Does Alcoholics Anonymous Work? (2023)


The largest, most rigorous independent study on Alcoholics Anonymous to date shows that AA can help people get sober, stay sober, drink less, and suffer fewer negative consequences of drinking, all while keeping health care costs down. Watch scientists John Kelly (Harvard/MGH) and Keith Humphreys (Stanford/VA) discuss their findings (published 3/11/20 by the Cochrane Collaborative), with commentary from psychologist Gabrielle Jones.


Alcoholics Anonymous is an international fellowship of people who struggled with alcohol addiction since its founding in America.

In 1935, tens of millions of people worldwide have joined local AAA meetings for help getting.

And staying sober AAA is non professional peer led and self-funded participation is anonymous and open to anyone looking for help with a drinking problem.

Aaa's foundation is abstinence.

It offers treatment not a cure for alcohol.


Aaa's approach is based on the 12 steps, which start with admitting to being powerless over alcohol.

Other steps, help members recover from addiction through social and spiritual support and aim to improve their relationships with others by making amends for past wrongs.

Go to any AAA meeting and you'll probably meet people who tell you that AAA is the only reason they're alive and sober today.

But there are plenty of critics too who claim that AAA is poorly, studied ineffective overhyped and more spiritual than scientific.

So is Alcoholics Anonymous actually effective in helping people recover from alcohol addiction, or is it more like a fad diet with mass popularity, but little in the way of real results, researchers at Stanford Harvard and the European Monitoring Centre for drugs and drug addiction set out to answer this question in a new landmark study, they systematically reviewed the most rigorous research on Alcoholics Anonymous to date.

And they found strong scientific support that AAA is effective in helping with recovery from alcohol addiction, here's, John, Kelly, one of the study's authors.

Well we did this study because alcohol is the world's favorite drug.

It is also the world's most lethal drug in terms of a psychoactive drug that can confer harms in terms of premature mortality disease and disability as well as a huge economic burden in terms of lost productivity criminal.

Justice costs and health care costs.

I was interested in a a from the very beginning of my career and I have to say at first I, didn't have a particularly respectful take on it.

It seemed to me that you had to have a degree.

You should be trained in medicine or psychology or social work, and you should understand things about neuroscience and and medications if you wanted to help people had problems, but my snobbishness was not well-founded more.

And more studies have sort of cropped up and it's written.

Why is it important to do those studies it's, the most common place people seek help for alcohol? Problems fact that something is popular doesn't mean that it works.

So your job as a scientist is to say, okay, you know, he's popular.

And so it that makes it of interest, but I'm still going to subject it to tests because these are vulnerable people.

And if it didn't work, you would have an obligation to let people know that.

So what we did in this particular study review was what we call a systematic review.

What that means is that it is a comprehensive review of all the available published science in a certain area.

The advantage of this review is that we reviewed randomized control trials.

So these were true experimental studies.

This integration of evidence is done under something called the Cochrane Collaboration, which is the gold standard in medicine internationally for assessing effects in any area for any type of medicine or any type of intervention and it's extremely structured and rigorous and how you have to go through the evidence, the author's searched, the world's largest databases for all the research ever done in any language on the effectiveness of a a relative to other addiction treatments.

They used predetermined standards for research design to identify the most rigorous and relevant studies.

Then they reviewed the top 36 reports for any evidence of bias and graded, the quality of the evidence.

Their final meta analysis included 36 reports on 25 different studies on the clinical outcomes and cost savings of Alcoholics Anonymous.

These reports involved, almost 150 scientists at 67 different institutions around the world and included more than 10,000 research subjects.

The most important conclusion of the review is that even though Alcoholics Anonymous was invented by peers and not by professionals and was not created by people like me whose do science for a living nonetheless, the science supports what they did.

And in fact, people who go to Alcoholics Anonymous are depending on the study and the sample about 20 to 60% more likely to end up abstinent than people who do not.

And that is a really big treatment effect.

I mean, if you think how many people die from alcohol problems, you know if you could increase survival rates for cancer, twenty to sixty percent, you would be, you know, overjoyed as it has as a hospital or as a researcher.

