Academic journal article Alcohol Health & Research World

Special Populations in Alcoholics Anonymous

Academic journal article Alcohol Health & Research World

Special Populations in Alcoholics Anonymous

Article excerpt

The vast majority of Alcoholics Anonymous (AA) members in the United States are white, and only a few studies have investigated the program's effectiveness for ethnic minorities. Project MATCH, a multisite research study aimed at developing guidelines for assigning alcoholics to appropriate treatment approaches, also assessed AA effectiveness for minority clients. Some differences in AA attendance existed among white, African-American, and Hispanic Project MATCH participants who had received some inpatient treatment before entering the study, but not among participants who had not received inpatient treatment. Further analyses of white and Hispanic Project MATCH participants demonstrated that although Hispanic clients attended AA less frequently than white clients, their involvement with and commitment to AA was higher than among white clients. For both Hispanics and whites, AA involvement predicted increased abstinence. KEY WORDS: Alcoholics Anonymous; special populations; minority group; ethnic group; sociocultural norms; AODD (alcohol and other drug dependence) recovery; Hispanic; African American; white American; epidemiology; psychosocial treatment method; outpatient care; aftercare; treatment outcome; AOD abstinence; comparative study; New Mexico; literature review

Alcoholics Anonymous (AA) describes itself as a mutual-help program that is based on the attraction of its members to the program's philosophy rather than on program promotion (Alcoholics Anonymous 1976). How attractive, however, is AA to ethnic minorities with alcohol-related problems? In other words, can a mutualhelp program with strong Protestant roots that was started by white, middleclass Americans equally appeal to clients with diverse ethnic and cultural backgrounds? The spread of AA-based 12-step ideology and practices to 44 countries and the publication of the AA core literature in at least 8 languages would argue in the affirmative. Several factors may explain the growth and acceptance of AA across cultures (Makela 1993). For example, the 12-step philosophy is intentionally broad and open to divergent interpretations. This ideological flexibility permits its wide application across diverse cultures holding different beliefs and values. Furthermore, AA explicitly renounces political affiliations and shuns associations with other social movements. This "isolationism" has facilitated the introduction of AA into geopolitical areas that have traditionally discouraged the formation of grassroots social movements.

A slightly different question is whether minorities consider AA an attractive resource when the program is practiced within a larger dominant culture, such as that of the United States. In this situation, minority groups are asked to both adopt and modify the majority's interpretations, values, and beliefs about what is most germane in 12-step ideology and practice. These conditions raise a series of related questions, such as the following: How do minority groups in the United States use AA? How, if at all, do practices among AA members vary because of ethnic and cultural differences? Finally, do ethnic and cultural factors influence the benefits associated with AA attendance and involvement? This article addresses those questions based on findings obtained from epidemiological studies, the Project MATCH treatment study, and analyses of two samples of Hispanic clients with alcohol problems recruited in Albuquerque, New Mexico.



Epidemiological analyses in the general population of the United States indicate that AA is well known among Hispanics and African-Americans. Moreover, a vast majority of the people in those ethnic groups generally would recommend AA affiliation for alcohol-related problems (Caetano 1993). Prevalence estimates vary considerably, however, on the extent to which African-American and Hispanic clients actually select AA as a resource. For example, Caetano (1993) suggested that the proportion of people among the general population who were likely to attend AA was greater among Hispanics (12 percent) than among African-Americans (5 percent) or whites (5 percent). …

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