What is AA?
AA: Those initials are instantly recognizable for anyone who’s ever experienced alcohol addiction, as well as their family, friends and loved ones. AA — or Alcoholics Anonymous — has been around since 1935, and people have been debating its effectiveness for almost that long.
For many, AA is a godsend, literally saving their lives from the ravages of alcoholism, while others experience mixed results. In a nutshell, AA works well for some people, and not so well for others. Research does, however, shed some light onto the variables that can affect AA’s effectiveness, as well as how you can make AA work for you.
History of Alcoholics Anonymous
Alcoholics Anonymous was founded 78 years ago in Akron, Ohio. Businessman Bill Wilson and physician Bob Smith both were alcoholics, but Wilson had been able to overcome his addiction. He attributed his ability to stop drinking to his involvement with a religious-based sobriety association and Wilson’s success, in turn, inspired Smith to stop drinking, too.
Working together, Wilson and Smith shared their steps to sobriety in a book entitled “Alcoholics Anonymous,” but colloquially known as “The Big Book.” The Big Book detailed the philosophies and methods that helped the two men battle their addiction, and formed the foundation of what’s known today as the 12-step model.
Critics note that Wilson didn’t have any formal medical training; rather, the 12 steps in his method come from a mixture of personal philosophies, religious beliefs and a structure that’s straight from the Bible. Regardless of its influences, the 12-step model put forth by AA took hold, and the organization grew quickly.
Today, more than 65,400 self-help AA groups — with more than 1.4 million members — meet regularly across the United States and Canada, and more than 11,000 clinics model their alcoholism treatment on the organization’s 12 steps. Worldwide, Alcoholics Anonymous has an estimated 2.13 million members that meet in more than 114,000 groups.
How does Alcoholics Anonymous Work?
The Alcoholics Anonymous program is based on Wilson and Smith’s 12 steps, as laid out in the Big Book. Though the methodology includes abstinence from alcohol, it also aims to change alcohol abusers’ entire thought process, in essence leading to a spiritual awakening.
Members work closely with other members, known as sponsors, in order to make it through the steps. Sponsors are on hand to provide support and act as mentors; ideally, a sponsor will be an experienced alcoholic who’s worked all 12 steps. Members are also encouraged to attend meetings as often as they need to prevent relapse into drinking, whether that’s once a week, or several times per day. Anyone with a desire to stop drinking can attend meetings.
At most meetings, members are encouraged to share their own stories about alcoholism, whether through a general discussion format or through scheduled speakers. Meetings may also involve study or discussion of the Big Book, the 12 steps, as well as celebrating members’ successes. Interestingly, physicians, therapists and psychologists aren’t supposed to attend meetings, unless they have an alcohol problem of their own.
Every three years, Alcoholics Anonymous releases information relating to membership. The 2011 survey found that more than 35 percent of members have been sober for more than 10 years. It also found that members attend, on average, 2.6 meetings per week.
Alcoholics Anonymous doesn’t include success rates in the survey, however. The fluid, informal nature of membership — and the organization’s insistence on anonymity and privacy for its members — means that AA’s effectiveness is difficult, if not impossible, to quantify. However, several studies have attempted to do so.
What do Studies of Alcoholics Anonymous Reveal?
Research into Alcoholic Anonymous’ effectiveness has landed along all sides of the spectrum, from some studies that conclude that AA absolutely works, to some studies that conclude that AA works as well as other forms of treatment, such as cognitive behavioral therapy.
One of the best known studies may be a 1997 investigation known as Project Match. Researchers randomly assigned almost a thousand alcoholics to to receive one of three possible treatments: Alcoholics Anonymous, cognitive behavioral therapy — which teaches coping skills to help prevent relapse — or motivational enhancement therapy, which focuses on increasing motivation to avoid unhealthy drinking. Those who participated in AA fared better than did those in other treatments. However, the study didn’t have a control group, or a group that received no treatment, so it’s hard to tell exactly how effective any of the three treatment methods were without being able to compare them to simply trying to stop drinking on one’s own, without a treatment program.
A few years later, Stanford University and the Department of Veterans’ Affairs published the results of 16 years worth of research. The study followed hundreds of problem drinkers, tracking who’d joined Alcoholics Anonymous, who’d sought professional help, and who’d tried to quit drinking on their own. Results showed that those who’d joined AA and gotten professional help within the first year of trying sobriety fared best overall.
AA Works for Those That Put in the Time
In fact, the earlier the study participants got involved with Alcoholics Anonymous, the longer they tended to stay involved with AA — and the longer they went without problem drinking. In contrast, those who joined AA, got sober, then dropped out of AA were much more liking to resume their alcohol abuse.
A few studies have found that AA, cognitive behavioral therapy and motivational enhancement therapy all have about the same success rates. This has led many to conclude that the chance of a successful treatment depends on a number of variables, such as:
- how the initial decision to stop drinking was made
- how committed you are to making a change
- the amount of support you can access
- the treatment methods available
- how long and how intensively you’ve been drinking
Either way, it’s undeniable that Alcoholics Anonymous has been instrumental in helping many, many alcoholics break their habit over the past century. As with many forms of treatment, you’ll get out of it what you put into it. Those who join AA early in the process, stick with the program, attend regular meetings and work through the 12 steps with a good faith effort have a better chance of achieving sobriety.