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Tilcayo Cats:Wellness hub

From Tilcayo Cats, the lean encyclopaedia by Tilcayo Knowledge Systems

Need support? This page covers a topic that some readers may find difficult. If it affects you or someone you know, you do not have to deal with it alone. Help is available from the NHS and from free, confidential helplines: see Where to get help at the end of this page, or the Wellness hub. If anyone is in immediate danger, call 999.

Safety notice. Tilcayo Cats is an encyclopaedia, not a support service, and cannot give medical, legal or personal advice. If you or someone else is in immediate danger, call your local emergency number. UK numbers are in the Where to get help section near the end of this page.

If something you have read here has brought up difficult feelings, you are not alone, and it is okay to ask for help. This page lists free, trusted organisations by topic and country. Each link goes to the organisation's own website, where you can find its current phone, text and chat details.

Addiction and recovery

United Kingdom

Ireland

United States

Canada

Australia

New Zealand

Worldwide and online

Family and loved ones

If someone you care about is drinking, using drugs or gambling, these organisations support families and friends.

United Kingdom

  • NHS: alcohol support – NHS guidance on getting help with drinking, including stopping safely and longer-term support.
  • Al-Anon UK and Eire – Support for families and friends of people who drink, including Alateen for young people aged 12 to 17. (Tilcayo Cats page: Al-Anon/Alateen) Safeguarding: meetings are open to anyone and members are not vetted. See staying safe in recovery groups.
  • FRANK – Honest information about drugs, with a free helpline and text service open any time.
  • Gam-Anon UK and Ireland – Support for families and friends of people who gamble. Safeguarding: meetings are open to anyone and members are not vetted. See staying safe in recovery groups.
  • CoDA UK – Co-Dependents Anonymous meetings in the UK. (Tilcayo Cats page: Co-Dependents Anonymous) Safeguarding: meetings are open to anyone and members are not vetted. See staying safe in recovery groups. CoDA describes itself as a fellowship for people who share a desire for healthy and loving relationships. Codependency is not a recognised diagnosis in the DSM, and there is no agreed definition of it.[4]

Ireland

United States

Canada

Australia

New Zealand

Worldwide and online

What the research says

A 2020 Cochrane review of 27 studies (10,565 people) looked at Alcoholics Anonymous and "twelve-step facilitation" (TSF), clinical programmes delivered by professionals that encourage people to take part in AA. It found high-certainty evidence that manualised TSF programmes led to higher rates of continuous abstinence than other established treatments such as cognitive behavioural therapy (CBT): about 42% of participants were completely abstinent after a year, compared with 35% receiving other treatments. On other outcomes, such as how much people drank and alcohol-related problems, AA-based programmes performed about as well as other treatments. The authors found the benefit came largely from people continuing to take part in AA after the programme ended.[5] A 2014 re-analysis of randomised trials, designed to remove the effect of people choosing for themselves whether to attend, also found that going to more AA meetings led to more days without alcohol.[6]

Research on how AA helps suggests that much of the benefit comes from its social side rather than from any particular belief: changes in a person's social network towards people who support recovery, growing confidence in staying sober in social situations, and fewer low moods.[7][8] Helping other members, for example by sharing experience, has also been linked with better outcomes for the helper.[9] Researchers found that spiritual change mattered mainly for a minority of people with more severe problems.[8]

The Cochrane review covered alcohol only. For drug use, a 2017 Campbell review of ten studies found twelve-step programmes were neither better nor worse than other psychosocial treatments, and said the evidence was weak.[10]

Criticism and debate

The evidence has not always looked this way. An earlier Cochrane review, published in 2006, found that no experimental studies clearly showed AA or TSF to be effective.[11] Because people choose whether to go to meetings, critics have long argued that studies may overstate the benefit, since people who keep attending may already be more motivated.[6] Many people also stop going: in one US study of 2,778 men treated for substance use problems, 40% of those who had attended twelve-step groups had dropped out a year after treatment.[12]

Researchers have raised concerns about courts ordering people to attend AA, including ethical questions and possible loss of civil liberties, and have urged more cautious referral practices.[13] The first step's idea of being "powerless" over alcohol is also debated: some critics argue it may disempower people who already feel powerless, especially women, while studies of women in AA report that many find healing and empowerment there.[14][15] The psychiatrist Lance Dodes argued in his 2014 book The Sober Truth that only a small percentage of people who try AA stay sober long term;[16] a review in the Journal of the American Psychoanalytic Association criticised the book's statistical arguments.[17]

How common are relapse and recovery?

