The effectiveness of Alcoholics Anonymous (AA) is very important to know. That’s because AA is the biggest and best-known alcohol abstinence program in the world.
I. About AA
II. Effectiveness of AA
I. About Alcoholics Anonymous (AA)
The first AA group was co-founded in 1935 at Akron, Ohio. One co-founders was a traveling salesman, Bill W. The other was a proctologist, Dr. Bob S. During that year a second AA group began in New York City. In 1939, a third formed in Cleveland.
AA’s “bible,” titled Alcoholics Anonymous, was written by Bill W. and published in 1939. It listed the now-familiar Twelve Steps of recovery. The 12 steps reflected the religious beliefs of the Oxford Group. It was a fundamentalist Christian movement. Both he and Dr. Bob were adherents.
The Twelve Steps
- We admitted we were powerless over alcohol—that our lives had become unmanageable.
- Came to believe that a power greater than ourselves could restore us to sanity.
- Made a decision to turn our will and our lives over to the care of God as we understood Him.
- Made a searching and fearless moral inventory of ourselves.
- Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- Were entirely ready to have God remove all these defects of character.
- Humbly asked Him to remove our shortcomings.
- Made a list of all persons we had harmed, and became willing to make amends to them all.
- Made direct amends to such people wherever possible, except when to do so would injure them or others.
- Continued to take personal inventory, and when we were wrong, promptly admitted it.
- Sought through payer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
- Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.1
These steps have been modified by other groups addressing behaviors involving narcotics, gambling, eating, shopping, sex, and even lip balm.
II. Effectiveness of Alcoholics Anonymous
It appears that for those who are able to consistently and fully apply these steps, the system can be effective. However, AA’s statistics show that only about 5% of members are successful for 12 months. The total body of research does not report evidence that AA or other 12 step programs are effective.2
Effects of No Treatment
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) conducted nation-wide research. It found that alcoholics who do not participate in AA have a much higher rate of success.3 Other research supports this finding. For example, studies of untreated alcoholics over time have found that
- about 18% were abstaining for at least two years.4
- 11% were abstaining over an unreported period of time.5
- 15% were abstaining after a period of seven year.6
- 15% were abstaining at the end of one year and 11% were abstaining after three years.7
This, and much more evidence, suggests that participating in AA generally results in a lower chance of success than not doing so.
AA Effective for Some People
Nevertheless, it is clearly helpful to some people. There are members who swear by the program. They even say it saved their lives. However, as addiction expert Gabrielle Glaser warns,
AA “can be just as damaging and dangerous for the people for whom it’s failing. AA doesn’t refer anybody out. It doesn’t tell anybody that AA is not for them. It’s very unlike professional organizations, which refer people to second opinions. AA tells people that if they don’t benefit, it’s basically their fault. This has produced, really, a lot of tragedies [such as suicides]….
She explains that
It causes people to blame themselves for failing and, consequently, spending more time in the program feeling worse about themselves. Families also blame their loved ones if they don’t do well or if they drop out rather than realizing that AA might not be the best approach [for them].”8
III. Alternatives for Moderation or for Abstinence
The good news is that there are may other free options for those seeking either to abstain from alcohol or to reduce their consumption. They include HAMS alcohol harm reduction program. Moderation Management. Rational Recovery. SMART Recovery. Women for Sobriety. And Secular Organizations for Sobriety (SOS).
These programs are based on scientific principles and evidence-based methods rather than faith.
IV. Resources on the Effectiveness of Alcoholics Anonymous
- AA. The Twelve Steps of Alcoholics Anonymous. Center City, MN: Hazelden, 1993.
- __. The Little Red Book. Center City, MN: Hazelden, 1970.
- __. An Interpretation of the Twelve Steps. Minneapolis: Coll-Webb Co., 1946.
- __. “Pass It On”: The Story of Bill Wilson and How the A.A. Message Reached the World. NY: AA, 1984.
- __. Living Sober. NY: AA, 1975.
- __. Came to Believe. NY AA, 1990.
- __. Twenty-Four Hours a Day. Center City, MN: Hazelden, 1975.
- __. Twelve Steps and Twelve Traditions. NY: AA, 1982.
Bill W. Alcoholics Anonymous. NY: Tarcher, 2014.
- ____ . Alcoholics Anonymous Comes of Age. NY: Harper, 1957.
Galanter, M. Research on Alcoholics Anonymous. NY: Springer, 2008.
- Robertson, N. Getting Better: Inside Alcoholics Anonymous. NY: Morrow, 1989.
- Szalavitz, M. After 75 Years of Alcoholics Anonymous, It’s Time to Admit We Have a Problem. Pacific Standard, Feb 10, 2014. Excellent coverage of effectiveness of Alcoholics Anonymous.
References for Effectiveness of Alcoholics Anonymous
- AA. How It Works. In: Alcoholics Anonymous. NY: AA, 2015.
- Ferri M., et al. Alcoholics Anonymous and other 12-step programmes for alcohol dependence. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No.: CD005032. Good for effectiveness of Alcoholics Anonymous.
- Alcoholics can Recover from Alcoholism and Drink in Moderation.
- Goodwin, W., et al. Felons who drink. Q J Stud Alc, 1971, 32, 136-147.
- Lemere, F. What happens to alcoholics. Am J Psychiat, 1953, 109, 674-675.
- Kendall, R. and Stanton, M. The fate of untreated alcoholics. Q J Stud Alc, 1966, 27, 30-41.
- Imber, S., et al. The fate of the untreated Alcoholic. J Nerv Ment Disord, 1976, 162, 238-247.
- Glaser, G. Critic Faults Alcoholics Anonymous. NPR, March 26, 2015.