Alcoholics Anonymous (AA) was founded in 1935 as a way for alcoholics to get clean and stay clean by working through a program of 12 steps and by getting social support from other alcoholics. Today, AA is still going strong and is a popular program for many people struggling with addiction. The 12 steps have inspired many other groups, like Narcotics Anonymous and Gamblers Anonymous. The steps are used by people with all types of addictive disorders.
The effectiveness of the 12 steps as a treatment for addictive disorders is not fully understood. Research has been contradictory, but individuals who swear by it and anecdotal evidence show that it is effective. The 12 steps and their associated programs may work very well for some people and less well for others. For anyone struggling with addiction it is important to remember that this is a disease that can be treated with evidence-based strategies and that the 12 steps can be a component of that treatment.
What is AA?
AA is an international, non-profit group that is available in most places around the world. The group describes itself as a fellowship of men and women that has no affiliations with any political or religious group and that has no restrictions on who can join. Anyone trying to stop drinking alcohol or drink less is welcome at the meetings.
The group was founded in 1935 by two men, Bill Wilson and Bob Smith. They both struggled with drinking and Wilson used his Christian faith to get sober. His transformation inspired Smith to stop drinking, and together the two wanted to help others do the same. They published the book, Alcoholics Anonymous, which included the 12 steps still in use today.
People attend AA meetings, which are completely free and available to anyone who walks through the door, share their personal stories, read from Wilson and Smith’s book, talk about the 12 steps, and celebrate and encourage each other’s sobriety. Members are supposed to work through the 12 steps, really engaging in each step and making concrete changes before moving on to the next one.
The 12 Steps
The backbone of the AA program is the process of going through the 12 steps. Some other groups have adapted these steps, but they are mostly the same across many 12 step programs:
- Admit to powerlessness over alcohol and addiction.
- Recognize that there is a higher power that can help restore sanity.
- Decide to turn one’s will over to that higher power.
- Make a deep self-examination to identify past actions that cause regret, anger, or shame.
- Admit past bad behaviors to others.
- Be ready to let a higher power help correct defects of character.
- Ask the higher power to repair or remove shortcomings.
- List all the people wronged because of alcohol abuse.
- Make amends to those wronged, unless making amends would harm anyone.
- Continue to recognize and correct shortcomings and mistakes.
- Pray or engage in some other spiritual practice, such as meditation.
- Communicate the message of the 12 steps to others who need help.
It is important to note that although the founders of AA were Christian, the modern group does not require members to be Christian or even to believe in any god. The spiritual requirements, such as a belief in a higher power, may be any kind of personal spiritual or religious belief.
The Effectiveness of the 12 Steps
The 12 steps used in AA and other programs are not supposed to be worked through quickly. The point is to really engage in self-reflection and spiritual practices to continually evolve and become a better person, while also maintaining sobriety and helping others do the same. Any breezing through of the 12 steps with no real effort will not be effective. Whether or not completing the 12 steps as they were intended is effective in overcoming addiction is uncertain.
Studies that have tried to determine the effectiveness of AA or the 12 steps have come to mixed conclusions. One issue is that there is not necessarily consistency from one set of meetings to the next, so giving an overall effectiveness rating for AA is challenging. One study compared a group of problem drinkers who worked through the 12 steps with help from a therapist with two other groups who were given other types of therapy. Those doing the 12 steps fared just about as well.
Another study found th76at attending AA meetings and going through the 12 steps is significantly more effective than trying to quit drinking with no assistance at all. Other studies have shown that the more involved people are with AA meetings and the more they attend them, the better their outcomes are, as compared to those who are not very involved.
Problems with 12 Step Programs
While there is some evidence that AA and 12 steps programs can help some people abstain, there are some issues with it. For instance, some people find the spiritual element off-putting, finding it difficult to get past step two. Another issue is that within the first few meetings attended, 40 percent of people drop out of AA. When AA or the 12 steps are used to supplement professional treatment for addiction, it can be very helpful, but the traditional way of approaching AA has no room for medical treatment or therapy, and this can be a problem.
Traditionally, AA is supposed to be a complete treatment program that involves no professional evaluation or therapy and insists upon complete abstinence from all drugs and alcohol. Overwhelmingly, addiction research shows that there are specific elements of treatment that work and these include behavioral therapies, medications, and individualized plans. None of this is allowed in a strictly traditional 12-step program.
While the evidence from research of 12 step programs will likely continue to be mixed, there is no doubt that a lot of people get benefits and support from using the 12 steps and attending meetings. If you or someone you love is struggling with addiction, a 12-step program may be one important tool in overcoming that addiction. Just remember that treatment involving a doctor, therapists, and other mental health professionals is the best way to find success in conquering addiction.