Addiction is a serious condition, and setbacks are common. The US National Institute on Drug Abuse (NIDA) says that 40 to 60% of people treated for substance use disorders relapse, similar to the 50 to 70% relapse rates for high blood pressure and asthma, and that relapse is a sign to resume or change treatment, not a sign that treatment has failed.[18] The World Health Organization estimated that about 400 million people were living with alcohol use disorders worldwide in 2019, and that in countries reporting data, fewer than 1% to no more than 35% of people with substance use disorders were in contact with treatment services.[19]

Many people do recover. The US National Institute on Alcohol Abuse and Alcoholism (NIAAA) says that most people who have alcohol use disorder recover or markedly improve.[20] A 2017 national survey estimated that 9.1% of US adults, about 22.35 million people, had once had a significant alcohol or drug problem and no longer did; about half had used some form of help, most often mutual-help groups.[21]

Stopping safely

If you are physically dependent on alcohol, stopping suddenly could be harmful, and the NHS advises getting medical advice first, and getting emergency help straight away for severe withdrawal symptoms such as seizures or hallucinations.[22] Stopping benzodiazepines suddenly, or cutting down too fast, can cause withdrawal effects that can be very serious and even life-threatening, so this should be planned with a healthcare professional.[23] NICE guidance says that assisted withdrawal from alcohol is usually done in the community, and that a stay in hospital or a residential unit should be considered for people at higher risk, for example those who have had withdrawal seizures or delirium tremens before, or who need to come off alcohol and benzodiazepines at the same time.[24] For coming off opioids, NICE recommends methadone or buprenorphine as the first-line treatment.[25] After treatment, the NHS lists mutual aid groups such as AA and SMART Recovery as one option for longer-term support,[22] and NICE guidance says that everyone seeking help for alcohol problems should be told about self-help groups such as Alcoholics Anonymous or SMART Recovery, and helped to attend.[24] Many people in recovery, and some researchers, regard these groups as a useful source of long-term support alongside medical care.

Staying safe in recovery groups

Fellowships such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), Cocaine Anonymous (CA), Marijuana Anonymous (MA), Gamblers Anonymous (GA) and Co-Dependents Anonymous (CoDA) are run by and for their members. Most people at meetings are there to recover and to help each other. But meetings are open to anyone, and nobody is screened, so a small number of people have used meetings to take advantage of vulnerable newcomers.[26][27] AA's own guidance says anonymity does not protect criminal or inappropriate behaviour, and that calling the police about crimes at or around meetings does not go against its traditions.[28]

A good sponsor

A sponsor is a more experienced member who offers to guide you. A good sponsor:

  • respects your boundaries;
  • never pressures you;
  • never insists that you share anything you are not comfortable sharing.

A sponsor is not a doctor, counsellor or lawyer. AA's own guidance says a sponsor does not offer professional services, and that a doctor, not a sponsor, should make medical decisions.[29]

Warning signs

Take care, and talk to someone you trust, if anyone in a group:

  • pressures you to share your sexual history, or your written "inventory", with them personally;
  • makes romantic or sexual approaches to you. The fellowships themselves warn against this: AA says sponsorship should be avoided where a romantic entanglement might arise,[29] and NA strongly suggests avoiding sponsorship relationships that may lead to sexual attraction;[30]
  • tries to control your money, your relationships or your medication. AA's literature says no member should "play doctor".[31] Never stop a prescribed medicine because someone at a meeting tells you to. Speak to your doctor first;
  • tries to cut you off from your family or friends;[27]
  • adds "steps", rules or tools that are not in the fellowship's own literature.