And so you know, we should be overjoyed that this peer grassroots organization is able to deliver this.

You know, shockingly large and reliable benefit to people who are struggling with serious alcohol problems in every study reviewed scientists compared participation in AAA, or in counseling that encouraged AAA participation to one or more other treatments, including professionally, delivered therapies outpatient treatment by a doctor psychologist or social worker, mindfulness meditation and education programs when they looked at complete abstinence from alcohol.

In every study AAA was as good as and most often better than other addiction treatments in a third of the studies AAA was better by large margins over other treatments.

For example, in one study 60% more people stayed abstinent through AAA than through cognitive behavioral therapy.

They also helped people stay abstinent over the long run.

It was more effective than other treatments at every time point over three years in the most rigorous set of studies at the same time.

There are people who go to a, and they don't end up for the abstinent, but they also cut their drinking a lot.

And this was a bit of a surprise for a pure abstinence organization.

But when we looked at outcomes beyond abstinence, like how many days of heavy drinking did you have or how much did you drink on the days when you were drinking, they also came out very well there when studies looked at AA's effects on partial sobriety measured by the number of days, people stayed sober AAA was better than other treatments in a third of the studies and equally good in the rest AAA was also equally good at reducing the number of drinks people consumed on the days.

They chose to drink in terms of alcohol-related consequences like health problems, miss days of work, duis and relationship problems.

Aaa was also as good or better than other treatments.

Another major finding I think a very important one from a societal perspective from a healthcare system perspective is the ability not just to produce higher remission rates.

But to do that at a much reduced healthcare cost people are going to the emergency room, not ending up in the hospital.

Bed they're, not using mental health or addiction, formal clinical services as much a a produce significant cost savings in four out of the five studies that analyzed costs.

And the savings could be dramatic.

For example, in one study a a participation reduced healthcare costs by more than ten thousand dollars per patient over two years, relative to cognitive behavioral therapy AAA was also better at helping these people.

Stay sober.

The takeaways are clear the most rigorous data available on Alcoholics Anonymous shows that it can help people get sober.

Stay sober, drink less and suffer fewer negative consequences of drinking all while keeping healthcare costs down.

But how does AAA actually work? How does AAA work? I mean, it's, it's, a real enduring mystery to scientists and there's been a lot of research done on this question.

And probably one important thing to say outright is it works differently for different people for most people, the major way that AAA works is via psychosocial factors.

So it helps people shift their social network by dropping heavy drinkers out of the network and adopting abstainers and people in recovery.

It has a lot of different.

You could say hands out to people in the river who are all drowning.

And each one grabs a different hand.

So for some people it's I need a fellowship of people who don't drink, they will not have to worry when I'm around them.

Then they will pull out a bottle or offer me a drink.

And they will specifically support me in that goal of mine second role, modeling and hope you can walk into a meeting feeling very, you know, just down on yourself and destitute.

And then you see somebody who who is like you now, but they're doing great.

And and and they they may tell their story of, you know, I was, you know, drinking and I lost my marriage and and my job and you're the guy, oh, my gosh, that sounds like me and said and now I'm doing great and I'm in recovery and I pull things back together with my wife and I've got a good job and I'm close to my kids again, that feels really good that that inspires hope there is another kind of very key component to AAA.

And that is the idea of sponsorship or mentorship.

And that really occurs through more experienced member taking on board, a new member under their wing as it were to really act as a kind of a recovery coach in these early days weeks and months is so critical.

When people are trying to change addictive behavior.

Another way that it works is it boosts cognitive and behavioral coping skills, much like calming, behavioral therapy would accept that it does that through the peer network support of meetings.

And so in other words, people learn skills in the meetings about how to stay sober and how to think differently about themselves and about the adaptation to recovery.

The other ways that we found that AAA works confers benefit again through proper mechanistic research is through reducing craving, reducing impulsivity maintaining motivation for abstinence over time at a high level.

So this constant vigilance that occurs through the reappraisal.

When people go to meetings they're reminded of what their addiction used to be like counselors, who treat addiction have seen how a a can adapt to serve different communities, here's, dr.

