Is Alcoholics Anonymous Effective?

By Sharma, Manoj; Branscum, Paul | Journal of Alcohol & Drug Education, December 2010 | Go to article overview

Is Alcoholics Anonymous Effective?


Sharma, Manoj, Branscum, Paul, Journal of Alcohol & Drug Education


Alcoholics Anonymous (AA) is a world wide organization that is a social support group for people with a desire to quit alcohol. The primary purpose of the organization is to help its members stay sober and to help other alcoholics achieve sobriety (Alcoholics Anonymous, 2010). It is not affiliated with or allied with any religion, sect, denomination, political viewpoint, any other organization or institution. It does not support or oppose any cause. It does not have any membership dues or charges any money for its services. It is supported primarily by voluntary contributions of its members.

The origins of AA can be traced back to another organization called Oxford Group in the early 20th century in the United States and Europe which was a religious movement emphasizing self improvement. In the early 1930's Alcoholics Anonymous was formed. June 10, 1935 is celebrated as the founding date of Alcoholics Anonymous. The hallmarks of AA are the Twelve Steps and the Twelve Traditions (Butler, 2010). Practicing the Twelve Steps helps one quit alcohol and remain sober.

AA is not the only Twelve-Step program for recovering alcoholics, but it is the most widely known and available program of its type. Recently the Cochrane Database conducted a systematic review of randomized controlled trials evaluating the effectiveness of AA and other Twelve-Step programs (labeled Twelve Step Facilitation or TSF). Eight studies were included in the review, and, of these, three evaluated AA programs. The conclusions of this review were that "no experimental studies unequivocally demonstrated the effectiveness of AA or TSF approaches for reducing alcohol dependence or problem" (Ferri, Amato, & Davoli, 2006).

While the Cochrane Review was surprising, given the popularity and wide dissemination of AA, Kaskutas (2008) noted in a letter to the editor in the Journal Addiction that the experimental evidence reviewed was just one of the six criteria for establishing causation that AA was effective. In another article Kaskutas (2009) has done a systematic review of these evaluations, and he notes that, with regard to causal evidence of effectiveness of AA, five out of six criteria are met. With regard to magnitude of effect, rates of abstinence in those who attend AA are about twice as high compared to those who do not. With regard to dose-response relationship, higher levels of attendance are related to higher rates of abstinence. With regard to the criterion of consistency, there is evidence for different samples and follow-up periods. Likewise the criteria of temporality and plausibility are also substantiated. The only criterion which has mixed evidence is the criterion of specificity. So, according to Kaskutas (2009), AA can be considered an effective approach.

There are noted advantages and disadvantages to AA. A major advantage of the program is that it is widely popular and available. There are AA programs in every state, including Washington D.C., and abroad. AA is also free to its members, which means it does not prohibit individuals from attending based on financial resources. Meetings also are usually given during convenient times such as the evenings. Social support is an advantage to AA, as members are encouraged to find a "sponsor" during the program. Sponsors are typically recovering alcoholics who can share their personal stories of sobriety and assist the AA member through the process. AA also has an online community, whereby one can keep connected to others in the program in the comfort of one's home or work and have contact with others on nonsession days. …

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