Category Archives: Alcoholism

Useful information about Alcohol Use and Abuse

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Looking for information about Alcohol Use and Abuse?

Liquor

Alcoholic beverages.
Photo courtesy of Pixabay.com

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Ever hear of the Alcoholism Awareness Council? I hadn’t. Recently I found this site, or more precisely they found me. Looks like a good source for information on alcohol use, alcohol use disorders, and what we used to refer to as alcohol abuse and dependence. They publish information, both statistics, and the latest research, in the field of alcohol use and abuse. Lots of links on this site to other sources, both researchers and government publications.

So if you are researching the state of alcohol use in America or working on a paper for a substance use class this site might be helpful.

Oh yes – sure, you can read counselorssoapbox.com also. I will do my best to keep you posted on the latest information in the fields of substance use disorders, mental health, and co-occurring disorders. But when you are not here at counselorssoapbox.com reading this blog, you might also want to check out the resources at Alcoholism Awareness Council           http://www.alcohol.org/

If you do check out the Alcoholism Awareness Council, please let me know what you think.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What is selective tolerance?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

What is

What is selective tolerance?
Photo courtesy of Pixabay.

Not all tolerance is created equal

What is tolerance?

Tolerance, as it applies to medications and drugs, is having less and less of a reaction to a drug the more it is used or having to use increasing amounts of the drug to get the same result. Tolerance, in the sense in which I am using the term here, is the way in which repeated exposures to something produce less and less of a reaction. People get used to things and so does your physical body.

When it comes to substances, whether they are legal, prescribed or street drugs, tolerance is that characteristic of the body to learn to resist things. The body develops an “immunity” or reacts less and less strongly the more times it experiences something.

Over time the drug addict uses more and more of their particular drug of choice. The person taking prescribed medications may also develop a tolerance resulting in needing a larger dose to achieve the same result or eventually they may need to be switched to a different drug.

Tolerance used to be one of the two symptoms that were used to define addiction. Withdrawal was the other one. Because tolerance and withdrawal are characteristics of many substances, not just drugs of abuse, we have had to look at other symptoms to define a problematic use of substances. We now call that problematic use a “substance use disorder.”

What is selective tolerance?

Selective tolerance is those times when someone develops a tolerance to one effect of the drug but not another. The body “selects” one action to develop tolerance to and not another.

A simple example of selective tolerance.

Coffee contains caffeine, a stimulant drug. Many people drink it first thing in the morning to help them wake up and get going. It is also common to find that consuming a caffeinated beverage to late in the evening results in not being able to sleep well that night. It is recommended that you not consume caffeine in the afternoon or evening so that you will get a full night’s sleep.

Have you ever known someone who could drink a lot of coffee or caffeinated soda just before bedtime and still sleep like a rock? Most of us have. That person has “built up a tolerance” to caffeine’s sleep interfering characteristic.

That same person will have some caffeine, probably a lot of it, the next morning, and report that the caffeine helps them wake up and get going.

How can this be? Did they develop a tolerance to caffeine or not?

It appears that they have developed a tolerance to one action of the caffeine but not the other. That is the thing we call selective tolerance.

It is quite possible that psychological factors play a role here, but there are lots of other times when someone develops a tolerance to one of a drug’s effects and not another.

There have been some divided opinions on whether drinking coffee is good or bad. My belief is that for most people, most of the time, coffee has more positive than negatives. The choices it up to you.

Could you develop selective tolerance to the effects of alcohol?

The research says that many people do just that. This may be why we see very inconsistent results in research on some of alcohol’s effects. I am not being an apologist for alcohol by saying this, just trying to get the story right. Despite the problems, alcohol causes our society another round of prohibition is unlikely.

My view is that those countries that have a total ban on alcohol often have high levels of problems with another drug. Many countries with a total ban on alcohol have a worse problem than the U. S. does when it comes to Heroin. The solution, such as it is, seems to be better educated on the effects of drugs on the mind and the body. Hence this blog.

Heavy alcohol drinkers develop tolerance to alcohol’s motor coordination effects.

Those who drink a lot find ways to hide the fact that they are under the influence. More concentration on walking straight may keep the drunk out of jail.  Research shows that many heavy drinkers do develop a tolerance to the motor coordination effects.

Heavy drinkers do not develop a tolerance to the bad decision-making effects

One key result of alcohol’s effects on the brain is disinhibiting the drinker. Under the influence, people say and do things that they would not do when sober. One study reported that they found no tolerance developing to alcohol’s disinhibiting effects in heavy drinkers (Miller, M., et al, 2012, no relation to me I know of.)

This study also notes that recent drinking patterns are predictive of tolerance. You do not need to be an alcoholic, a chronic drinker, or even a heavy lifetime user of alcohol to show tolerance to some of its effects.

So we conclude that people do develop selective tolerance to the effects of alcohol and probably most other drugs. Drinking a lot of alcohol is still not a good idea. While your liver may develop tolerance with repeated doses of alcohol, it can also develop Fatty liver, alcoholic hepatitis, and cirrhosis.

