Sunday April 20th 2014

How effective is A.A.?

I’ve recently been sifting through statistics from university research from PubMed (a public database of biomedical research) about the effectiveness of Alcoholics Anonymous.  This is in an effort to both GET HONEST about recovery techniques and to air out some of the misconceptions I have of the organization.  What I have found is that a great deal of controversy exists on the subject.  And to quote A.A.:

A.A. is not aligned with any sect, denomination, politics, organization or institution; does not wish to engage in any controversy; neither endorses nor opposes any causes.

Problems exist intrinsically by trying to evaluate A.A.  As early as 1976 researchers noted the difficulty in scientifically tracking effectiveness and critiqued the over-simplification of cross-sectional or longitudinal studies as measures of 12 step effectiveness.  (British Journal of Psychiatry ).   Another problem that exists in trying to predict and measure outcome behaviors of alcoholism treatment is that A.A. does not exist in a vacuum but is used as a modern form of treatment in combination with other interventions. Medication, psychiatric counseling and out-patient addiction treatment to name a few.

But a recent 2006 study has keenly summarized he current situation: after 70+ years since the birth of the organization, we still DON’T KNOW how effective A.A. is.   The Italian Agency of Public Health reviewed eight clinical trials for alcoholism involving over 3000 participants and found that, “No experimental studies unequivocally demonstrated the effectiveness of AA or Twelve Step Facilitation approaches for reducing alcohol dependence or problems” (Cochrane Review on Alcoholics Anonymous effectiveness); this leaves little hope of a clear picture.  Unless A.A. is ready to take its own inventory…and let the world know about it.

What is bothersome to me is not so much the lack of data on A.A., but A.A.’s disinterest in the topic.  I get the sense that the General Service Office wouldn’t touch the issue with a ten foot pole.  But as a professional marketer, I must object.  This does a great disservice to potential members.  Instead of offering facts, the organization offers promises.  Without vital information, new members go on faith alone…and the example of a handful of successful candidates who MIGHT represent 1-2-3% of those who attempt the program.  Who really knows?

This is on par with any religion.

But even without scientific statistics, A.A. members co-exist in a space of steady growth.  And who am I to say what will work for a loose body of people who come together whose primary purpose it to stay sober?  What do you think?  Should A.A. take stock?  Would this do more harm than good?  Does it really matter what a person’s statistical chances are in 100 of staying sober?  And even if it doesn’t matter, wouldn’t you like to know?

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28 Responses to “How effective is A.A.?
ambra
3:13 pm December 31st, 2008

hey. i’ve never commented before but this post kinda got me going.
Being sober isn’t something that anyone can do for anyone else. You can not expect AA to rid even one alcoholic of their addiction on its own. When you’re addicted to a substance, as i have been in my life, you are the only person that can make you sober. AA offers merely a twelve step program of support…they are the real life version of a self help book. they require only dedication for their support. Going to a therapist, medication, and AA can not change a persons habits. Its an uphill battle that each individual must fight one day at a time.
Many clinical anti depressants only show about a 3% effectiveness rate but they are often relied on in the psychiatric community. When you are struggling to get out of darkness you are the only person that can make it happen….but you can still choose the tools you may need to help you succeed.
AA is a tool.

Addiction Helper
5:39 pm December 31st, 2008

For those who are looking for addiction help its important to have resources such as AA to turn to. For a lot of people AA is the first place they would know to turn to because it’s been around so long. Even if the person needs more help than can be offered through AA it’s a good first step.

Marc
9:54 pm December 31st, 2008

Since A.A stands for Alcoholics Anonymous I don’t see how it would be possible to track any metric on its members. Also, it would not be perceived as a safe place by Alcoholics if the organization would have such practices.

Minh
12:49 pm January 6th, 2009

Having an alcohol addiction is a very difficult condition to deal with. If someone has the signs and symptoms of alcoholism, it is important to get them into effective treatment as soon as possible. The sooner an alcoholic gets into an effective alcohol treatment programme, the less likely they are to suffer from the more serious long term effects of alcohol abuse.

John
8:31 pm January 11th, 2009

Love your blog! I just started writing my own sober blog and enjoy seeing what others are writing on the subject. I am a member of AA and part of the small percentage of those staying sober. I have a group of sober friends who are serious about their recovery and we have all had great success with the 12 Steps, I feel that AA is an important institution because it is widely known and offers anyone the opportunity to get sober anonymously. I agree with Marc’s comment that it would be a problem for AA to keep statistics like that. However, I am also of the belief based on my own experience that more is required to live a happy life in long term sobriety. AA and the 12 Steps are an essential foundation for my program of recovery and always will be, but I find I need to go further today to really dig deeper into my core issues. Other modalities are presenting themselves in my life and AA has helped me to be open-minded to try them out.

scott
4:35 am January 19th, 2009

Hi Lee

Appreciate the article.

