treatment, but here at least is one they can all use.   


The alcoholic's continual craving for alcohol makes abstinence -- an important goal of treatment -- extremely difficult. The condition is also complicated by denial: Alcoholics might be reluctant to admit their excess drinking either because of denial or guilt. Another barrier to receiving care is that physicians screen only about 15% of their primary care patients for alcohol disorders.

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The purpose of the Central Office is to receive, distribute and follow up on calls for help, to answer inquiries about AA, to cooperate with local public information committees, maintain information about local hospitals and recovery facilities for alcoholics, to provide local AA meeting lists, to provide a newsletter, and to order, sell and distribute AA literature.  
While both alcohol abuse and alcoholism are included in the alcohol use disorder diagnosis and involve engaging in maladaptive behaviors in the use of alcohol, abuse of this substance does not include the person having withdrawal symptoms or needing more and more amounts to achieve intoxication (tolerance) unless the person has developed alcoholism.
Alcohol Use Disorder is a pattern of disordered drinking that can involve interference in daily tasks, withdrawal symptoms, discord in relationships, and risky decisions that place oneself or others in harm's way. More than 15 million American adults struggle with this condition, according to the National Institute on Alcohol Abuse and Alcoholism. Like all addictions, alcohol use disorder is inextricably linked to a complex matrix of biological, social, and psychological factors. Research highlights a genetic component to the disease, as about half of one's predisposition to alcoholism can be attributed to his or her genetic makeup. As a psychological malady, people may turn to alcohol to cope with trauma or other co-occurring mental disorders. Socially, alcoholism may be tied to familial dysfunction or a culture embedded with binge drinking. The brain's reward pathways also play an essential role: Alcohol consumption is associated with increased dopamine activity, which corresponds with pleasure, craving, and habit formation.

This is the big one. Many scientific arguments for hereditary alcoholism have been made. In fact, we have an extensive article on the topic, worth the read. While less than 20% of alcohol users actually become alcoholics, there are over 930 genes associated with alcohol use, and there is absolutely a genetic factor in risk for alcoholism. Perhaps the one-fifth of drinkers that do develop a disorder is genetically predisposed somehow. More research must be done to say for sure.
As with similar substances with a sedative-hypnotic mechanism, such as barbiturates and benzodiazepines, withdrawal from alcohol dependence can be fatal if it is not properly managed.[55][61] Alcohol's primary effect is the increase in stimulation of the GABAA receptor, promoting central nervous system depression. With repeated heavy consumption of alcohol, these receptors are desensitized and reduced in number, resulting in tolerance and physical dependence. When alcohol consumption is stopped too abruptly, the person's nervous system suffers from uncontrolled synapse firing. This can result in symptoms that include anxiety, life-threatening seizures, delirium tremens, hallucinations, shakes and possible heart failure.[62][63] Other neurotransmitter systems are also involved, especially dopamine, NMDA and glutamate.[25][64]
Jump up ^ "HEALTH AND ETHICS POLICIES OF THE AMA HOUSE OF DELEGATES" (PDF). June 2008. p. 33. Archived (PDF) from the original on 20 March 2015. Retrieved 10 May 2015. H-30.997 Dual Disease Classification of Alcoholism: The AMA reaffirms its policy endorsing the dual classification of alcoholism under both the psychiatric and medical sections of the International Classification of Diseases. (Res. 22, I-79; Reaffirmed: CLRPD Rep. B, I-89; Reaffirmed: CLRPD Rep. B, I-90; Reaffirmed by CSA Rep. 14, A-97; Reaffirmed: CSAPH Rep. 3, A-07)
Before you do anything, it’s important to know whether your friend or loved one has an alcohol addiction. Alcohol use disorder, or alcoholism, is more than just drinking too much from time to time. Sometimes alcohol as coping mechanism or social habit may look like alcoholism, but it’s not the same. People with alcohol use disorder don’t drink in moderation, even if they say they’re only having one drink. To learn more, read about alcoholism and its symptoms.

