Step 3 (AA & 12 Step Programs)
Overview: Alcoholics Anonymous (AA) & The Twelve Steps
Alcoholics Anonymous (AA) is a peer support group centered around spirituality, self-reflection, and change. The goals, steps, and structure of AA come from “The Big Book” by Bill W, who also founded it. AA is centered around 12 steps that act as guidelines to overcome alcoholism.
What is Step 3 in AA?
The third step of A.A. is “Made a decision to turn our will and our lives over to the care of God as we understood Him.” The third step is the culmination of steps 1 and 2, which involve admitting alcohol addiction and believing in a higher power.
The third step of AA dictates a willingness to turn one’s life around and place it in the care of a higher being. All steps of AA focus on the personalized change needed to overcome addiction.
What is the Purpose of Step 3 in AA?
The purpose of step three is to succumb to a higher power. This involves allowing that higher purpose to be a driving force to avoid alcoholism.
AA doesn’t require a stout religious view or upbringing. AA only requires that a participant genuinely seeks help and accepts that they cannot defeat addiction alone.
The first three steps of AA require the participant to admit they're powerless over alcohol. These steps involve admitting you need help from a higher power.
What are the Spiritual Principles of Step 3 in AA?
Each step in AA has spiritual principles. These provide direct actions to achieve the steps.
The primary principle for step 3 is faith. During this step, a participant is meant to give up their old ways and surrender control of their own lives.
In doing so, they may avoid certain alcohol triggers. They must also believe that the system works and that the higher power will help them overcome their addiction.
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How Do You Complete This Step?
Completing step 3 means consciously repeating your impotence over alcohol. AA only works for people genuinely seeking help and treatment for their substance abuse.
To complete step 3, you must surrender your will and life to a higher power or purpose. You must fully admit your addiction, reject your old ways and embrace treatment.
Many people may only declare their desire to quit alcohol to placate their friends and family. This mentality will reduce AA's effectiveness. Simply put, you must internally want to quit drinking for the program to succeed.
What are the Challenges of Step 3?
For many, faith can be a difficult principle. People who come from non-religious upbringings or who hold atheist beliefs may struggle. However, it’s important to remember that faith in a higher power is key to the success of AA.
Although a higher power often refers to God’s will, it doesn't necessarily have to be God. A higher power or higher purpose can vary between people.
For example, a higher power or purpose could refer to your:
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Questions About Getting Sober?
If you or a loved one have alcohol abuse issues, AA can help. The recovery process is life-long, but with the proper help, overcoming addiction is possible.
Treatment centers and AA groups exist all over the U.S. and are equipped and ready to help.
The first step in AA and any recovery process is admitting there’s an issue. If you need alcohol to function, it’s time to seek help.
Physical Health Effects of Alcohol
Moderate alcohol consumption is generally safe, depending on your health and tolerance. However, frequent drinking can lead to various health effects.
Excessive alcohol use, or binge drinking, can affect your health in many ways, including:
Alcohol and the Liver
Consuming too much alcohol for an extended period contributes to three types of liver disease: steatosis (fatty liver), cirrhosis, and alcoholic hepatitis.
These diseases disrupt liver function, severely damaging the body over time. Women have a higher risk of developing alcohol-induced liver injuries than men.
Alcohol and the Heart
Directly after drinking alcohol, your heart rate and blood pressure rise. Once the substance is out of your system, your vital signs return to normal.
However, excessive alcohol consumption can:
- Result in an irregular heartbeat and high blood pressure
- Weaken heart muscle
- Thin your blood
- Increase the risk of a heart attack, an enlarged heart, heart failure, stroke, and death
Alcohol and the Pancreas
Drinking alcohol causes the pancreas to produce toxic substances. This can result in pancreatitis (inflammation and swelling of the pancreas).
Alcohol and the Digestive System
Alcohol directly aggravates your gastrointestinal tract (digestive system). This is because your digestive system is the first exposure site after alcohol ingestion.
Alcohol makes your stomach produce extra acid, leading to inflammation of the stomach lining (gastritis). Diarrhea, vomiting, heartburn, ulcers, and stomach pain after drinking are common side effects.
Alcohol and Cancer Risk
Regularly drinking alcohol, especially heavy drinking, increases your risk of developing certain cancers, including:
- Oral cancer
- Larynx cancer (voice box)
- Esophageal cancer
- Colon cancer
- Liver cancer
- Breast cancer (among women)
Alcohol and the Reproductive System
Women who regularly consume alcohol have a greater risk of infertility and decreased menstruation. Drinking during pregnancy can also lead to developmental issues in babies, including:
- Fetal alcohol spectrum disorders (FASDs)
- Physical, mental, or intellectual disabilities
Similarly, men who binge drink are more likely to develop erectile dysfunction than men who don't.
Alcohol and the Skeletal System
Alcohol can negatively affect the muscular and skeletal systems by thinning the bones over time. This increases the risk of falls, fractures, muscle weakness, cramping, and atrophy.