First, Alcoholics Anonymous adheres to a strict set of 12 Traditions that, I believe, are divinely-inspired. One Tradition states that AA is based upon attraction rather than promotion; which suggests that the alcoholic will only come to AA when he is ready, not because some slick marketer has sold him on the programme.

In addition, anonymity is the spiritual foundation of all the Traditions; thus, marketeers will likely never be able to measure AA’s recovery success rates as the anonymity of its members are a central tenet to the success of the programme.

So, marketing practitioners: hands off! The only marketing necessary is the literal truth imparted from AA’s recovering alcoholics to those problem drinkers who still suffer. That, my friend will sell AA to those who truly want it.

DWIGHT TWALA
8:57 am May 5th, 2009

My name is Dwight Twala i am 25yrs of age , i really need help my main problem is that whenever i tell myself that i wont drink alcohol on a weekend i end up doing it . what is so sad about it is that i end up letting down my parents my girl friend and my three year old child i really do want to quit but its just that it becomes very difficulf to do a way the habit one of my friend told me that all habits die hard i dont think thats true , i think i can do this i know i can quit drinking i just need good advise i dont think i will be able to let my parents, my child and my girlfriend down anymore cause i have noticed one think there is really no achievement in drinkink the only problem is to kill this habit but i find very difficult to do so, Please Help

John Fitzgerald
10:35 pm May 19th, 2009

Well stated about AA! I have a lecture on addiction last night and as usually happens, there is always someone in the audience who objects to my comments about 12-step programs. Even when I preface my comments with a general statement that mutual support in groups is good, as soon as I begin to discuss some of the down sides of self-help groups it always get ugly. Check out my comments on addiction treatment: http://www.addictionmanagement.org

5:36 pm June 25th, 2009

Hi Dwight. I’m sorry to hear that you’re in the middle of this addiction. I can only suggest that you go to A.A. groups…because it’s a good start and it worked for me. Check their site at: http://aa.org

Mike
3:37 pm June 29th, 2009

Hey, thanks for the post.

the only promises that I know of in AA are the ones that will happen if you remain sober, attend AA Meetings, and communicate openly and honestly. AA doesn’t guarantee anyone will STAY sober, they are offering a chance for those who have an honest desire to stop. So, asking or requiring an “Anonymous” program to open up its ‘books’ to show it sucess rates is, in my opinion, impossible. Asking someone to identify themselves for ‘tracking’ purposes is setting that person up for failure. The pressure for some can be too much if they know they are being tracked like that. God willing, I am coming up on my 17th year of sobriety in the immediate future. I don’t take it for granted and honestly if you ask me what has kept me sober I could not give you a definitive answer except to say that when I needed the AA program to be there for me it has ALWAYS come through.

Not much more can be said about other people, places or things.

Sean
4:26 am December 10th, 2009

A.A. is NOT effective. I speak from experience and empirical evidence suggests this to be true. Of course, I’m an ATHEIST, not an agnostic. AA’s origins go back to a religious conception and it says so in the big book. AA’ers quit fooling yourself. It IS a cult/religion. If you are praying and believing in higher powers and what ever you are subscribing to a religious point of view. Sorry to put it so plainly, but it is true. The majority of the people who go into aa are not sucessful and perhaps it has something to do with grappling with your religiousity. What is sad is that people actually buy into this. It’s like Santa Clause and all the other lies adults tell to children. I conquered a drug and alcohol addiction and after really seeing aa is nonsense, I started anti-depressants, have a good diet and exercise program and work hard at a good job. I haven’t touched anything in 5 years. If you want to believe in something, try believing in yourself. If you are having problems that make you use, find out what it is and correct it and get on with your life. Be reasonable and use common sense. You’ll be surprised how you’ll bloom. Remember, we all boil at different degrees.

Dr. Judith Miller
11:34 pm December 15th, 2009

AA – is a great support system and has been around for a long time and been the crusader for sober living. However, science is now understanding the root cause of addiction – and that is brain disease. Once the neurotransmitters are balanced – then the addictive cravings decrease and then and only then can counseling/therapies and AA be successfully for what they were intended to be support systems and providing tools to live a sober life.

This is a fascinating time to live in – and science is providing many answers not just for addiction to alcohol and drugs – but for all compulsive behaviors. Neurology, biology and physics will also prove that other physical and mental illnesses are also due to imbalances in the brain. Many of these imbalances are caused not only by substance abuse – but also from environmental toxins. It is time to clean up and wake up!