What the fellowships' own books say

In the Fifth Step, members admit their wrongs "to God, to ourselves, and to another human being". AA's main book, Alcoholics Anonymous (the "Big Book"), says a solitary self-appraisal is usually not enough. It suggests the person you share with could be a member of the clergy, a close-mouthed and understanding friend, your doctor or psychologist, or a family member. It does not say this has to be a sponsor.[32] On sex, the book says AA does not want to be "the arbiter of anyone's sex conduct".[33]

The Big Book was written in the 1930s and first published in 1939. AA itself notes that one chapter was written when there were few women in AA.[2] Some of its wording is now seen as outdated or offensive, and its old-fashioned English can be hard to follow or easy to misuse. In 2024, AA published a Plain Language Big Book to help readers who find the original hard to read.[34]

Each fellowship has its own approved literature. NA's main text is its own Basic Text, and NA says only NA-approved literature should be read at NA meetings.[35] MA's main text is Life with Hope.[3] You can always check what your own fellowship's literature says. CA is different: it uses AA's Big Book as its main text.[1]

CoDA describes itself as a fellowship for people who want healthy and loving relationships. Codependency is not a recognised diagnosis in the DSM, the main diagnostic manual used in the US, and there is no agreed definition of it.[4] Many people who identify as codependent link their difficulties to their family background, and counselling approaches based on family systems theory explore this.[4]

You do not have to work things through with a sponsor. You can talk things over with a doctor, a counsellor or a faith leader instead.

Mental health

United Kingdom

  • Mind – Mental health information and support in England and Wales, including an infoline on weekdays.
  • NHS 111 – Urgent medical help, day or night, by phone or online. Choose the mental health option for urgent mental health support.
  • Samaritans – Free listening service, 24 hours a day, for anyone who is struggling.
  • Childline – Free, confidential help for children and young people under 19, by phone or online.
  • Shout – Free, confidential text support at any time.
  • SignHealth – Health and wellbeing support for Deaf people, including therapy in BSL.
  • Beat – Eating disorder support, including helplines for each UK nation.
  • CALM (Campaign Against Living Miserably) – Helpline for anyone who is struggling, including if you are thinking about ending your life. Open 5pm to midnight every day.
  • NHS: mental health for children, teenagers and young adults – NHS advice for young people, and for parents and carers, including where to get help.
  • Rethink Mental Illness – Information and support for people living with severe mental illness, and for their carers.
  • Bipolar UK – Peer support and information for people affected by bipolar.
  • Andy's Man Club – Free peer-support groups for men, every Monday at 7pm.
  • Borderline Arts – Creative projects and peer support for people with a diagnosis of borderline personality disorder (BPD/EUPD).
  • CoDA UK – Co-Dependents Anonymous meetings in the UK. (Tilcayo Cats page: Co-Dependents Anonymous) Safeguarding: meetings are open to anyone and members are not vetted. See staying safe in recovery groups. CoDA describes itself as a fellowship for people who share a desire for healthy and loving relationships. Codependency is not a recognised diagnosis in the DSM, and there is no agreed definition of it.[4]

Ireland

  • HSE: mental health – HSE information on mental health, self-help and getting urgent help.
  • Pieta – Free support for people who are thinking about ending their life or hurting themselves, by phone or text.
  • Samaritans Ireland – Free listening service, 24 hours a day, for anyone who is struggling.
  • Aware – Support for people affected by depression, bipolar disorder and anxiety, including a support line.
  • Childline (ISPCC) – Free support for children and young people, 24 hours a day.
  • Mental Health Ireland – Information about mental health and local supports.

United States

Canada

Australia

  • Beyond Blue – Support for anxiety and depression.
  • Lifeline Australia – Crisis support by phone, text or chat, 24 hours a day.
  • healthdirect – Free government health information and advice, including a list of mental health helplines.
  • Suicide Call Back Service – Support for anyone who has lost someone who ended their life, 24 hours a day.
  • headspace – National youth mental health foundation for 12 to 25 year olds, including online support (eheadspace).
  • SANE Australia – Support for people with complex mental health needs, and their families and friends.