Alcohol and Immunity
Alcohol lowers your immune system. This makes it more difficult for your body to fight off infections, including the common cold and flu, as well as pneumonia and tuberculosis.
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How Alcohol Affects Your Brain and Central Nervous System (CNS)
Heavy alcohol use negatively impacts reasoning, memory, and overall brain function. The hippocampus, which aids in learning and stores memories, can be particularly vulnerable to alcohol.
According to the University College London’s Whitehall II study recording 30 years of data from 1985 to 2015, even moderate drinking over extended periods can lead to brain shrinkage.10 Regularly drinking four or more alcoholic drinks daily increases your risk of hippocampal shrinkage by almost six times compared to non-drinkers.
This shrinking is because alcohol dehydrates tissues. Moreover, consistent dehydration can cause lasting damage to these sensitive areas.
Effects on Key Brain Regions and Associated Side Effects
Consistent alcohol consumption primarily affects the prefrontal cerebral cortex and cerebellum. The prefrontal cortex is critical in planning and decision-making. The cerebellum is responsible for balance and motor function.
When alcohol impairs these brain regions, it can result in various side effects like:
- Memory problems
- Poor coordination
- Reduced cognitive performance
- Vision issues
- Difficulty concentrating
- Low self-worth and confidence
- Mood swings
- Stress and anxiety
Determinants of Alcohol's Impact on the Brain
Multiple factors influence the severity of alcohol's adverse effects on the brain, including:
- Frequency and quantity of alcohol consumption
- Genetics, family history, and education level
- Age and gender
- Overall health status
- The age at which you began drinking alcohol
- Risks of prenatal alcohol exposure
The Biochemical Mechanism of Alcohol
The liver metabolizes alcohol. When you drink it, your stomach and small intestine absorb it into the bloodstream.
From there, enzymes in your liver break down about 95 percent of the alcohol you consume. Your body eliminates the remaining five percent through breath, sweat, or urine.
Alcohol's Impact on Neurotransmitters
While the liver breaks down alcohol, it also affects essential neurotransmitters in the brain. These chemicals include GABA, dopamine, and serotonin.
- GABA: Alcohol increases the activity of GABA, a neurotransmitter that has a calming effect on the brain. This is one reason why alcohol can make you feel relaxed or sedated.
- Dopamine: Alcohol consumption increases the release of dopamine, a neurotransmitter associated with pleasure and reward. This is why alcohol can initially make you feel happy or euphoric.
- Serotonin: Alcohol inhibits the production and release of serotonin, a neurotransmitter involved in regulating mood, appetite, sleep, and pain sensation. This can lead to increased feelings of depression or anxiety.
The Role of Enzymes in Alcohol Metabolism
The primary enzyme involved in alcohol metabolism is the alcohol dehydrogenase (ADH). This enzyme converts alcohol into acetaldehyde, a toxic byproduct.
Another enzyme, aldehyde dehydrogenase (ALDH), converts acetaldehyde into acetate. This substance is less toxic. Your body also safely eliminates it from its system.
However, some people have genetic variations that affect the activity of these enzymes. These variations can determine how quickly or slowly you metabolize alcohol, making you more or less susceptible to its effects.
Mental Health Effects of Alcohol
Excessive alcohol use also leads to mental health conditions. A drinking-related condition is also known as a dual diagnosis or co-occurring disorder.
- Depressive disorders: The most typical co-occurring psychiatric disease among people who misuse alcohol is major depressive disorder.13 Depression comes in many forms, including clinical depression, persistent depressive disorder, and bipolar disorders. The effects of alcohol come in waves throughout life or can be long-term.
- Anxiety disorders: These conditions lead to constant worrying about daily situations. Alcohol-induced anxiety is separate from an independent anxiety disorder but is often hard to differentiate.
- Other mood disorders: These include social phobia, post-traumatic stress disorder (PTSD), and panic disorder, which have an increased co-occurrence with alcohol dependence.
- Increased risk of self-harm: This occurrence is high among alcoholics due to intoxication and lack of inhibition. Self-inflicted injuries, such as cutting or attempted suicide, are common among people with dual diagnoses.
Other Ways Alcohol Can Affect Your Life
Besides severely affecting your physical and mental health, alcohol can also lead to social and legal problems.
Learn more about how alcohol consumption can impact your life by reading the articles below:
Underage drinking can lead to several serious health issues. Teenagers’ brains are still developing, which makes them more susceptible to adverse physical and mental health effects.
Hangovers can make you feel horrible the day after drinking. However, for more frequent alcohol users, hangovers can seriously affect the quality of your life and lead to mental, physical, social, and interpersonal issues.
Physical Effects of Alcohol
Alcohol has dangerous effects on your physical health. Alcohol consumption increases your risk of injuries, liver disease, heart disease, gastrointestinal issues, cancer, and more.