People need to understand that we live in an addictive society – and to choose a sober life takes a strong individual. In the past these people were regarded with doubt because they had a “problem” and were in “treatment.” Today we can look at recovering addicts with pride – because it takes a great deal of strength to choose sobriety in an addictive culture.

Maria
11:11 am February 12th, 2010

AA can be effective only for religious people and disciplined people. Sometimes AA meeting can become addiction of its own, but in this case it’s a positive addiction.

Kennedy
8:55 pm February 27th, 2010

AA has been a great tool in my sobriety, but some aspects are missing in my recovery like programs that focus on getting my life in order regarding finances, relationships, marriage, and day to day stressors that the addict deals with. I would recommend a program called The 13th Step.

David MC
5:18 am March 10th, 2010

Many people everyday try AA unsuccessfully but there are many success stories as well . Actual success depends on an individuals mindset or desire to quit. The only person who can make that decision for you is YOU . Long time members say that a person will only come when they are ready so trying to force someone into the program is a lost cause. The AA program will work for many people but there definitely are exceptions as there are in all things. Strict adherence to the suggestions made at meetings and an overall willingness to swallow your pride are a must. You will be told that it is a spiritual program not a religious one but the religion can get pretty heavy so be prepared and go with an open mind. People will tell how they managed to say sober with their faith and whatever,but remember this is only their opinion no one can tell you what to believe or how to come to a conclusion about what you are hearing. You can stop drinking if you are willing to go to meetings and stop drinking one day at a time. Remember you only have to stay sober to-day we’ll worry about tomorrow when it gets here. Stay sober to-day and you have it made because everyday is to-day. I personallly am a relatively new member who never thought i could quit for a day and its been three and a half months so there is hope for just about everyone. GOOD LUCK

12 stepper
6:27 am March 15th, 2010

If you’re not an alcoholic whose actually worked the 12 steps with a sponsor, not just sat in the back of a few meetings you cannot evaluate the effectiveness of AA, period. We have a saying that the only way one of us will drink after working the steps is if we fail to maintain our spiritual fitness which is a daily process laid out precisely to us in the program. If I were to relapse, which I have not, the blame would only be on myself for not using the tools laid out so clearly to me. If you doubt the effectiveness of AA and the 12 steps you probably have never worked them, or possibly relapsed and want to blame someone else, or your’e someone who could make lots of money off an alcoholic who chooses not to go to AA. The best things in life, AA included, are free.

Jake
7:43 pm March 31st, 2010

Well it looks like this convo, halted a while back, but i feel i should say something.

AA only works for those who work it, like therapy, or even like a job. AA is a set of ideas, guidelines, and a community to help you threw your addiction. At first i hated it. I would say that i did not even have to be sober, after a year of drug abuse, and alot of lack of trust, i said AA was a cult, and the only reason why i went was couse freinds, and family, and my school cared about me and said give it a try. I relapsed 5 times in the course of 4 months after treatment. It was not AAs, fault it was problem with honesty, and lack of effort for my recovery, i decided to give aa a try, and my life could not be better, i have a community, and a great guide of morals, to live by, i do dislike some of the things they say, like its the only way to be sober, but those are certain people and not the movment its self. Like any medications, treatment, thearapy, or support group, you have to do the job of getting it. Well with meds its more up to the way your brain reacts. But with illness like addiction. this is a great thing for people. Those who do not get sober, usally do not want to be, or are doing nothing about it. Like with any problem, you have to do something. AA mainly is good, and i hope the people who do not like it, find another way to be sober. But for me, its works well.

Teresa Billinger
8:18 pm April 16th, 2010

This a question that is coming to service more so now than ever. I do believe that AA has it’s strong points but on the other hand I was told in NA that with recovery comes relapse…well that is like telling a thief when the alarm system is going to be turned off. So what did I do but used again and spiraled farther into my drinking than ever.

But on the other hand…working the steps, meeting others who were struggling with the same addictions and finding my place of serenity was awesome. I just chose to move forward and out of my addiction and become powerful not powerless. I grew past it I guess where they said I never would. HMMMM!!

So I guess it is good on some aspect but I agree it should be used along side other forms of treatment and not solely alone as a treatment. Maybe some revamping of the big book might be in order…as hard as it is to change a legacy…sometimes things change and grow and so needs to the inside workings.

LIVE~LAUGH~LOVE

Jane Derry
8:58 pm May 31st, 2010

You’ll get as much out of AA as you put into AA.

downloader
11:40 pm July 1st, 2010

Wow! Thank you! I always wanted to write in my site something like that. Can I take part of your post to my blog?