Use all medications and drugs with caution and be aware that while you may be developing some tolerance, getting used to using this drug, there are probably other effects the drug is having on your body and your mind that you are unaware of.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Effects of Alcohol last long after you sober up

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Alcoholic beverages.
Photo courtesy of Pixabay.com

Alcohol continues to affect you after it has left your bloodstream.

Researchers are finding that the effects of alcohol are not limited to what we see or experience while the alcohol is present in the bloodstream. Those effects continue long after the liver has removed the alcohol from the bloodstream. Here are some of the things researchers are reporting about the effects alcohol leaves behind after it has done its work.

One of these lingering effects increases the risk that alcoholics or those with an alcohol use disorder will drink again.

1. Hangovers impair your driving skills.

One study measured attention, coordination, and vigilance in college students the night after they had consumed enough alcohol to become legally intoxicated. Students were tested one day and then again the next. Some students were instructed to not drink alcohol overnight, others were allowed to drink to intoxication. The following week the groups switched. This allowed a comparison of how students did on the various tests after a night of drinking or no drinking.

This study was done in the college dorm to avoid increasing the number of drunk people out on the roads. I did not do this research, just reporting what I read.

The results?

Students who had drunk to intoxication, that would be enough alcohol to reach a point one zero blood alcohol content (.10), were just as impaired the next morning when their blood alcohol content had returned to zero as they had been the night before.

You are just as impaired with a hangover as when you are legally drunk!

Actually, many of the subjects in this experiment were in worse shape with a hangover than when they were legally drunk. Memory, attention, motor coordination even the ability to plan were all significantly affected.

2. Alcohol causes the blood-brain barrier to “leak.”

The purpose of the blood-brain barrier is to keep things out of the head that does not belong there. It also has to let things in that the brain needs. This functioning as the brain’s border patrol is hard work for that blood-brain barrier. When that Blood-Brain Barrier is under attack, under the influence of alcohol, it has trouble doing its job.

One thing that gets kept out of the brain when you have alcohol in your system is glucose. Your brain may only be 2% of your body but it uses 20% of the energy, so a shortage of fuel develops quickly while all those alien Alcohol molecules are storming the brain’s border.

This is why so many hangover remedies include sweet ingredients. Without energy, the brain can’t work efficiently.

3. Impaired coordination lasts a long time.

At some point, and that precise level is still debatable, high levels of alcohol in the bloodstream alter or damage the part of the brain that controls coordination. Evidence of this comes from several sources.

Chronic alcoholics exhibit unsteady gates even when they have undergone detox and their blood alcohol levels are at zero.

Children born with fetal alcohol syndrome, the most severe form of damage to a child as a result of the mother’s alcohol consumption, exhibit a particular form of uncoordination. When moving their arms they move them much more rapidly when close to the body than when farther away. There is also a decided jerkiness to their arm movements. All of this points to Alcohol causing impairment in the brain’s ability to regulate motion long after there has been any physical presence of alcohol.

This impairment in coordination lasts into adulthood.

4. Alcohol shrinks the brain’s size and volume.

The prefrontal lobes of the brain shrink about 11% in those who have abused alcohol over some period of time. Other parts of the brain shrink also, resulting in an expansion of those blood-filled spaces called Lateral Ventricles by as much as 42%.

I have not found a source that quantifies this as to how much alcohol over how long a time this takes to happen. What has been established, at least tentatively, is how much of the damage to the brain can be repaired.

The size of the lateral ventricles seems to shrink with sustained abstinence. The ventricles shrink and the surrounding brain tissue expands and or grows back a little but not all the way.  The damage to the prefrontal lobes does not seem to be repaired.

This results in many people in alcohol recovery having impaired executive functions. They need to learn or relearn planning, scheduling, and decision-making skills.

Combine the changes in the brain with the loss of coordination and the result is 33% to 50% of all those with an alcohol use disorder will have cognitive or motor disorders in addition to difficulty controlling their consumption of alcohol.

5. Alcohol lowers inhibitions long after it has exited the body.

Most of us know that alcohol lowers inhibitions and allows people to do and say things that they would not otherwise do. What has been discovered recently is that a pattern of recent heavy drinking increases that disinhibited behavior. The result is that drinking heavily even if only for a while increases the risk of your making poor decisions even during times when you are not drinking.

One researcher observed that this residual loss of control is one more reason that people with alcohol use disorders are at high risk of drinking again even when they are trying to stay sober.  The brain really has rewired itself and the part of the brain that says “do not do that” is off-line for an extended period of time after a recent episode of heavy drinking.

There are other long-term consequences of drinking alcohol but let’s leave that for a future post.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Why you get drunk and they don’t

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Inebriated people.

Alcoholism.
Photo courtesy of Pixabay.

Some people get higher blood alcohol concentrations (BAC) than others.

If a group of people all drink the same number of drinks, even if they are all drinking exactly the same amount of alcohol in those drinks, one person will end up with a higher blood alcohol content than others.