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Schuckit, M. A., Smith, T. L., Danko, G. P., Trim, R., Bucholz, K. K., Edenberg, H. J., ... & Dick, D. M. (2009, May). An evaluation of the full level of response to alcohol model of heavy drinking and problems in COGA offspring. Journal of studies on alcohol and drugs, 70(3), 436-445. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670749/
Standing by your friend or family member’s progress during and after treatment is important, too. For example, alcohol is everywhere. Even after recovery, your person will be in situations they can’t predict. Ways you can help include avoiding alcohol when you’re together or opting out of drinking in social situations. Ask about new strategies that they learned in treatment or meetings. Stay invested in their long-term recovery.
As is true with virtually any mental health diagnosis, there is no one test that definitively indicates that someone has an alcohol-use disorder. Screening tools, including online or other tests may help identify individuals who are at risk for having a drinking problem. Therefore, health care professionals diagnose alcohol abuse or dependence by gathering comprehensive medical, family, and mental health information. The practitioner will also either perform a physical examination or request that the individual's primary care doctor perform one. The medical examination will usually include lab tests to evaluate the person's general health and to explore whether or not the individual has a medical condition that might have mental health symptoms.
While Wilson and Smith credited their sobriety to working with alcoholics under the auspices of the Oxford Group, a Group associate pastor sermonized against Wilson and his alcoholic Groupers for forming a "secret, ashamed sub-group" engaged in "divergent works".[19] By 1937, Wilson separated from the Oxford Group. AA Historian Ernest Kurtz described the split:[19]
Alcohol misuse and dependence are primarily diagnosed through the use of clinical screening surveys. Several hundred such surveys exist, and they vary in the number and nature of questions they ask. Some of the more common scientifically-validated questionnaires include the Michigan Alcohol Screening Test (MAST), a shorter version called the Brief MAST, the Alcohol Use Disorders Identification Test (AUDIT), and a commonly employed, quick survey called the CAGE questionnaire. These surveys ask a range of questions about frequency of drinking, problems that result, and ability to stop.
During alcoholism treatment, therapy teams provide lessons on relapse prevention. These lessons are designed to help people spot the people, places, and things that can drive them to return to drinking. With the help of these lessons, people can learn to both avoid and/or handle their triggers so they won’t pick up an alcoholic beverage when they’re under stress.
AA's program is an inheritor of Counter-Enlightenment philosophy. AA shares the view that acceptance of one's inherent limitations is critical to finding one's proper place among other humans and God. Such ideas are described as "Counter-Enlightenment" because they are contrary to the Enlightenment's ideal that humans have the capacity to make their lives and societies a heaven on earth using their own power and reason.[33] After evaluating AA's literature and observing AA meetings for sixteen months, sociologists David R. Rudy and Arthur L. Greil found that for an AA member to remain sober a high level of commitment is necessary. This commitment is facilitated by a change in the member's worldview. To help members stay sober AA must, they argue, provide an all-encompassing worldview while creating and sustaining an atmosphere of transcendence in the organization. To be all-encompassing AA's ideology places an emphasis on tolerance rather than on a narrow religious worldview that could make the organization unpalatable to potential members and thereby limit its effectiveness. AA's emphasis on the spiritual nature of its program, however, is necessary to institutionalize a feeling of transcendence. A tension results from the risk that the necessity of transcendence, if taken too literally, would compromise AA's efforts to maintain a broad appeal. As this tension is an integral part of AA, Rudy and Greil argue that AA is best described as a quasi-religious organization.[40]
We take your privacy seriously and understand the magnitude of your current situation, as well as its impact on your career and family. While we are required to report monitoring information for mandated admissions, health care professionals entering IPRP on a voluntary basis have complete confidentiality. So, don't hesitate to pick up the phone and call us for more information. 
Luckily, if the 12-Step program has proven itself ineffective for you and your recovery needs, there are many alternatives to choose from. Even if they are not physically available to you, the majority of them have a strong Internet presence and can provide support with online forums for members to share their experiences in, which for some who are uncomfortable sharing in person may even find to be a preferable option.
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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]

Alcoholism is the most severe form of alcohol abuse and involves the inability to manage drinking habits. It is also commonly referred to as alcohol use disorder. Alcohol use disorder is organized into three categories: mild, moderate and severe. Each category has various symptoms and can cause harmful side effects. If left untreated, any type of alcohol abuse can spiral out of control.
When a service is offered (especially in a crisis), that service is expected to work.  In the case of the addict, simply providing 'treatment' cannot be viewed the same way as other services.  Substance abuse detox that transitions to the 12-step program requires a level of immersion on the end of the user.  I used to HATE hearing 'It works if you work it'.  But... it's true.
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Support in sobriety and in attaining long-lasting recovery is found in 12-Step practice and regular participation in 12-Step programs and groups. These groups are designed for the addict, the alcoholic, and the family members of those with addiction. The philosophy is based on developing a relationship with a Higher Power and a helping fellowship that encourages an honest mindset and self-sacrifice. 12-Step fellowships facilitate a daily practice for sober and healthy living.
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When a service is offered (especially in a crisis), that service is expected to work.  In the case of the addict, simply providing 'treatment' cannot be viewed the same way as other services.  Substance abuse detox that transitions to the 12-step program requires a level of immersion on the end of the user.  I used to HATE hearing 'It works if you work it'.  But... it's true.