Jim T.
12:50 pm August 7th, 2010

All medical evidence suggests that AA is the ONLY thing with a proven track record. Having said that, I do not subscribe to the thought of keeping “statistics” on members “success”. Progress in ones own recovery depends solely on willingness to believe in a power greater than ourselves. Willingness to take action and willingness to pass that on with no recognition . Humility is essential. Can you imagine keeping a record of relapses and posting them on line for all to see? If the newcommer is to continue to enter AA, anonymity must be ABSOLUTE!

Jim T.
Delray Beach, FL.

Jana Burson M.D.
10:46 pm August 16th, 2010

I always recommend 12-step meetings to my patients, because there is considerable evidence to prove these meetings help. In fact, studies of AA’s effectiveness have been conducted since 1945.

A metanalysis of thirty-three studies, done from 1945 until 1990, shows a positive association between the frequency of AA meetings attended by an alcoholic and increased abstinence from alcohol. In other words, an overall summary of these studies shows that the more AA meetings attended, the more likely the alcoholic stayed sober. (1) However, there were two of the thirty-three studies that showed a negative association, meaning that more AA meetings was associated with less time of sobriety. At times, organizations that oppose Alcoholics Anonymous quote one of these two studies and give no information about the other twenty- nine studies.

Of course, it may be that alcoholics who are more motivated to stay sober go to more AA meetings, and the number of meetings attended was thus a marker of commitment to sobriety. Was it the degree of motivation of the person, rather than the AA program, that produced the better outcomes? Later studies done in the 1990s controlled for the degree of personal motivation, and still showed a positive correlation between number of meetings attended and sobriety. (2)

Later studies looked not at the number of AA meetings attended, but rather the degree of involvement of alcoholics in the AA program. Several studies showed that the degree of involvement was a more important determinant of length of time of abstinence from alcohol than just the number of meetings attended. Multiple studies, looking at outcomes other than abstinence from alcohol, have found that AA attendance was also associated with emotional well-being, serenity, and finding purpose in life. (1)

AA has never claimed to have all the answers or solutions. (3) Strangely, most alternatives to twelve step recovery use as their main selling point, “Not like Alcoholics Anonymous.” I have read books authored by people who seem quite bitter that AA did not “fix” them, as if AA had some obligation to do so. Twelve step recovery programs don’t force membership on anyone. In fact, the only way to become a member is to say you want to be a member.

So… if 12-step meetings help, great.

If not, then don’t go.

They have helped about two million people worldwide, but they don’t work for everyone. Thankfully, there’s more than one path to recovery.

1. Tonigan, J. Scott, “Alcoholics Anonymous Outcomes and Benefits,” in Recent Developments in Alcoholics, Volume 18, Research on Alcoholics Anonymous and Spirituality in Addiction Recovery, edited by Marc Galanter and Lee Ann Kaskutas. P 357-372.
2. McKeller J, Stewart E., Humphreys k, “Alcoholics Anonymous and positive alcohol-related outcomes: cause, consequence, or just a correlate?” Journal of Clinical Psychology, 2003, April, 71 (2) p 302-308.
3. Alcoholics Anonymous, 4th ed., (often called the “Big Book of Alcoholics Anonymous”) Alcoholics Anonymous World Services Inc., New York City, 2001, p 164.

sleepyshepherd
2:38 pm October 18th, 2010

I can think of one very good reason that AA is successful and that is the very fact that it is anonymous. It takes a lot of courage admitting that you are an alcoholic because with it comes the shame and guilt of all of the things you have said and done to loved ones and friends. A person with an alcohol addiction or any other addiction can only step into recovery and stay there if they can count on a support system. Most of the time everyone the alcoholic knows is also an alcoholic or addict; the very existence of AA makes it possible to obtain support and to spend time with other people who can relate to him without worrying about the things that he shared getting spread throughout to his community. You will not find any data on the statistics of members or club business; the fact that AA has been around for so long and do have people who talk about it, and their success stories of years in sobriety should satisfy the question of its legitimacy.

Does it work for everyone? I believe that AA is an organization that should exist because it has helped so many people get sober and stay that way; it did not work for me. I was a hopeless alcoholic beginning in my 20’s up until 1995. When I first went into recovery I was isolating myself from my friends and just about everyone because either my friends triggered me or I was just afraid to go out sober. I realized that it was not healthy for me to cut myself off from the world and had heard of AA and decided to give it a try.