This unequal blood alcohol level is not about tolerance

We are not talking about the subjective feeling of being more or less drunk here. Some people feel it more than others. Some people have practiced drinking so much they have built up tolerance. They don’t look or act drunk even at high blood alcohol concentrations. But if we test them on a machine, that person with the high tolerance, the one that thinks they can hold their liquor, they will be just as uncoordinated and incoherent as anyone else.

The number of drinks is not the only thing that affects how high your blood alcohol content goes.

Here are some of the factors that affect how drunk you actually get as measured by blood alcohol content.

1. More drinks equals a higher BAC.

The more alcohol you consume the drunker you get. But not everyone gets to the same number. Drink an extra drink or a stronger one and you get more alcohol in your bloodstream.

2. Bodyweight influences blood alcohol.

Alcohol mixes very rapidly in water. Most of the body is water. The bigger you are the more that one drink gets diluted and the lower your blood alcohol level will be. A 200-pound person can drink more alcohol than a 100-pound person before they reach that legally drunk point. That big person cannot drink twice as much, by the way, but they can consume slightly more.

3. Gender influences how much you can drink.

Men’s stomach produces more of the enzyme that breaks down alcohol. One book reported that men’s stomachs neutralize 10% of the alcohol before it ever leaves the stomach. This means that women get a higher blood alcohol level than a man even if they are the same weight. Guys have known about this for years but ladies now you know.

4. Older people get higher blood alcohol levels.

As we get older our livers slow down even if it is low mileage and you rarely abused it. One drink per day may be OK for a thirty-something but past age seventy 4 drinks a week will be too much.

4. A damaged liver can’t metabolize alcohol like it used to.

Excessive alcohol consumption is one way to damage a liver, there are others. Viral infections, over the counter and prescribed medications when used in excess can also damage that liver. Add alcohol, a non-prescription pain reliever used in excess, and a viral infection and your liver may go on strike.

5. Just because you stop drinking does not lower your blood alcohol.

This is a common mistake. You feel a bit woozy. You stop drinking alcohol and start drinking coffee. Now feeling fully awake you feel safe to drive. You have not had a drink for an hour or more, it should be safe to drive right?

Most alcohol is absorbed in the small intestine. You stop drinking but the alcohol keeps moving from the stomach to the intestines to the bloodstream. The result? For the next 30 to 90 minutes your blood alcohol content will continue to go up.

An hour and a half after you stopped drinking your blood alcohol content is higher than when you stopped.

This does not mean you should knock down that last one and then drive home as fast as possible before it hits you. What it should tell you is that a whole lot of physical features will conspire to take your blood alcohol level above where you think it is.

One other Alcohol factor can get you.

Drinking energy drinks, strong coffee, and a little eye-opener. People do stimulants, legal and illegal kinds. And then they feel that they are alert enough to drive. Just like the person who has developed tolerance you may feel OK but given a test of reaction time or judgment you will probably fail. Missing a point in a video game is no big deal. Feeling OK and then driving and hurting yourself or others, that is a really big deal.

So there are some reasons why you may be drunker than you think you are and why one person can drink more than you and dot get drunk but you may need to drink less or not at all to avoid the consequences of high blood alcohol contents.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What is binge drinking?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drinking

Binge drinking.
Photo courtesy of Pixabay.com

Why binge drinking matters.

Binge drinking is a pattern of drinking that has been linked to a host of physical, mental, and behavioral problems.

In the binge drinking pattern, the drinker consumes a large quantity of alcohol on one drinking occasion. Anyone might experience an occasional episode of heavy drinking but with consistently heavy drinkers or binge drinkers, their typical pattern of consumption is that when they drink the get drunk.

The concept of binge drinking relates more to how high the level of alcohol in the bloodstream goes rather than when or how much the drinker consumed over a unit of time.

So if someone chooses to drink a lot one night why is this of any concern to others? Why should it matter to the drinker if their pattern of drinking is a binge-drinking pattern? First the concerns and then some more precise definitions of what qualifies as binge drinking.

There are two principal concerns with binge drinking.

1. Alcohol damages the drinker’s brain and body.

The higher the blood alcohol content (BAC) the more damage to the body. Alcohol and its primary breakdown product, Acetaldehyde, are highly toxic to the body. In small amounts, the body can cope with this foreign substance. Above a certain point, there is damage to the body. A single episode of binge drinking is likely to leave minimal long-term damage. Repeated binge drinking will leave more long-term damage.

At high enough levels many substances can cause death. For alcohol, that point is a blood alcohol content around .60 (point six zero.)

Have one drink per day and it may be healthy, or non-harmful anyway. Save those drinks up and consume them all on one night and the damage may be permanent.

Blood alcohol level is also related to repeated head trauma (Winquist et al., 2008.) Long-term high levels of alcohol damages brain cells in the prefrontal cortex which may decrease by 10% or more. Binge drinking also causes cells surrounding the lateral vertices to shrink resulting in an expansion of this fluid-filled cavity in your brain by about 42%. Alcohol and especially heavy or binge drinking cause these cells in your brain to shrink resulting in more empty, blood-filled spaces in the brain (Wolerock, 2009.)

High blood alcohol levels also result in memory loss and the creation of false memories, a process called confabulation.