New Zealand

Ghana

Worldwide and online

  • Co-Dependents Anonymous (CoDA) – Fellowship for people who want healthier relationships, with meetings in many countries and online. (Tilcayo Cats page: Co-Dependents Anonymous) Safeguarding: meetings are open to anyone and members are not vetted. See staying safe in recovery groups. CoDA describes itself as a fellowship for people who share a desire for healthy and loving relationships. Codependency is not a recognised diagnosis in the DSM, and there is no agreed definition of it.[4]

Crisis and listening services

If you need to talk to someone now, these services can help. In an emergency, call your local emergency number.

United Kingdom

  • NHS 111 – Urgent medical help, day or night, by phone or online. Choose the mental health option for urgent mental health support.
  • Samaritans – Free listening service, 24 hours a day, for anyone who is struggling.
  • Childline – Free, confidential help for children and young people under 19, by phone or online.
  • NHS: where to get urgent help for mental health – Clear NHS guidance on who to contact in a mental health crisis.
  • Shout – Free, confidential text support at any time.
  • CALM (Campaign Against Living Miserably) – Helpline for anyone who is struggling, including if you are thinking about ending your life. Open 5pm to midnight every day.

Ireland

  • HSE: mental health – HSE information on mental health, self-help and getting urgent help.
  • Pieta – Free support for people who are thinking about ending their life or hurting themselves, by phone or text.
  • Samaritans Ireland – Free listening service, 24 hours a day, for anyone who is struggling.
  • Childline (ISPCC) – Free support for children and young people, 24 hours a day.

United States

Canada

Australia

New Zealand

Ghana

Health conditions

United Kingdom

  • NHS 111 – Urgent medical help, day or night, by phone or online. Choose the mental health option for urgent mental health support.
  • NHS website – NHS information on health conditions, symptoms and treatments.
  • Beat – Eating disorder support, including helplines for each UK nation.
  • Bipolar UK – Peer support and information for people affected by bipolar.

Ireland

  • HSE – Ireland's public health service: information on conditions and services.

United States

  • MedlinePlus – Trusted health information from the US National Library of Medicine.

Canada

Australia

  • healthdirect – Free government health information and advice, including a list of mental health helplines.

New Zealand

  • Healthline – Free health advice, 24 hours a day.

Ghana

Deaf and disability support

United Kingdom

  • RNID – Information and support for people who are deaf, have hearing loss or tinnitus.
  • Royal Association for Deaf people – Advice and support for Deaf people who use British Sign Language (BSL).
  • SignHealth – Health and wellbeing support for Deaf people, including therapy in BSL.

Ireland

United States

Canada

Australia

  • Deaf Australia – National organisation representing Deaf people who use Auslan.

New Zealand

  • Deaf Aotearoa – Services and advocacy for Deaf people in New Zealand.
  • NZ Relay – Phone relay services for people who are Deaf, hard of hearing, deafblind or speech-impaired.

United Kingdom

Ireland

United States

Canada

Australia

New Zealand

Tilcayo Cats has not yet been able to check addiction, Deaf support or legal services in Ghana. They will be added once they have been checked.

Where to get help

If you are worried about your mental health or someone else's, these services can help. The numbers below are for the United Kingdom.

  • Emergency: if someone is in immediate danger or has been seriously hurt, call 999.
  • NHS 111: for urgent help or advice that is not an emergency, call 111 or use NHS 111 online. It is free and open day and night.
  • Your GP: a GP can talk with you about how you are feeling and can refer you to services, including NHS Talking Therapies.
  • Samaritans: call 116 123, free, day or night, to talk to someone who will listen.
  • Childline: children and young people under 19 can call 0800 1111 free, or talk online at childline.org.uk.
  • Shout: text SHOUT to 85258 for free, confidential text support at any time.
  • Outside the UK: Find A Helpline is a free directory of helplines in other countries.

For support in other countries, and for more services, see the Wellness hub and Pip's support guide.