The first meeting was fine because I had the opportunity to cry about it and get a lot of things off of my chest and a better outlook for my future; however, any of the subsequent meetings I attended would cause me to experience these almost uncontrollable cravings and the longer I sat in a meeting the more likely I would leave there straight to the liquor store – this happened 3 times. Yet any other day or time, I would be able to re-focus on something else by journaling or listening to music on my headphones. I found that every time I started to think about going to an AA meeting, I would start rationalizing that it had been a while since I drank and that I was in control and could have just one drink and stop.

This may sound funny but it is true; during times of weakness along with my other “tools” to stay sober, just the idea of AA got me through another day. Signed, sober going on 11 years.

Typo
9:11 pm November 3rd, 2010

Thanks for this interesting post!

What’s always struck me with AA is the message that if you have one single drink you’re right back where you started. It sounds so scary to me. One slip up, and all that hard work down the drain!

Signed,
Typo

PickledGherkin
7:25 pm January 26th, 2011

AA is a dangerous cult. Read the Orange Papers. Read stinkin-thinkin[dot]com. AA spreads dangerous lies. Alcoholism is not a disease.

pressingtheissue
12:04 am January 27th, 2011

I’m a recovering Heroin/Cocaine/Alcohol addict and have been told countless times to go to N/A and A/A every day. I first went to N/A a few years back and was approached by a drug dealer there. I used that night.. I found out that this is not an isolated incident. I then was advised to go to A/A and just say that I was an addict. For some reason it seems to do me more harem than good. All I could think about was getting loaded! I really believe that It’s not for everyone. I’ve been fine with out it, others may need it. Remember addiction is different for everyone!Check out my site, pressingtheissue for more info. Just click on my name above!

jerry
6:40 am February 2nd, 2011

AA requires surrender and willingness but suppose you are not able or capable of surrender–suppose you are oppositional defiant and rebellious-are you doomed or is there other paths-
I propose that many people get long time clean and sober and get high again and state they have relapsed but i believe that most people that relapse have never really relapsed due to they never recovered!
My reasoning goes like this-Addicts by their nature or just habit “just do what they want to do-when they want to do it-with who they want to do it with- anytime they want to do it.” This means that most addicts that believe they relapsed never relapsed because when they did not want to do drugs or drink they stopped and stayed stopped till they no longer wanted to do “recovery” and wanted to do “addiction” again. This means that there was no qualitative change in their thoughts or behaviors- for they wanted to use drugs and then they wanted to stop and stayed stopped till they gave into the wants again to get high and they got high. this means they are just doing what they want whether it is to use or not to use -it is all the same psychic pattern.
An addict has to learn to resist their own impulse to not do something and then they have changed-meaning when they learn to force themselves to attend meetings or go to church or what have you-then that person has changed;but any person that has never learned to resist their own impulses has never recovered and therefore could never have relapsed. A person who loves recovery and going to those meetings and making coffee or calling sponsor is someone doing what they want to do and nothing more or less-nothing has changed in any spectacular ways-but the person THAT FORCES THEMSELVES TO TAKE RECOVERY ACTIONS–IS developing strong resistance to acting on impulse and they are in RECOVERY-only for as long as they do what they don’t want to do-IN the end the only thing that will protect someone is if they have the ability to resist the offer or opportunity to get high or do drugs. The more we practice forcing ourselves to take recovery actions the stronger we become-we are taking the Rebelious-Defiant-Oppossitional behavior and making it an asset instead of a liability.it should be especially noted that when a person admits “powerlessness and surrender as well as unmanageability” does nothing to improve or build self esteem or sense of self worth or give them a sense of personal value that would be a deterrent from using drugs BUT the person who challenges themselves and forces themselves to take recovery actions that they do not want to do then when they overcome their on desires or feelings or impulses–THAT person experiences increase in Self Esteem-any time we force ourselves to do the right things automatically builds and increases Self Esteem.

karen mcmullen
12:07 am March 8th, 2014

This blog hasn’t been updated since 2011, so on 3/8/14 I wanted to say something. i wonder what happened to the guy that couldn’t stop drinking on weekends. Wish he was still writing. I have been in AA since 1985 and if it were not for meetings, and support of the program, change, and learned to handle my cravings, and most important , stop drinking. I tried other programs but AA has the most people, so that means the most information on how to stay sober. The knowledge in AA is unbelievable, thousands of men and women, who have found a way out of the hell of alcoholism. i thought I would of die a drunk but this program gave me a way out of the bondage of the drink. The best thing is that it’s free. Where in this day and age is there a place to learn about yourself, that is free or a dollar if you choose to put in a basket. So come aboard to the most successful program dealing with alcohol. If you don’t like us, we return your misery and hope that we will someday see you again. Our doors are always open.

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