2. Intoxicated people hurt themselves and others.

At high blood alcohol levels, there is an increased risk of harming self and others. Most places set strict limits on the legal level of alcohol in the bloodstream you may have and still drive. Those limits are admittedly imprecise. Two people with the same blood alcohol content may not be equally impaired, but the higher the level goes for any given individual the more impaired they become.

Increasing blood alcohol levels reduce coordination, lower inhibitions, and impair judgment and memory. Intoxicated people, those who have binge drank on this occasion are 55 times more likely to attempt suicide. They are the major source of serious and fatal car accidents. They are more likely to commit crimes and harm others.

There are exceptions, sober people can do bad things, many intoxicated people do not commit crimes, but the higher the blood alcohol content the more the risks.

There is also a severe risk if the person binge drinking is or becomes pregnant. The unborn fetus does not have a developed liver. So mom-to-be needs to have her liver do the alcohol detox for this unborn child. We used to think a drink or two each day was OK. Now we are convinced that any alcohol during pregnancy is a bad idea and binge drinking is especially risky for mom and unborn child.

What is the definition of binge drinking?

Most definitions of Binge drinking are common sense approximations. Using blood alcohol content would be more precise but all that blood drawing is inconvenient.

The definition of binge drinking we use here in the United States is five or more standard drinks for a man, 4 or more for a woman on any particular drinking occasion. This is roughly the amount of alcohol that will make you legally too drunk to drive.

Standard drinks are calculated so that regardless of what you are drinking you can estimate how much alcohol is in your drink.

Despite what many people think, the alcohol in any alcoholic beverage is the same substance, ethanol. So this “I only drink Beer” I can’t have a drinking problem is nonsense. All those other statements about why one beverage is better than others, nothing to do with the alcohol.

When it comes to blood alcohol content, alcohol is alcohol.

In the U. S. a twelve-ounce beer is one standard drink. A four or five-ounce glass of wine is also a standard drink. If you are drinking whiskey, scotch, vodka, etc., then one ounce of a 90 to 100 proof beverage is a standard drink.

No cheating here

People will try to fool themselves. You know that drinking a tall can or 40-ounce beer is not one standard drink. Right? Neither is drinking 151 (a beverage with 75 ½ % alcohol.)

Alcohol content can vary from state to state or country to country. Outside the U. S., tell me the alcohol content of beers is higher. Pouring more of a beverage in a glass does not let you count it as one standard drink either.

The amount of alcohol it takes to make one person’s blood alcohol content reach .08 or .10 may vary. Some tell me it’s not fair that others can drink a lot and not get arrested for driving drunk and they ended up in jail after only a few. Why this happens is a subject for another blog post.

Binge drinking is not a moral thing.

Some people have argued that telling people to not binge drink is making a moral judgment. They should be able to tie one on if they choose. Choosing to binge drink, drink till you get legally drunk (or illegally drunk if you prefer that term) does not necessarily make you a bad person.

If you drive 60 miles per hour in a 25 mile per hour school zone and a child runs out, your braking distance is a lot longer than if you were driving the prescribed 25.  There is more likelihood that you will harm a person’s crossing the street and if you hit them you could mess up the rest of your life also.

Similar case with binge drinking. If you binge drink this can increase the risk that you will damage yourself health-wise or harm others if you drive or are around them. We are just saying there is a warning out on this behavior.

Now if this is your typical pattern of behavior, when you drink you always binge and end up drunk this is a worry. If having developed some problems due to your excessive drinking in the past you continue to binge drink then this is a bigger problem.

If your drinking, binge, or otherwise is interfering with your life, consider changing your drinking pattern. If when you try to control your drinking you find you keep losing control, it is time for some professional help.

This blog is largely devoted to the topics of mental health and substance use disorders. Especially those times when people have both issues, which is called co-occurring disorders. Alcohol is one of the top problems in this area. Stay tuned for more on alcohol’s effect on your body, brain, and your mental health.

Past posts on this topic you may want to look at include:

Dangers of Binge Drinking

Alcohol prevents healing

6 Myths about alcoholism

Blackouts – common or rare?

What is confabulation? Relationship to false memories and Wernicke-Korsakoff’s syndrome 

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Alcohol, Drugs and Mental Illnesses

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs.

Drugs.
Photo courtesy of Pixabay.

How are alcohol and other drugs connected to mental and emotional problems?

There are clearly a large number of connections between drug and alcohol use and abuse and mental, emotional, and behavioral illness. The recognition of these connections has resulted in a growing emphasis on the relationships between drugs and alcohol and those conditions that we call Mental Illnesses.

This overlap, those times when someone has both a substance use disorder and a mental illness, was called first dual-diagnosis and more recently co-occurring disorders. The overlap is common but not total.

There are people with a mental illness that do not have a substance use disorder. There are also those with a substance use disorder that do not have a mental illness. Over time we have come to see that the overlap is so large that it is more common to see someone with both of these problems than not. The professionals in the field have come to think of co-occurring disorders as an expectation and not an exception.