Gabrielle Jones, a clinical psychologist and addiction expert who was not involved in the Cochran review, I have a lot of people who come to me and say, how does a a actually work and that's also a very difficult question because everybody is different how AAA might work for a person of color who is generally used to being in community with others that's.

The direction I would take I would talk about how being in community gives you a support system.

It gives you a network.

It gives you people to lean on.

They understand that from from a cultural perspective, people also seem to benefit in AAA from the experience of helping others, which is to AA's philosophy.

What that means is, this is not a service it's, not like going into a restaurant where you're the customer.

And you just take things you're also supposed to give things.

And one of the interesting findings about the social support literature is that giving support seems to be as good for our health as getting it.

And it really structures itself in ways.

You can do that for some people it's, you know, maybe the simplest thing of like I set up the chairs before the meeting or I make the coffee, but it's a role.

And it gives a sense of Worth and a sense of service.

So we talk often in psychology about harm reduction and I believe that community based meetings are a source of harm reduction, because that allows people to have somewhere to go when they have nowhere to go.

And it allows people to get things off of their chest when they don't have anywhere else to do that and it's a place where they know, they'll be encouraged to be sober, it's, not a bar it's, not a restaurant.

It is a safe haven where other people are sober and are accomplishing what people want to accomplish.

And in underserved communities that can't have or don't have access to mental health or physical health as easily a a being right down.

The street really makes a difference in terms of recovery.

The underserved in our communities can really benefit from AAA and community-based meetings because they are free, and they are often easily accessible.

So you can generally find an AAA meeting at a nearby church or community center, because of the wide stretch of AAA, you could go almost to any country in the world and find an AAA meeting in your language.

And that is really what makes it beneficial, because we don't have that privilege in the health care system.

So what do the results of this new review mean for professionals, who counsel people with alcohol addiction, I think first and foremost is that this should be on the radar screen of every clinician who treats alcohol use disorder for several reasons.

One is that you're more likely on average to increase somebody's chances of remission that can help them.

It can help their family, and it can reduce the burden on the healthcare system.

I would hope that physicians and pastors and social workers would see this study and understand how valuable AAA and 12-step meetings and community meetings can be for people that they are interacting with for their family members for their friends and I would hope that they would advocate or encourage their clients to at least try some of these meetings just because sometimes you know given our healthcare system, the people that we see who have addiction problems or struggle with addiction, don't, necessarily have the resources to go to a rehabilitation facility for 30 or 60 days.

And in the mean time they can go to an a a meeting or a meeting of sorts just to get them started.

What does the study mean for you? If you have an alcohol problem? What it means is that Alcoholics Anonymous, in fact, has a good evidence base and a good chance of improving your life it's, not a guarantee you can't make guarantees about addiction.

But the evidence is there that it is a perfectly rational thing to do to give it a try and see.

So you can take some hope from this.

If you've been wondering, you know, should I seek help for my drinking in Alcoholics Anonymous.

It is a perfectly.

Wise course to pursue.


What is the actual success rate of AA? ›

Although AA has been criticized by some sources for having a low success rate, the rate likely isn't 5% like some say it is. Addiction specialists cite success rates slightly higher, between 8% and 12%. A New York Times article stated that AA claims that up to 75% of its members stay abstinent.

Is AA the most effective treatment for alcoholism? ›

AA shines. Most of the studies that measured abstinence found AA was significantly better than other interventions or no intervention. In one study, it was found to be 60% more effective. None of the studies found AA to be less effective.

Does the 12 step program really work? ›

The short answer to whether or not the twelve steps are really effective is that they can be very helpful in aiding people on the road to recovery. The twelve step program not only helps people get sober in the first place, but also work as a great source of support for the long term.

Why AA doesn t work for some people? ›

Different people have different beliefs and needs, and an AA meeting may not align with everyone's values or personal goals. Some people may find the camaraderie and support offered by AA meetings to be beneficial, while others may find the meetings monotonous or unhelpful.

What is the life expectancy of AA? ›

AA Amyloidosis Life Expectancy

The average life expectancy after diagnosis is 11 years.

