Alcoholics Anonymous: Is it a Form of Addiction Treatment?
Alcoholics Anonymous (AA) is an organization designed to help those struggling with alcoholism to stop drinking and maintain sobriety. Founded in 1935 by Bill Wilson and Dr. Bob Smith, the group was reported to have over 2 million members worldwide in 2015. And though AA is well known, and many members testify to its role in helping them, there is a great deal of debate among lay people and professionals about just how effective AA is.
Is AA treatment?
“Treatment” is traditionally defined as a healthcare service delivered by a trained professional in a clinical setting. Prior to founding AA, both Bill Wilson and Dr. Bob Smith had received professional treatment for their severe alcoholism and had been unable to sustain sobriety. Yet they grew to share a powerful experience helping one other abstain from drinking and sustain their sobriety. This recovery formed a critical cornerstone of their approach to AA. Thus, AA was developed intentionally as a peer-delivered mutual self-help model and not as a professional treatment model.
Many people suffering from alcoholism have been helped by AA either as an alternative to or in addition to professional treatment. Because AA appears helpful to many people with severe alcoholism, many of its principles have been adopted by professional treatment programs, especially those following the Minnesota Model (for example, Hazelden/Betty Ford). Other forms of professional treatment which emphasize AA principles or techniques have also been studied and found effective, including Twelve-Step Facilitation Therapy or Individual/Group Drug Counseling. Most addiction treatment providers and many healthcare professionals will also recommend AA or other peer self-help meetings as an addition to professional treatment.
We know AA works for many people: But why?
For much of the history of AA, research on its inner workings and effectiveness was limited due to the anonymity of its members, with only self-reported accounts of abstinence from some members available for examination. Without hard evidence for such a long period of time, the effectiveness of the program has been questioned, despite the large body of anecdotal evidence of AA being an integral part of successful recovery for many members.
Yet in the past few years, research on AA has expanded. Recent studies have shown that AA can be a helpful addition to treatments like cognitive behavioral therapy (CBT) and naltrexone. Other forms of testimony to the effectiveness of its approach include its world-wide availability (there are currently meetings in 170 countries) and its extension to all forms of addictive behavior, including Narcotics (NA), Cocaine (CA), Marijuana (MA), Overeating (OA), Gambling (GA), Sex (SAA), and Co-dependency (CoDA).
New research suggests that AA helps many people struggling with alcoholism not only because of its spiritual component, but for the lifestyle changes it encourages and supports. Though spirituality has shown to be helpful for individuals in AA to achieve and maintain abstinence, there are other reasons the program appears to be effective for many people: new, supportive social networks free of contact with alcohol. These support networks are useful for a number of reasons.
A new network of people in recovery helps protect individuals with alcoholism from being exposed to alcohol in social settings. Though this may seem obvious, many people in recovery try to minimize the environmental cues or social situations that greatly increase their chances of drinking or wanting to drink. This can be difficult because, in many cultures like ours, many adult social activities involve alcohol use. By spending more time with individuals who are abstaining from alcohol, AA members are able to effectively reduce their exposure to these environmental cues.
AA: The social network
A social network of abstinent and recovering individuals may help motivate behavioral changes and provide role models for healthier and happier living. As a support group, AA seems to help those with alcoholism fundamentally alter the way they view themselves, making them more confident in their ability to stay sober. Indeed, scientific studies as well as individual testimonials show that AA can be an integral part of recovery from alcoholism.
Max Dorfman, MA
Max is a Science Writer at Center on Addiction