This understanding that there are reasons for the overlap, or co-occurrence, of these two different disorders has spawned a lot of efforts to find effective treatments for people with multiple disorders. The advances in brain studies have resulted in a lot of research studies on the effects of various drugs and the brain. We now know more than ever before about how drugs and alcohol are affecting people’s thinking, feeling, and behavior.

Alcohol, the drinkable kind, has been around and in use longer than any other drug. We know more about this particular substance and its effect on the brain than probably any other chemical. I recently did a literature search for current scientific articles on the effects of alcohol on the brain and the search returned 28,834 articles. Other searches would, of course, have returned even more.

Given this huge and growing body of research, I thought I should spend some time and some blog posts reviewing some of this new knowledge. While I can’t read every study and surely will only be able to report on a few highlights, I want to tell you about some of the things we know and some of the things I think about the effects of drugs on the brain and on those things we call mental illness.

There are several sources of this new knowledge. These studies, beginning with the ones focused on alcohol come from the following areas.

1. Fetal Alcohol Spectrum Disorders.

Studies of children who have been exposed to Alcohol before birth show changes in the body, brain, learning, and behavior of those children. We used to think that only those children who were exposed to large amounts of alcohol developed problems. The more the research progressed the more we have concluded that any amount of alcohol consumed during pregnancy increased the risks to the child.

Just because a woman drank during pregnancy does not automatically mean that any problems her child has are the result of her drinking. Still, the link is so strong that most authorities now believe that there is no safe level of alcohol consumption for a woman who is or may become pregnant.

One result of the large overlap between substance use disorders and other mental illnesses is that a lot of people with a diagnosed disorder are at extra risk for risky sexual behavior and unplanned pregnancy. Parents with a disorder or two are more likely than others to produce an unplanned child.

2. Binge drinking.

The amount of damage drinking does to the body is correlated with the blood alcohol level. As a society, we have been looking at how much alcohol in the bloodstream is a safe level for someone to have and still drive.

Studies of the effects of various levels of alcohol on brain function have taught us a lot about the way in which increasing the level affects the person.

It looks certain that the higher the blood alcohol content the more the damage to the body and the brain. One drink a day all month may be theoretically safe but 30 drinks on one day is a very hazardous way to drink.

3. Alcohol affects the structure and functioning of the brain.

We have known for a long time that chronic alcoholics have a reduced brain volume. We are now seeing studies of the effects of alcohol on brain regions and on the production of neurotransmitters. One treatment for depression is to increase the levels of serotonin in the brain. This is done by slowing the natural breakdown of serotonin which is one way many antidepressants work.

We know that alcohol is altering these neurochemicals and so may be increasing the risk of developing a mental illness, may make one worse, or may mimic a disorder.

4. Chronic Alcoholics.

Studies of chronic alcoholics, how their brain works, and the changes that the brain undergoes have added to our understandings of what the alcohol may be doing to the other parts of the body and brain. Because alcohol totally mixes with water, and blood contains a lot of water, no part of the body avoids being damaged by drinking.

5. Developmental studies.

Studies of teens have suggested ways in which alcohol consumption may be affecting the development of the brain. The correlations between the amount that a teen drinks and the results of the rest of their lives, while not a proof of cause and effect, makes us think there are more connections than we previously realized.

We know that “F” students typically drink at least twice as much per week as the “A” students.

We also know that heavy drinkers take longer to heal from injuries than nondrinkers.

6. Brain scans and mice studies on the effects of alcohol.

Brain scans typically capture only a moment in time. Mice studies are not proof that what we see in mice is what is happening in humans. But when the two agree it lends credence to the concept that alcohol is fundamentally altering the way in which brains and the nervous systems function.

7. Learning studies and functional studies.

There have been a lot of studies on how alcohol and other drugs have been affecting people’s memory, behavior, visual and special recognition, learning, and other specific brain functions.

Now that you know where the information is coming from let’s begin in future posts to look at why we think mental illness and substance use disorders so often occur together and then what are some of the specific effects of alcohol and other drugs on the body and the brain.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What does carrying a court card mean?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

What is a “Court Card” and where do you get one?

Alcoholics Anonymous (A.A. Meetings) and the court or treatment facilities are not related.

A. A. has a policy of declining outside money so that they can stay independent and focus on helping the next alcoholic.

So why do so many judges, courts, and rehab programs recommend that people go to A.A? And how do you get a form for the court telling the judge that you went to a meeting if everyone who attends is anonymous?

The simplest solution to this dilemma is the “court card.”

Some courts or probation departments have specific forms they want you to carry and have signed. Others will simply tell you to get a “court card” signed. Programs that require the client to turn in “meeting slips” may also have their own form they want people to use.

In these cases get the form from the person who told you to go to A.A., not from the A.A. meeting.

For practical purposes, most people use any small pieces of paper with their name at the top and a place for the secretary of the meeting to record the date, the name of the meeting, and a place for the secretary to sign.

A.A. meetings are all volunteer-run so they do not have offices, write letters and because of anonymity, they do not keep records of who attends. For those reasons make sure you are nice to the person you ask to sign your paper.