Need support? This page covers a topic that some readers may find difficult. If it affects you or someone you know, you do not have to deal with it alone. Help is available from the NHS and from free, confidential helplines: see Where to get help at the end of this page, or the Wellness hub. If anyone is in immediate danger, call 999.

Notes

  1. ↑ 1.0 1.1 1.2 1.3 "Tools of Recovery". Cocaine Anonymous World Services. Retrieved 2026-10-02.
  2. ↑ 2.0 2.1 2.2 2.3 "To Wives" (PDF). Alcoholics Anonymous (4th ed.). Alcoholics Anonymous World Services. 2001. p. 104.
  3. ↑ 3.0 3.1 "Life with Hope". Marijuana Anonymous. Retrieved 2026-10-02.
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 Bacon, Ingrid; McKay, Elizabeth; Reynolds, Frances; McIntyre, Anne (2018). "The Lived Experience of Codependency: an Interpretative Phenomenological Analysis". International Journal of Mental Health and Addiction. doi:10.1007/s11469-018-9983-8.
  5. ↑ Kelly, John F.; Humphreys, Keith; Ferri, Marica (2020). "Alcoholics Anonymous and other 12-step programs for alcohol use disorder". Cochrane Database of Systematic Reviews. 3 (3) CD012880. doi:10.1002/14651858.CD012880.pub2. PMC 7065341. PMID 32159228.
  6. ↑ 6.0 6.1 Humphreys, Keith; Blodgett, Janet C.; Wagner, Todd H. (2014). "Estimating the efficacy of Alcoholics Anonymous without self-selection bias: an instrumental variables re-analysis of randomized clinical trials". Alcoholism: Clinical and Experimental Research. 38 (11): 2688–2694. doi:10.1111/acer.12557. PMC 4285560.
  7. ↑ Kelly, John F.; Hoeppner, Bettina; Stout, Robert L.; Pagano, Maria (2012). "Determining the relative importance of the mechanisms of behavior change within Alcoholics Anonymous: a multiple mediator analysis". Addiction. 107 (2): 289–299. doi:10.1111/j.1360-0443.2011.03593.x. PMID 21917054.
  8. ↑ 8.0 8.1 Kelly, John F. (2017). "Is Alcoholics Anonymous religious, spiritual, neither? Findings from 25 years of mechanisms of behavior change research". Addiction. 112 (6): 929–936. doi:10.1111/add.13590. PMID 27718303.
  9. ↑ Zemore, Sarah E.; Kaskutas, Lee Ann; Ammon, Lyndsay N. (2004). "In 12-step groups, helping helps the helper". Addiction. 99 (8): 1015–1023. doi:10.1111/j.1360-0443.2004.00782.x. PMID 15265098.
  10. ↑ Bøg, Martin; Filges, Trine; Brännström, Lars; Jørgensen, Anne Marie Klint; Fredriksson, Maja Karrman (2017). "12-step programs for reducing illicit drug use". Campbell Systematic Reviews. 13 (1): 1–149. doi:10.4073/csr.2017.2.
  11. ↑ Ferri, Marica; Amato, Laura; Davoli, Marina (2006). "Alcoholics Anonymous and other 12-step programmes for alcohol dependence". Cochrane Database of Systematic Reviews (3) CD005032. doi:10.1002/14651858.CD005032.pub2. PMID 16856072.
  12. ↑ Kelly, John F.; Moos, Rudolf (2003). "Dropout from 12-step self-help groups: prevalence, predictors, and counteracting treatment influences". Journal of Substance Abuse Treatment. 24 (3): 241–250. PMID 12810145.
  13. ↑ Speiglman, Richard (1997). "Mandated AA attendance for recidivist drinking drivers: policy issues". Addiction. 92 (9): 1133–1136. doi:10.1111/j.1360-0443.1997.tb03671.x. PMID 9374010.
  14. ↑ Kelly, John F.; Hoeppner, Bettina B. (2013). "Does Alcoholics Anonymous work differently for men and women? A moderated multiple-mediation analysis in a large clinical sample". Drug and Alcohol Dependence. 130: 186–193. PMC 3596430.