What is the hardest step in AA? ›

Those who subscribe to the 12 steps of AA recognize that for most addicts, step one is usually the hardest. Admitting you are powerless over alcohol requires a tremendous amount of courage, humility and even fear. It can bring on a flood of powerful emotions including shame, anger and grief.

What is the average length of sobriety in AA? ›

The average time of sobriety of successful AA members, as reported by AA, is more than five years.

What is the number one killer of alcoholics? ›

Heart Failure. Heavy drinking is dangerous for the heart. Alcohol can increase a person's blood pressure and ultimately cause a heart attack or a stroke.

How toxic is AA? ›

AA cells typically contain a mixture of toxic heavy metals including mercury, lithium, zinc and nickel that can cause severe damage to the gastrointestinal tract due to their corrosive nature, with mercury oxide batteries most likely to degrade and fragment.

What is the most effective treatment for alcohol dependence? ›

Cognitive-behavioral therapy (CBT) helps to identify feelings and situations that can lead to heavy drinking and teaches coping skills and stress management techniques to change the thoughts that cause a desire to drink.

Is alcoholism a disease or illness? ›

Most medical professionals agree. The American Medical Association (AMA) classified alcoholism as a disease in 1956 and included addiction as a disease in 1987.

What are the disadvantages of a 12 step program? ›

Lack of structure.

While 12-step programs can provide some structure to your life, you may spend only about an hour a week in the 12-step meetings themselves—and they typically provide little to no framework for what to do with the rest of your time.

What are the disadvantages of AA? ›

While it is true that AA does have a number of weaknesses most notably of which is the induction of feelings of guilt and to some extent helplessness in its members, even its critics acknowledge that AA does not manipulate its members for the personal advantage of any one person or group of people.

What should you not say in AA? ›

Here are some examples of things you should avoid speaking about during an AA meeting:
  • Unrelated Topics. ...
  • Controversial Topics. ...
  • Substance Use Behaviors. ...
  • Distressing or Traumatic Incidents. ...
  • Grievances or Resentments.
Oct 25, 2021

What percent of people fail at AA? ›

Some addiction specialists have claimed that AA has a 5 to 10 percent success rate. A study showed a 35% abstinence rate when participants continued to attend AA meetings for 2-3 years.

Do people outgrow AA? ›

You cannot outgrow the Alcoholics Anonymous program because it is designed with constant maintenance in mind. The AA program is designed to help people get sober but it is also designed to help people maintain sobriety and recovery in the long term.

How long can heavy drinkers live? ›

The teetotaler (0 drinks/week) and the excessive drinker (8+ drinks/week) were projected to live to 92 and 93 years old, respectively. The same person having one drink per week was projected to live to 94, and the moderate drinker (2-7 drinks/week) was projected to live 95 years.

Can you recover without AA? ›

Several recovery paths exist. These may include holistic pathways, clinical interventions, or support groups alternative to AA. Some individuals have no formal recovery support at all and still successfully resolve an alcohol or drug problem.

What does Step 7 mean in AA? ›

Step 7 asks people to humble themselves and acknowledge that they are not perfect. This is accomplished by asking a higher power to help remove these shortcomings. It is important to remember that for some people, this may involve asking God, as they understand Him, for help.

How long does it take to complete all 12 steps of AA? ›

How Long Do the 12-Steps Take? The average length of time it takes for someone to work through the 12 steps once can vary. Many 12-step sponsors encourage sponsees and newcomers in AA and other 12-step programs to attend 90 meetings in 90 days, or at least one meeting a day for three months.

What is the hardest part of recovery? ›

Relapsing is one of the biggest challenges many addicts in recovery face both during and after rehab. Cravings, stress, anxiety, and old acquaintances can all be potential threats when you're trying to stay sober.

Does one sip count as a relapse? ›

Yes. If you have been diagnosed with the chronic condition called alcohol use disorder, also called alcoholism, then the answer is, “Yes, one drink counts as a relapse.”

Can you be sober and still drink? ›

The answer to this question is not a simple yes or no. It really depends on the individual and their level of addiction. A heavy drinker may be able to occasionally have a drink without relapsing.