Also, remember to get the court card in before the meeting starts and pick it up after the meeting is over. Take care of your responsibility to get it signed.

Remember if you lose this one there is no going back and getting it signed later. Lose that “court card” and you get to do some more meetings and get a new card or paper signed.

The posts I write about A.A. are from my perspective as a therapist and clinical counselor and do not necessarily reflect the views of A.A. World Services. For more on A.A. and their program of recovery check out the “A.A. Big Book” titled Alcoholics Anonymous at the links below or contact A.A. World Services at their website.

The Big Book of Alcoholics Anonymous

The classic text on Alcoholism and recovery, this is the book that started off the whole 12 step phenomenon.

Alcoholics Anonymous from The Anonymous Press

One of the Kindle editions – At 99 cents this is such a bargain. This edition needed a separate listing. No Kindle reader? No Problem, if you have a computer you can download a free Kindle reader.

http://www.aa.org

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What will you have to do if you go to an A.A. meeting?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

AA big book

Alcoholics Anonymous big book.

A. A. etiquette, Does and Don’ts.

You need to go to an Alcoholics Anonymous meeting, maybe you have decided you have a drinking problem, or maybe the judge or probation has told you that you will have to attend a certain number of meetings. Most rehab programs will require meeting attendance also.

What should you expect the first time you go? What will they ask you to do and say? What should you not do? Are they going to grill you about your private business?

When I teach Substance abuse counseling I encourage students who are not regular attendees of A. A. meetings to go to a meeting and have that experience of walking through the door the first time.

Here are some of the things that you might experience that first time at A. A.

For this description, I will assume that you have checked a schedule and are attending an “open” meeting so you will not be asked to qualify as an Alcoholic. I will describe a “typical” meeting, though things may happen differently in various areas and meetings are free to set up their own procedures as long as those procedures do not violate the 12 steps or the 12 traditions.

A. A. Members practice a policy called Anonymity. This is different from what counselors observe when we say most things we talk about in counseling are “confidential.”

When you introduce yourself, in order to protect your “anonymity” you will introduce yourself as let’s say “Mark A.” You are not expected to use your last name. You could use a middle name, an alias, or any name you chose. No one is going to check your I. D.

Just remember if you introduce yourself by an alias or a nickname that it will be embarrassing later when you know these people to have to say – oh and by the way my name is really Bob.

There may be a sign-in sheet that goes around. This is to help the secretary or meeting chair know who to call on. These sheets are not kept and are not used to prove you were there. They are destroyed after the meeting is over. You do not need to sign in if you chose not to.

If you have a “court card” or another document that you need to be signed to prove you are there get there before the meeting starts and give that paper to the person conduction the meeting. This person is customarily called the “secretary.

I will talk more about court cards in an upcoming post.

If this is a book study people will take turns reading. They may go around the table or the Secretary may call for volunteers or may call on people. If you do not feel like reading it is fine to just tell them you pass.

During the discussion part of the meeting or if this is an all discussion meeting, then anytime, you may get called on. Either by the name you signed in with or by something abstract like – “how about the man in the blue shirt over there, would you like to share?”

If you do not want to share it is perfectly permissible to say something to the effect of “I just want to listen.” At that point, the secretary or chairman will move on to someone else.

You will never be required to talk or answer questions, though some members may be interested in you and at breaks, before or after the meeting, they will come up to you and introduce themselves. At that point, they may ask you a question about yourself as a way of starting a conversation.

It is acceptable to just say you wanted to see what happens at an A. A. meeting or to ask the person who introduced themselves to tell you about their experiences in A. A.

At some point in the meeting, they will practice the “seventh tradition.”

This means that they will pass a basket and people put in what they can. If you are a member (want to stop drinking) put something in if you can.

A. A. does not accept money from outside sources so the money put in the basket pays for the room and the coffee. If there is food, someone bought it and donated it.

If you decide to share, talk about your problems with alcohol and staying sober. If you have other problems or issues, you may mention them in passing but stick to the topic which is mostly staying sober.

A. A. members understand that the people who come to meetings may well have many problems. There are now over 200 twelve-step groups patterned after A. A. Not all of those groups have meetings all over all the time the way A. A. does, so people may turn up at an A. A. meeting who do not think they have a problem with alcohol.

Most of those people who come in thinking that their main problem is something other than alcohol say depression or anxiety, may be surprised as they listen to learn how much their alcohol consumption is impacting those other problems.

Beyond those simple things, sit back and listen. Hang around after the meeting and talk to the people who are there. You just might make some new clean and sober friends and discover that going to meetings is something you enjoy doing rather than something forced on you by the court or a rehab program.

Next time let’s talk about “Carrying a Court card.”

The posts I write about AA are from my perspective as a therapist and clinical counselor and do not necessarily reflect the views of AA World Services. For more on AA and their program of recovery check out the “AA Big Book” titled Alcoholics Anonymous at the links below or contact AA World Services at their website.

The Big Book of Alcoholics Anonymous

The classic text on Alcoholism, recovery this is the book that started off the whole 12 step phenomenon.