  15. ↑ Bond, L. M.; Csordas, T. J. (2014). "The Paradox of Powerlessness". Alcoholism Treatment Quarterly. 32 (2–3): 141–156. doi:10.1080/07347324.2014.907050.
  16. ↑ Dodes, Lance; Dodes, Zachary (2014). The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry. Beacon Press. ISBN 978-0-8070-3315-9.
  17. ↑ Roth, J. D.; Khantzian, E. J. (2015). "Book review: The Sober Truth". Journal of the American Psychoanalytic Association. 63 (1): 197–202. doi:10.1177/0003065114565235.
  18. ↑ "Treatment and Recovery". Drugs, Brains, and Behavior: The Science of Addiction. National Institute on Drug Abuse. Retrieved 2026-10-02.
  19. ↑ "Over 3 million annual deaths due to alcohol and drug use, majority among men". World Health Organization. 25 June 2024. Retrieved 2026-10-02.
  20. ↑ "Treatment for Alcohol Problems: Finding and Getting Help". National Institute on Alcohol Abuse and Alcoholism. Retrieved 2026-10-02.
  21. ↑ Kelly, John F.; Bergman, Brandon; Hoeppner, Bettina B.; Vilsaint, Corrie; White, William L. (2017). "Prevalence and pathways of recovery from drug and alcohol problems in the United States population: Implications for practice, research, and policy". Drug and Alcohol Dependence. 181: 162–169. doi:10.1016/j.drugalcdep.2017.09.028. PMC 6076174.
  22. ↑ 22.0 22.1 "Alcohol support". NHS. Retrieved 2026-10-02.
  23. ↑ "Should I stop my benzodiazepine or z-drug? (NG215 patient decision aid)". National Institute for Health and Care Excellence. Retrieved 2026-10-02.
  24. ↑ 24.0 24.1 "Alcohol-use disorders: diagnosis, assessment and management of harmful drinking (high-risk drinking) and alcohol dependence (CG115)". National Institute for Health and Care Excellence. 23 February 2011. Recommendations 1.3.1.7, 1.3.4.2 and 1.3.4.5. Retrieved 2026-10-04.
  25. ↑ "Drug misuse in over 16s: opioid detoxification (CG52)". National Institute for Health and Care Excellence. 25 July 2007. Recommendation 1.3.1.1. Retrieved 2026-10-04.
  26. ↑ Glaser, Gabrielle (24 June 2013). "Twelve Steps to Danger: How Alcoholics Anonymous Can Be a Playground for Violence-Prone Members". ProPublica. Retrieved 2026-10-02.
  27. ↑ 27.0 27.1 Cunha, Darlena (22 September 2015). "'I was fresh meat': how AA meetings push some women into harmful dating". The Guardian. Retrieved 2026-10-02.
  28. ↑ "Safety and A.A.: Our Common Welfare (SMF-209)" (PDF). Alcoholics Anonymous World Services. Retrieved 2026-10-02.
  29. ↑ 29.0 29.1 "Questions and Answers on Sponsorship (P-15)". Alcoholics Anonymous World Services. Retrieved 2026-10-02.
  30. ↑ "IP #11, Sponsorship". Narcotics Anonymous World Services. Retrieved 2026-10-02.
  31. ↑ "The A.A. Member—Medications and Other Drugs (P-11)". Alcoholics Anonymous World Services. Retrieved 2026-10-02.
  32. ↑ "Into Action" (PDF). Alcoholics Anonymous (4th ed.). Alcoholics Anonymous World Services. 2001. pp. 72–75.
  33. ↑ "How It Works" (PDF). Alcoholics Anonymous (4th ed.). Alcoholics Anonymous World Services. 2001. pp. 68–70.
  34. ↑ "Plain Language Big Book: A Tool for Reading Alcoholics Anonymous" (PDF). Alcoholics Anonymous World Services. 1 November 2024. Retrieved 2026-10-02.
  35. ↑ "The Group Booklet". Narcotics Anonymous World Services. Retrieved 2026-10-02.
Last checked: 2 October 2026. Links go to each organisation's own website. Tilcayo Cats is not connected to any of them.
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