- A new study concludes that the Alcoholics Anonymous program is the most effective way to treat alcohol use disorder.
- The researchers said people who complete the organization’s 12-step program have better success at abstinence as well as relationships with family members and friends.
- They add that Alcoholics Anonymous is free and doesn’t require making appointments or filling out insurance forms.
Alcoholics Anonymous (AA), the worldwide fellowship of sobriety seekers, is the most effective path to abstinence.
So says a study published today in Cochrane Database of Systematic Review.
Keith Humphreys, PhD, one of the study’s authors and a professor of psychiatry and behavioral sciences at Stanford University, acknowledges he was once one of the many medical professionals skeptical of the effectiveness of AA.
“I used to think, ‘How dare these people do things that I have all these degrees to do?’” he told Healthline.
But as years went on, Humphreys noticed that his patients who were most successful in sobriety all had AA in common.
So, he changed his view and hopes the release of this study helps others do the same.
“I would like people who make the mistake I did — assuming that something nonprofessionals developed can’t be any good — to learn that they are wrong,” Humphreys said.
“I also want anyone out there who is struggling with a drinking problem to know that the best science we have shows that AA is indeed helpful and is worth giving a try,” he said.
Humphreys and his co-authors chose to publish in Cochrane, he says, to drive home the importance of the results.
“Cochrane Reviews are the gold standard in medicine for integration of all the research about a particular intervention,” Humphreys said. “We wanted to do this work through Cochrane because of its rigor and reputation.”
Humphreys’ team evaluated 35 studies involving the work of 145 scientists and the outcomes of more than 10,000 participants.
They said they found that long-term patient outcomes were better across the board when AA was part of treatment.
This backed up what Humphreys had been seeing in his clients.
“I spent a lot of time in my first research project following up former patients and was struck at the pattern I observed: The ones who got connected to 12-step groups were simply doing a lot better, not just in terms of stopping substance use but also in having better relationships with their families and feeling more fulfilled in life,” he said.
“The other thing that struck me is that treatment comes and goes. Maybe it’s a month or a couple months but then people are on their own,” he said.
“In contrast, I would meet people who relied on AA as long as they needed to — years or decades even. That made me realize AA was better matched to the realities of a chronic disorder, like addiction, than were the treatments I was trained to provide,” he explained.
Suzanne, a healthcare professional who overcame addiction and will soon celebrate 10 years of sobriety, isn’t surprised by the study’s conclusions.
“What AA brings you is real accountability, and accountability from those who truly get it,” she told Healthline.
Suzanne says she tried both counseling and AA over the years and found AA was, for her, the best fit with the best results.
“A big part of it is, to put it bluntly: no bullsh*t,” she said. “You try it and someone is going to call you out on it. And being called out on your bull by an understanding community is just what you need.”
“Mind you, a therapist is great,” Suzanne added. “I think everyone should have one. But therapy is only as good as what you give them. If you spin it, you might not get called out. AA is all about peer pressure, positive peer pressure.”
There’s another big bonus of AA that Humphreys points out.
It’s free and always has an “open appointment,” so to speak.
“Addiction is a chronic disorder, and no matter what kind of help people seek, they often take two steps forward and one step back until they get into stable recovery,” he said.
“In AA, this is easier than it is for professional treatment because you don’t have to fill out any forms or get your insurance company to say it’s OK. You can just pick yourself up and give it another go whenever you want,” Humphreys said.
Suzanne notes she has excellent health insurance, but she could see how having to see a doctor, get approval, and then book an appointment would slow down recovery.
With AA, you walk in the door, she says, and it’s done.
“I cannot imagine how things would be for some people I know who have been quite successful in AA,” she said. “A lot of people I have met would not be able to do this were it not free.”
“We know that fewer than 1 in 10 people with alcohol use disorder (AUD) receive any help in a given year ,so it is encouraging that the evidence appears to support the potential benefits of AA,” Koob told Healthline.
“We recommend that clinicians and consumers make decisions about treatment for AUD based on scientific evidence, and this carefully conducted meta-analysis suggests that AA should be on the list of options to consider,” he said.
Koob points out that treatment success can vary from person to person.
“The symptoms of AUD vary from person to person, so it is not surprising that the effectiveness of treatment approaches varies among individuals, too,” he said.
“For some people, one treatment approach may be sufficient while others may need a combination of therapies. NIAAA offers a resource called the
Humphreys hopes to continue research and is gratified that this study backs up AA as a worthwhile approach.
With marketing campaigns around expensive treatment programs and options, he says, it’s rewarding to see that AA works.
“AA itself doesn’t do any marketing, but profit-driven treatment agencies do, including in ways that may muddle the AA message,” he said. “So it’s worth remembering that AA itself is free of charge, and you don’t need to go to an expensive rehab program to gain access to it.”
It’s also, Suzanne says, a model for all kinds of other treatments.
“We have support groups for everything now, and that’s a good thing,” she said. “You know, person-to-person support groups really were born from AA. So the program is helping everyone.”