Alcoholics Anonymous from The Anonymous Press

One of the Kindle editions – At 99 cents this is such a bargain. This edition needed a separate listing. No Kindle reader? No Problem, if you have a computer you can download a free Kindle reader.

http://www.aa.org

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What goes on at an A. A. meeting?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

AA big book

Alcoholics Anonymous big book.

What happens at an A. A. Meeting?

Last time, about a week ago I talked about the various kinds of A. A. meetings. The actual activates taking place could vary depending on whether this is a speaker meeting or a book study, still, every meeting will have a lot of similarities. If you are expecting to, or are expected to attend some other 12 step group, translate the rest of this as needed.

I refer a lot of clients to A. A. and I believe they need to know what to expect. Here are some of the things they need to be aware of in my area. Things may be slightly different in your town, but not very different.

Every sandwich comes on bread and probably has a spread on it, but the meat may be different, so may the garnish. Think of A. A. meetings in that manner. Various meetings will be slightly different so just some basic similarities first.

There are certain things that I can very much assure you will not happen at a meeting. This is not a networking group. Though you may make friends as time passes. There should be no political or commercial pitches. You will not be asked or required to sign up for anything or to contribute any amount of money. They will pass the hat or basket but putting something in it is up to you.

No pressure or requirement to do much of anything except listen if that is what you chose to do. They also ask that you stay on topic.

What is the topic at an A. A. meeting? – Not drinking.

The meeting will be called to order by the secretary or chairman. The Secretary usually serves for a period of time, say 6 months more or less. That person also will customarily have been sober for a period of time. Each group sets its own rules. If lots of people want to be secretary then the suggested sober period gets longer.

There may be a chairperson that changes from, week to week; less sobriety is required to chair a meeting than to be the secretary.

They may have passed around a sign-in sheet first, or they may pass it around now. As I mentioned before people sign in by first name last initial only (that confidentiality thing) and you do not have to sign in if you chose not to. No one keeps these sign-in sheets, not that I know of, so there is no way to prove you were there unless you get something signed at the time of the meeting.

The meeting will likely start with a moment of silence and the recitation of the “serenity prayer.” Many groups will have the serenity prayer, the twelve steps, and the twelve traditions as well as some sayings, posted on the wall.

There may also be a picture of three men and a bed. This refers to the very first meeting where two sober members went to visit a man in the hospital. The idea of A. A. all started with the understanding that to stay sober you need to get out of self and start doing for others. (They refer to that ideal as the 12th step.)

Court cards are an “outside issue.” A. A. does not get paid for this; they do it as a courtesy. If you ask the secretary for a signature to prove you were there, be nice about it. Get there on time, put your card in the basket, or ask the person upfront where it goes and stays until the end to get your card back.

Meetings often start with some readings, the Secretary may hand out some things to read or they may read from a page in the book. You do not have to read if you do not want to.

Once the meeting starts they will follow the format for that particular meeting. They may take turns reading and sharing or they may just share.

The 7th Tradition.

At some time during the meeting, they will pause to “practice the 7th tradition.” This means they will pass the basket. People who are members put in what they can. If you are not a member you are not expected to contribute.

You are a member if you have a desire to stop drinking. You do not have to say you are an alcoholic, though most people do because they define their problems as alcoholism. You do not go to Cancer treatment place for diabetes and presumably, no one goes of their own free will to an A. A. meeting if they do not have a problem with alcohol.

If you are there for some other reason, make sure you are attending an open meeting (most are) and confine what you share about to your problems related to alcohol. If you are a student required to attend or do not have a problem related to alcohol you simply tell them that you would like to listen.

At the end many meetings, but not all, they will hold hands and recite a prayer. Often this is called the “Lord’s Prayer, or Our Father.”

This is usually announced as “we will say this prayer for those who care to join us.” If this is not part of your religious or spiritual tradition you are not obligated to say the prayer. If you have problems with the hand holding thing – do not do it.

The best part of most meetings is the meetings before and after the meeting. This is the time when members and visitors sit around or stand outside and talk. This conversation is often accompanied by drinking coffee or smoking. Many meetings, but not all, have gone nonsmoking. Check the schedule or ask about this if this is a concern for you.

Aside from your own fears or embarrassments, attending or visiting a meeting is a pretty easy thing to do. You will find most people there willing to talk with you and shake your hand whether you think you are an alcoholic or not. They are likely to welcome you as long as you are not trying to sell them something or change them in some way.

Go with the flow and you will be surprised how enjoyable attending meetings can be and how much you will be welcomed and accepted.

Many people tell me that A. A. was the first place in their life they were accepted for themselves and not because they were drinking or paid for that acceptance.

The posts I write about AA are from my perspective as a therapist and clinical counselor and do not necessarily reflect the views of AA World Services. For more on AA and their program of recovery check out the “AA Big Book” titled Alcoholics Anonymous at the links below or contact AA World Services at their website.

The Big Book of Alcoholics Anonymous

The classic text on Alcoholism recovery, this is the book that started off the whole 12 step phenomenon.