...more and more, Bill discovered that new adherents could get sober by believing in each other and in the strength of this group. Men [no women were members yet] who had proven over and over again, by extremely painful experience, that they could not get sober on their own had somehow become more powerful when two or three of them worked on their common problem. This, then—whatever it was that occurred among them—was what they could accept as a power greater than themselves. They did not need the Oxford Group.
Denial is one of the biggest obstacles to getting help for alcohol abuse and alcoholism. The desire to drink is so strong that the mind finds many ways to rationalize drinking, even when the consequences are obvious. By keeping you from looking honestly at your behavior and its negative effects, denial also exacerbates alcohol-related problems with work, finances, and relationships.
In asking questions about mental health symptoms, mental health professionals are often exploring if the individual suffers from alcohol or other drug abuse or dependence disorders, as well as depression and/or manic symptoms, anxiety, hallucinations, or delusions or behavioral disorders. Physicians may provide the people they evaluate with a quiz or self-test as a screening tool for substance-use disorders. Since some of the symptoms of alcohol use disorder can also occur in other mental illnesses, the mental health screening is to determine if the individual suffers from a mood disorder or anxiety disorder, as well as schizophrenia, schizoaffective disorder, and other psychotic disorders, or personality or behavior disorders like attention deficit hyperactivity disorder (ADHD).
Alcoholism formerly called alcohol dependence or alcohol addiction, is the more severe end of the alcohol use disorder spectrum. It is a destructive pattern of alcohol use that includes tolerance to or withdrawal from the substance, using more alcohol or using it for longer than planned, and trouble reducing its use or inability to use it in moderation. Other potential symptoms include spending an inordinate amount of time getting, using, or recovering from the use of alcohol, compromised functioning, and/or continuing to use alcohol despite an awareness of the detrimental effects it is having on one's life.
Photodynamic therapy (PDT) is a procedure that treats precancerous cells, in addition to other types of cancer cells. The medical treatment does this with the help of a photosensitizing drug and a light source that activates the applied drug, destroying cancer cells. PDT is approved to treat non-small cell lung cancer, esophageal cancer, and Barrett's esophagus. It's used to treat actinic keratosis, as well as acne, rosacea, skin cancer, sun damage, oily skin, wrinkles, warts, psoriasis, and enlarged sebaceous glands.
Alcoholics Anonymous (AA), founded in 1935, was the first twelve-step program ever created. The steps, which are very similar to ones already mentioned, were put in place at that time. In 1946, twelve traditions were created that governed how groups functioned and related to each other as membership was quickly growing. Traditions included the practice of anonymity by only using one’s first name and the tradition of “singleness of purpose.” The latter tradition meant that AA would have “but one primary purpose – to carry its message to the alcoholic who still suffers.” As such, this precluded attendance by anyone who did not suffer from alcohol misuse and resulted in the formation of other 12 step programs.
The World Health Organization examined mental disorders in primary care offices and found that alcohol dependence or harmful use was present in 6% of patients. In Britain, 1 in 3 patients in community-based primary care practices had at-risk drinking behavior. Alcoholism is more common in France than it is in Italy, despite virtually identical per capita alcohol consumption.

While some people with alcohol use disorder can cut back or stop drinking without help, most are only able to do so temporarily unless they get treatment. Individuals who consume alcohol in lower amounts and tend to cope with problems more directly are more likely to be successful in their efforts to cut back or stop drinking without the benefit of treatment.
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alcohol dependence = alcohol abuse combined with tolerance, withdrawal, and an uncontrollable drive to drink.[99] The term "alcoholism" was split into "alcohol abuse" and "alcohol dependence" in 1980's DSM-III, and in 1987's DSM-III-R behavioral symptoms were moved from "abuse" to "dependence".[100] It has been suggested that DSM-V merge alcohol abuse and alcohol dependence into a single new entry,[101] named "alcohol-use disorder".[102]


The Steps start from a basic acceptance that we can control and change only ourselves and our own reactions to people and events. Twelve Step participants take ongoing inventory of themselves and honestly acknowledge the ways they have hurt themselves and others. When they are ready, they attempt to make amends to all persons they have harmed. Trust, acceptance, love, goodwill and forgiveness are key elements in a Twelve Step program just as they are important elements of any healthy relationship.
We are excited by the launch of our new Alcoholics Resource Center web site and hope that each of you will share in that excitement. The purpose of this site is to provide information and social networking to support our fellow AA members. We believe that this site will meet a need for those interested in all matters related to AA within the scope of the Traditions.

