No conversation about alcoholism or alcohol use disorder recovery is complete without mentioning Alcoholics Anonymous. The group has become synonymous with the concepts of recovery and lasting sobriety and has been instrumental in changing the conversation surrounding addiction since its inception roughly 80 years ago. As the science and psychology of addiction evolves, the role of Alcoholics Anonymous may change somewhat, but is likely to remain a cornerstone of many people’s aftercare efforts, if not their overall recovery journeys.
What is Alcoholics Anonymous?
Alcoholics Anonymous (AA) is a global, community-based program that was created to help those struggling with problematic drinking get sober with the support of their peers through daily meetings and discussions surrounding addiction.1 AA gives men and women a place to come together and share their experiences, recover from alcoholism and maintain sobriety.1 Its concept revolves around that premise that alcoholism is an illness that can be managed, but not controlled.
AA was founded by Bill Wilson and his physician, Doctor Bob Smith in 1935 and eventually grew to include two more groups by 1939.2 That same year, Wilson published Alcoholics Anonymous, a text which explained its philosophy and methods.2 We know it today as the 12 Steps of recovery. Over the years, the 12 Steps have been adapted by other self-help and addiction recovery groups, such as Gamblers Anonymous and Narcotics Anonymous, to those struggling with other forms of addiction. Additionally, many groups have changed the explicitly Christian overtones of the original 12 Steps to reflect more secular or agnostic philosophies.3
There are no other requirements to AA other than having a desire to quit drinking, and it is not associated with any organization, sect, politics, denomination, or institution. Those attending AA make a commitment to join either voluntarily, as a continuation of therapy or via court-mandated rehab.
Stats on Alcohol Abuse
Per the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), in order to be diagnosed with an alcohol use disorder (AUD), individuals must meet any two of 11 criteria during the same 12-month period.4 An estimated 16 million people in the U.S. have an AUD, yet only a small percentage of those individuals seek treatment.5 In 2015, only 4.4% of people age 12 and older received specialty treatment for an alcohol use disorder.6
According to the 2017 National Survey on Drug Use and Health, 51.7% of people age 12 and older reported drinking in the past month, 24.5% of people age 12 and older binge drank in the past month (4 or more drinks for women and 5 or more drinks for men on one occasion), and 6.1% engaged in heavy alcohol use over the past month (binge drinking on 5 or more days over the past 30 days).7
Given the number of individuals struggling with or at risk for an AUD, it is understandable that AA has grown to what it is today—an organization with more than 115,000 groups worldwide.8
What Are The 12 Steps?
AA’s 12-Step approach follows a set of guidelines designed as “steps” toward recovery, and members can revisit these steps at any time. The 12 Steps are:9
- 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 prayer 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.
Scientific Support and Success Rates
Alcoholics Anonymous’ Big Book cites a 50% success rate with 25% remaining sober after some relapses.10 However, since many of the group’s published success rates are provided by AA itself—and because some members choose to remain anonymous or don’t want to admit to relapsing—there isn’t enough impartial data to measure those rates.
The American Society of Addiction Medicine (ASAM) states that approximately 10% of the people who become part of a 12-Step program enjoy long-term success in their recovery.11 Yet, members also tend to drop out at a 40% rate during their first year, according to some studies, causing group attendance to change often.12
In 2014, AA reported that 27% of the 6,000 members who participated in an internal study were sober for less than a year; 24% retained their sobriety for up to five years, and 13% lasted for as long as a decade.8 Fourteen percent of the study’s participants stayed sober between 10 and 20 years, and 22 percent reported remaining sober for more than two decades.8
A long-term study conducted by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found, at both one and three-year follow-up interviews, that people with alcoholism who both received formal treatment and attended an AA group had a better chance of staying sober than those who only received formal treatment.13 NIAAA concluded that stronger connections between community-based meetings and professional treatment resources will equate to a more efficient systemic approach to managing alcohol use disorders.13
. Alcoholics Anonymous. (2017). This is A.A. An introduction to the A.A. Recovery Program.
. Alcoholics Anonymous. (n.d.). Historical Data: The Birth of A.A. and Its Growth in the U.S./Canada.
. U.S. National Library of Medicine. Kaskutas L. A. (2009). Alcoholics Anonymous Effectiveness: Faith Meets Science. Journal of addictive diseases, 28(2), 145–157.
. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association. 490-491.
. National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol Use Disorder.
. Substance Abuse and Mental Health Services Administration. (2017). Behavioral Health Barometer, United States, Volume 4.
. Substance Abuse and Mental Health Services Administration. (2018). Key Substance Use and Mental Health Indicators in the United States: Results from the 2017 National Survey on Drug Use and Health.
. Alcoholics Anonymous. 2014 Membership Survey.
. Alcoholics Anonymous World Services, Inc. (2016). The Twelve Steps of Alcoholics Anonymous.
. Alcoholics Anonymous World Services, Inc. (2001). Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered From Alcoholism.
. The American Society of Addiction Medicine. (2015). The Relevance of Twelve-Step Recovery in 21st Century Addiction Medicine.
. Lilienfeld, S. and Arkowitz, H. (2011). Does Alcoholics Anonymous Work? Scientific American.
. National Institute on Alcohol Abuse and Alcoholism. (2011). The Role of Mutual-Help Groups in Extending the Framework of Treatment. Alcohol Research & Health, 33(4).