Alcoholics Anonymous from The Anonymous Press

One of the Kindle editions – At 99 cents this is such a bargain. This edition needed a separate listing. No Kindle reader? No Problem, if you have a computer you can download a free Kindle reader. For more information on A.A.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What is an Alcoholics Anonymous (A.A.) meeting like?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

AA big book

Alcoholics Anonymous big book.

What happens at an A. A. Meeting?

This should be an easy question. It’s not. Let me explain what an A. A. meeting is and how very different these meetings can be.

While most people think of Alcoholics Anonymous as meetings you go to, it all started with a book titled aptly enough “Alcoholics Anonymous.” Back then there were few A. A. meetings. Most people learned about Alcoholics Anonymous from buying and reading the book.

Reading the book “Alcoholics Anonymous.”

I continue to recommend that people read the book whether or not they elect to attend meetings.

Over time more and more meetings have sprung up, mostly meetings of people who had read the book and wanted to learn more or get help in participating in the A. A. program of recovery.

With all these groups starting up, they each had to develop their own set of rules. There got to be so many rules that at one point Bill W. one of the two co-founders, said if they followed all those rules, even he could not be a member. The result was that each group or meeting could figure out their own way of doing things as long as their rules did not conflict with the 12 Steps and the Twelve Traditions.

Today there are a whole lot of very different A. A. meetings. Most groups have their meeting times listed and included in schedules and you can find those schedules online or in print form.

Meetings can be categorized by what the program for a meeting will be, who is able to attend, where the meeting is held, and so on. There are also designations for rules for particular meetings.

Types of A. A. meetings.

They can also be categorized by what is on the program at that particular meeting. First the rule types and then the program types.

Smoking and non-smoking meetings.

In the old days, most meetings were smoking allowed. Back then you could tell a good meeting by the full ashtrays. Nowadays more meetings are non-smoking. They may be held in a place that does not allow smoking or the members may have decided to make their meeting a non-smoking one.

Open and closed meetings

There used to be more prejudice about people admitting they had a drinking problem, let alone saying they were alcoholics, so some meetings became closed meetings, meaning that they asked that only alcoholics attend those meetings.

The majority of meetings, especially the large ones, are open meetings that anyone who wants to go can attend. They do ask that if you share, you only talk about alcohol problems and your recovery from alcoholism. Sorry, no commercial pitches or religious and political solicitations are part of this program.

Men’s only or Women’s only meetings

I recommend to female clients that whenever possible they attend a few women’s only meetings. The point of meetings is to work on your recovery not to find a new partner.

Meetings and fellowships

Meetings customarily meet once per week at a particular time and place. They may use any room available; say a church meeting hall, a room at a school, or business. The meeting rents the room from the place and then has its own meeting. The A. A. group may meet at say the Methodist church on Friday night, but it is an A.A. meeting, not a Methodist meeting, so any faith, or those with no faith, are welcome to attend.

A fellowship is a group of meetings that goes in together and rents a room so that there are primarily A. A. meetings in that place. A fellowship might have a morning meeting each day, a noon meeting each day, and one or more evening meetings each day all in the same place.

Go to a fellowship for a few weeks and you will develop a group of clean and sober friends. I encourage clients to try out a fellowship as soon as possible. I also encourage them to try a number of meetings until they find the one that is right for them.

Different A. A. meetings will have different formats.

Speaker meetings

At a speaker meeting, one or a couple of people will get up and talk about their experiences in recovery.

Book studies

At a book study, a portion of the book is read and they people discuss what this means and how they might apply it to their recovery. Books would include the A. A. Big Book, 12 and 12; As Bill sees it, and so on. These meetings do not include reading from any religious books like the Bible or the Koran as that would make the meeting a religious meeting not an A. A. meeting.

Open participation meetings

At this meeting members, (remember you are a member if you decide you want to stop drinking) are encouraged to talk about what is on their mind as it applies to drinking, not drinking, and their recovery from alcoholism.

Meetings, by the way, are not therapy sessions. Sometimes it is hard to tell the difference but the focus of the meeting should be on your problems with alcohol and your efforts to not drink.

The Big Book suggests that people share “in a general way,” what they used to be like, what happened and what they are like now.

So there you have the types of meetings that you might choose to attend, but what will actually happen if you chose to go to an A. A. meeting? If you need to or want to attend a meeting, consider which meeting type you might like to attend or try out several and see what is best for you.

In a future post, I want to describe what the experience of attending an A. A. meeting might be like.

The posts I write about AA are from my perspective as a therapist and clinical counselor and do not necessarily reflect the views of A.A. World Services. For more on A.A. and their program of recovery check out the “A.A. Big Book” titled Alcoholics Anonymous at the links below or contact AA World Services at their website.

The Big Book of Alcoholics Anonymous

The classic text on Alcoholism, recovery this is the book that started off the whole 12 step phenomenon.

Alcoholics Anonymous from The Anonymous Press

One of the Kindle editions – At 99 cents this is such a bargain. This edition needed a separate listing. No Kindle reader? No Problem, if you have a computer you can download a free Kindle reader.

http://www.aa.org

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

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