What to expect after 6 months of sobriety? ›

In the first 6 months of your sobriety, your body will start getting rid of toxins in order to become healthier. By the 6 month mark, your skin appears healthier. People around you notice your eyes are clearer. You've been taking care of yourself and bathing regularly, so your hygiene has improved.

What age are most alcoholics? ›

Chronic severe alcoholics average 38 years of age. They begin drinking around age 16 and develop alcohol dependence later, around 29 years of age. This group has the highest rates of drinking, consuming alcohol on an average of almost 248 days a year and binge drinking on 69% of them with a maximum of 15 drinks.

What is the most common drink for alcoholics? ›

Among the most common types of alcohol abused include:
  • Gin.
  • Tequila.
  • Vodka.
  • Whiskey.
  • Rum.
  • Brandy.
Jul 10, 2020

Who are most likely to be alcoholics? ›

Age Factors

Individuals in their early to mid-twenties are the most likely to abuse alcohol and suffer from alcohol use disorders. The younger that an individual starts consuming alcohol, the more likely they are to develop alcoholism later in life. This is especially true of individuals who start drinking before 15.

Is it OK to go to AA drunk? ›

Fortunately, AA welcomes new members whether they are drunk, high, or sober. However, individual AA groups may have their own traditions regarding attending meetings under the influence.

Why is the success rate of AA so low? ›

AA, or Alcoholics Anonymous, has a low success rate because of the difficulty of its program. Those who seek help to achieve sobriety through AA must adhere to a strict set of values and principles, which can be challenging to maintain over time.

Can AA battery acid hurt you? ›

Coming into contact with, inhaling or swallowing alkaline battery acid can cause the following: Possible eye damage, temporary loss of vision or blindness. Skin irritation or burning. Nose and throat irritation or coughing and shortness of breath upon inhalation.

What can you take naturally to stop drinking? ›

Herbal supplements like Ashwagandha, kudzu, milk thistle, and St. John's wort may reduce alcohol withdrawal symptoms and prevent cravings. Lifestyle changes, better nutrition, exercise, meditation, mindfulness, and relaxing hobbies can also help you feel better while living alcohol-free.

Is there a pill for alcoholism? ›

Three medications are approved by the U.S. Food and Drug Administration to treat alcohol use disorder: acamprosate, disulfiram, and naltrexone. Acamprosate and naltrexone reduce alcohol consumption and increase abstinence rates, although the effects appear to be modest.

What are the 4 types of drinker? ›

There are four types of drinker – which one are you?
  • Social drinking. To date, nearly all the research on drinking motives has been done on teens and young adults. ...
  • Drinking to conform. ...
  • Drinking for enhancement. ...
  • Drinking to cope.

What mental illness do alcoholics have? ›

Axis I disorders commonly associated with alcoholism include bipolar disorder, certain anxiety disorders (e.g., social phobia, panic disorder, and post–traumatic stress disorder [PTSD]), schizophrenia, and major depression (Helzer and Przybeck 1988; Kessler et al.

Is alcoholism a form of mental illness? ›

Yes. Since 1956, the American Medical Association (AMA) has identified alcoholism as a disease characterized by compulsive decision-making, impulsive behavior and relapse.

What are the pros of AA? ›

The benefits of AA
  • Meetings are free.
  • There is no obligation to join.
  • You can go as often as you wish to any meeting, in any location.
  • There are no intrusive questions or obligations.
  • You can retain anonymity.
  • Open to everyone regardless of race, religion or beliefs.
  • It creates a network of support.

Do you have to believe in God to do the 12 step program? ›

You Don't Have to Be Religious to Attend 12-Step Programs

No. While the 12 Steps were inspired by spiritual ideals, a 12-step program itself is not religious at all.

Why is the 12th step so important? ›

12 Step meetings allow you to meet others in similar situations who will reassure you that you are not alone as well as provide you with advice on how to get through obstacles that may challenge your recovery.

Is AA good for depression? ›

The research team discovered that those who attended AA meetings at a frequent rate had fewer symptoms of depression as the study proceeded. At the same time, they drank less frequently and intensively compared to those participants who did not attend AA meetings.