Standing by your friend or family member’s progress during and after treatment is important, too. For example, alcohol is everywhere. Even after recovery, your person will be in situations they can’t predict. Ways you can help include avoiding alcohol when you’re together or opting out of drinking in social situations. Ask about new strategies that they learned in treatment or meetings. Stay invested in their long-term recovery.
To get started with Recuva, visit the program's website and download the version of Recuva you want. The best option for someone who already has files to recover is the portable download. The portable version of Recuva allows you to avoid installing anything after discovering that you need to recover a file. If you are downloading the program for future use and don't have any files to recover, the standard installable download is fine.
At secular meetings there is generally much more acceptance of medication-assisted recovery, much less emphasis on deficits in "moral character," and no prayer.  The focus is present-centered, avoiding "war stories," and pragmatic:  "how am I staying sober today?  What tools am I using?" Participants are also generally not required to label themselves as addicts or alcoholics, which can be refreshing for many people new to recovery.  In LifeRing, "crosstalk" is a key element of meetings, so folks in recovery are sharing their strategies for success.
When 7-Data Recovery merged its powers with Disk Drill, it gained the capacity to preview files before restoring them. It’s built into the Basic Edition for free! Preview shows that files will be retrieved before starting the restoration process. Now you can see exactly what 7 Data Recovery can retrieve before spending a single minute just opening for the best.
Parents may also inadvertently contribute to children’s alcohol problems, especially if they model bad drinking behaviors. Kids who grow up in homes with a great deal of drinking may come to see the behavior as normal. If their parents drink as a coping mechanism for stress or anxiety, kids may come to do the same. In this case, the genes aren’t at the root of the problem; it’s the behaviors parents model that causes concern.

Prior to entering any inpatient or outpatient rehabilitation program for alcohol use disorder, the possibility that the person with this disorder could suffer from physical symptoms of alcohol withdrawal needs to be addressed. People who have a pattern of extensive alcohol abuse are at risk for developing a potentially fatal set of withdrawal symptoms (delirium tremens or DTs) that may include irregular heartbeat, sweating, high fever, shaking/tremors, hallucinations, and even fatal seizures, three days after withdrawal symptoms begin. Those individuals will need to enter a detoxification (detox) program that includes the use of close medical support, monitoring, and prescription of medications like chlordiazepoxide (Librium) or clonazepam (Klonopin) to help prevent and ease the symptoms of alcohol withdrawal.
Jump up ^ "HEALTH AND ETHICS POLICIES OF THE AMA HOUSE OF DELEGATES" (PDF). June 2008. p. 33. Archived (PDF) from the original on 20 March 2015. Retrieved 10 May 2015. H-30.997 Dual Disease Classification of Alcoholism: The AMA reaffirms its policy endorsing the dual classification of alcoholism under both the psychiatric and medical sections of the International Classification of Diseases. (Res. 22, I-79; Reaffirmed: CLRPD Rep. B, I-89; Reaffirmed: CLRPD Rep. B, I-90; Reaffirmed by CSA Rep. 14, A-97; Reaffirmed: CSAPH Rep. 3, A-07)
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.[7] 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.[65] 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.[126]
ASAM’s definition of addiction document concludes that “treatment of addition saves lives,” and it points out that “in some cases of addiction, medication management can improve treatment outcomes,” and that “in most cases of addiction, the integration of psychosocial rehabilitation and ongoing care with evidence-based pharmacological therapy provides the best results.” Much of “what’s new” in the professional treatment of addiction in the past two decades has involved new pharmacological therapies that have been brought into the marketplace. But psychosocial interventions, which are “not as new,” are the foundation of the treatment most persons receive when they seek assistance from an addiction treatment professional or agency.

The program’s emphasis on negative feelings of powerlessness and guilt. Continuing in that train of thought, while the idea behind the 12 Steps may have been revolutionary at the time, for many they can feel outdated and even counterproductive. The 12-Step program demands that those in it break themselves down to be built back up, focusing on the notion that you are incapable of taking responsibility not just for your alcoholism but for yourself as well, that there is something wrong with you, and instilling what can feel more like shame than motivation.

We have found in clinical treatment that the 12-Step philosophy is a vital part of permanent sobriety. When a person maintains a 12-Step practice, including getting a sponsor and working with others, recovery is about more than relapse prevention – it is a pathway to an existence that is happy, joyous, and free. The 12-Step program a gateway into longterm recovery. By focusing attention on the 12-Steps, we set our patients up for long-term success. We engage patients in this paradigm because:
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