Twelve-step treatment

Alcoholics Anonymous (AA) is a self-help organization for people whose common goal is recovery from alcoholism, and it is the most widely accessed resource for individuals with alcohol problems (McCrady and Miller 1993). The philosophy is based on the concept of alcoholism as a chronic disease that cannot be cured, but one that can be halted by means of complete abstinence. AA has described 12 principles or steps to guide those in recovery. Twelve-step facilitation, a manual-based psychotherapy to promote AA participation (Nowinski et al. 1992), was equally efficacious, compared with cognitive-behavioral and motivational enhancement therapies, in a large study of treatments for alcohol dependence (Project Match Research Group, 1997). 

Ouimette PC, Finney JW and Moos RH (1997). Twelve-step and cognitive behavioural therapy for substance abuse A comparison of treatment effectiveness. J. Consult. Clin. Psychology, 65, 230-240. 

Residential programmes and relapse prevention work for cocaine misusers often represent modified forms of treatment that is applicable across all substances (Weiss et al. 2005, Vaughan McMahon 2006). Abstinence-based programmes such as twelve-step groups can contain a mix of users of various substances, and the place for this approach has not yet been usurped by any demonstrably more effective therapy, although there is currently much interest in some particular behavioural treatments. 

Treatment programs based on the twelve steps of Alcoholics Anonymous and that encourage attendance at Alcoholics Anonymous meetings have been the most common approach used in the United States. The first Alcoholics Anonymous group was formed in Akron, Ohio in 1935 by Bill Wilson and Dr. Bob Smith. Today there are approximately 99,000 groups in existence across America. 

Current research has demonstrated that there are no medical treatments effective for treating amphetamine abuse. This means that other drugs cannot be substituted to assist in the weaning process. However, thousands of individuals have successfully gone through withdrawal and continue to abstain from amphetamine use despite the long and uncomfortable process. Twelve-step programs are helpful for many substance abusers in recovery. 

The treatment of drug addiction has become big business. Private treatment centers charge thousands of dollars a week to get people off cocaine, alcohol, marijuana, narcotics, and tranquilizers Twelve-step programs modeled on Alcoholics Anonymous have proliferated m all cities, and special programs now exist to treat the relatives of dependent persons — Adult Children of Alcoholics and Codependents Anonymous, for example. Despite the boom in the treatment industry, the rate of addiction has only increased. 

Reading this, some parents may wonder that if most treatment is directed toward membership in an AA or similar self-help program, why not get their son or daughter directly into a twelve-step group (which is free) and skip treatment (which is expensive) ... 

Redesigned and Expanded Treatment of Enzyme Mechanisms NEW Mechanism Figures designed to lead students through these reactions step by step. The first reaction mechanism treated in the book, chymotrypsin, presents a refresher on how to follow and understand reaction mechanism diagrams. Twelve new mechanisms have been added, including lysozyme. 

In a simple scheme, this valve has sixteen outlets which bring each of the twelve zeolite stages in contact either with the fresh Cu feed, or with the eluant, and with the steps in the treatment of the p-xylene rich extract and the raffinate containing the other aromatics. A recovery pump at the bottom of the column re-injects the fluid at the top, ensuring continuous liquid countercurrent flow. All these operations must be strictly controlled and programmed. 

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