How does AA change your life? ›

AA meetings create a safe and caring environment where you can learn to talk about your feelings rather than drink them away. In effect, learning to “speak” these unexpressed parts of yourself into existence becomes a powerful tool that helps you take back control of your life from alcohol's effects.

What are the benefits of being sober in AA? ›

Lesser Known Advantages of Being Sober. It's no secret that being sober has many benefits over living in active addiction. They include stable neurology, increased energy, ease of falling and staying asleep, improved skin, and, of course, saving both time and money.

What are the two sins in AA? ›

there are only two sins; the first is to interfere with the growth of another human being, and the second is to interfere with one's own growth. Happiness is such an elusive state.

What are the 4 C's of AA? ›

The four C's are compulsion, cravings, consequences, and control.

What is the first rule of AA? ›

Step 1: We admitted we were powerless over alcohol—that our lives had become unmanageable. Step 2: Came to believe that a Power greater than ourselves could restore us to sanity. Step 3: Made a decision to turn our will and our lives over to the care of God as we understood Him.

What is the real success rate of AA? ›

Although AA has been criticized by some sources for having a low success rate, the rate likely isn't 5% like some say it is. Addiction specialists cite success rates slightly higher, between 8% and 12%. A New York Times article stated that AA claims that up to 75% of its members stay abstinent.

What is the relapse rate for alcoholics? ›

Unfortunately relapse rates for individuals who enter recovery from a drug or alcohol addiction are quite high. Studies reflect that about 40-60% of individuals relapse within 30 days of leaving an inpatient drug and alcohol treatment center, and up to 85% relapse within the first year.

Do people grow out of AA? ›

You cannot outgrow the Alcoholics Anonymous program because it is designed with constant maintenance in mind. The AA program is designed to help people get sober but it is also designed to help people maintain sobriety and recovery in the long term.

Who has the longest period of sobriety in AA? ›

James H. is truly a unique individual. He is ninety-five years old, sixty-six years sober, and one of the greatest "life-changers" of the past one hundred years.

How often do most people go to AA meetings? ›

The most common and most recommended frequency of AA meetings is once a week, but some people only go when they feel like they need to go, and other people go every day.

Why is AA so successful? ›

There are two basic reasons for the high rate of recovery found among A.A.'s: Alcoholics Anonymous members enter into a new relationship with a Power greater than themselves that enables them to remain sober; Through sponsorship and attendance at meetings, A.A.s spread the message of recovery to other alcoholics.

Can you drink everyday and not be an alcoholic? ›

Nine in 10 adults who drink too much alcohol are not alcoholics or alcohol dependent, according to a new study released by the Centers for Disease Control and Prevention in collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSA).

How likely is it to relapse after 1 year sober? ›

For those who achieve a year of sobriety, less than half will relapse. If you can make it to 5 years of sobriety, your chance of relapse is less than 15 percent.

Does one drink break sobriety? ›

If you're wondering, “does one drink break sobriety?” Yes, it does! If you've been diagnosed with an alcohol use disorder (alcoholism) and have abstained from alcohol, even one drink can break your sobriety. With relapse, the risk of returning to active alcohol abuse is a real threat.

Can you leave AA and stay sober? ›

I know of hundreds of people who have successfully left AA and continued in their recovery. They are not just surviving — they are thriving. One former AA member named David believes that AA provided structure long after he stopped attending. “We're all looking for a framework to live.

Is it possible to stay sober without AA? ›

Even if you choose not to go to AA meetings, you can still live “one day at a time.” When you live one day at a time, sobriety does not appear as impossible. You can focus on short-term sobriety, staying sober for 24 hours at a time.

Is it OK to leave AA? ›

The program can help some people bring order to issues like work, relationships, finances, and so forth. But not everyone. The bottom line is your safety and well-being. If you find you can have a happy, sober life without AA, there is no “law” that you have to stay.

What is the hardest month of sobriety? ›

The first week of sobriety is often the most difficult. You may experience withdrawal symptoms that last for a few days or weeks. These symptoms are uncomfortable, and the risk of relapse can be high.

What are the hardest years of sobriety? ›

The first year of sobriety will be the hardest but also the most rewarding, and it will help you feel like a new person in a new world of possibility.

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