Psychological Effects of Alcohol
Alcohol consumption also harms your mental health. Heavy alcohol use impairs brain functions, such as memory and reasoning. Scientists have linked frequent alcohol use to depression, anxiety, mood disorders, and self-harm (e.g., suicide attempts and cutting).
Insomnia and Alcohol Addiction
An estimated 20 percent of adults in the U.S. drink alcohol to help them fall asleep. However, alcohol use has a direct, adverse effect on a person’s sleep quality. Alcohol addiction can lead to several long-term sleep problems, including insomnia.
Drunk Driving and DUIs
Over 10,000 people die from drunk driving accidents every year.14 Drunk driving puts everyone on the road in danger. A Driving under the influence (DUI) offense may cause you to lose your license, pay a hefty fine, or end up in jail.
What is Alcohol Use Disorder (AUD)?
Alcohol use disorder (AUD), or alcohol addiction or alcoholism, is a chronic relapsing brain disease. It develops when you misuse alcohol despite knowing its adverse effects.
AUD affects the brain's operations. Therefore, it causes symptoms like compulsive behavior and intense cravings.
What are the Symptoms of AUD?
Common symptoms of alcohol use disorder include:
- Inability to limit alcohol consumption
- Failed attempts to reduce or stop alcohol consumption
- Spending a significant amount of time drinking or recovering from drinking
- Cravings for alcohol
- Neglecting responsibilities and obligations
- Continuing to drink alcohol despite physical, emotional, or social harm
- Using alcohol in unsafe situations, such as when driving
- Neglecting social activities and hobbies
- Developing alcohol tolerance
- Experiencing alcohol withdrawal symptoms when not drinking, such as sweating, tremors, and nausea
Treatment and Rehabilitation for Alcohol Dependency
Alcohol dependency is a chronic disease that requires professional treatment and ongoing support. Some common methods used to treat alcoholism include:
Detoxification, or detox for short, is removing alcohol from your system while managing withdrawal symptoms. This typically takes place in a medically supervised facility.
Inpatient Rehabilitation Programs
Inpatient rehabilitation programs provide intensive therapy and support for people struggling with alcohol addiction or substance abuse. You'll live in a specialized facility and receive 24/7 care.
This approach allows you to focus solely on your recovery without outside distractions. Moreover, you'll have access to therapy, support groups, and medical care during your stay.
Outpatient Rehabilitation Programs
Outpatient rehabilitation programs offer similar treatments as inpatient rehab. However, it allows you to continue living at home.
You'll regularly attend therapy sessions and support group meetings while managing your daily responsibilities. This option may be more suitable for those with mild AUD or those who can't leave their obligations for extended periods.
Support groups, such as Alcoholics Anonymous (AA), provide a community of people going through similar struggles. These groups offer emotional support, accountability, and guidance in maintaining sobriety.
Strategies for Responsible Drinking
You can lower your risk of developing an addiction to alcohol by practicing responsible drinking. Here are a few strategies you can use to drink responsibly:
- Set limits and stick to them.
- Alternate alcoholic drinks with non-alcoholic beverages.
- Eat before and while drinking.
- Pace yourself and sip your drink slowly.
- Avoid binge or excessive drinking by consuming less than four drinks for women and five for men daily.
- Avoid drinking when you are feeling stressed or sad.
- Avoid drinking to cope with problems, emotions, or stressors.
- Monitor your alcohol consumption and cut back if necessary.
- Seek help if you can't control your drinking habits.
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- W., Bill. “Step 3.” Alcoholics Anonymous, 1939, https://www.aa.org/twelve-steps-twelve-traditions
- Kelly JF, Abry A, Ferri M, Humphreys K. Alcoholics anonymous and 12-step facilitation treatments for alcohol use disorder: A distillation of a 2020 cochrane review for clinicians and policy makers. Alcohol and Alcoholism. 2020;55:641-651. doi:10.1093/alcalc/agaa050
- Village A, W. Hood R, eds. The pragmatic believer—faith development and personal experiences of a ‘higher power’ in seasoned members of narcotics anonymous. In: Research in the Social Scientific Study of Religion, Volume 29. BRILL; 2018:123-144. doi:10.1163/9789004382640_008
- “Why Is Spirituality an Essential Part of a Recovery Program?” Psychology Today, https://www.psychologytoday.com/us/blog/the-craving-brain/201706/why-is-spirituality-essential-part-recovery-program.
- “What Makes AA Work?” Harvard Gazette, 12 Sept. 2011, https://news.harvard.edu/gazette/story/2011/09/what-makes-aa-work/.
- Suire, Jared G., and Robert K. Bothwell. “The Psychosocial Benefits of Alcoholics Anonymous.” American Journal on Addictions, vol. 15, no. 3, Jan. 2006, pp. 252–255, 10.1080/10550490600626622. https://onlinelibrary.wiley.com/doi/abs/10.1080/10550490600626622.