What is Alcoholics Anonymous? 12-Step Effectiveness & How It Works

Alcoholics Anonymous (AA) is a free peer-run fellowship where alcoholics help one another achieve and maintain sobriety. The organization uses a structured 12-Step program based on personal accountability and spiritual growth.

In this article you’ll learn the origins of AA and the 12-Step movement as well as their core principles. We’ll go over the meeting formats and options that await when you enroll. These programs have had much success, and you’ll read about the factors that contribute to the organization’s achievements.

Lastly, you’ll learn how to find treatment near you. This includes resources to find the best fit for your condition.

Key Facts

• AA is a personal and spiritual development program; it doesn’t promote any religion.
• Anonymity and mentorship (sponsorship) are core program principles.
• Open, closed, and specialized meetings assure comfort and safety when sharing.
• Engagement and regular meeting attendance promote success.

What is Alcoholics Anonymous?

Alcoholics Anonymous is a peer-run fellowship that’s supported through voluntary contributions and open to anyone desiring to address their alcohol addictions. AA has chapters in 180 different countries with millions of active members. While spiritually based, AA doesn’t promote or favor any religion.

A Brief History Bill W, Dr. Bob & the Big Book

AA started in 1935 in Akron, Ohio, when Bill W. and Dr. Bob S. met at an Oxford Group meeting that explored spiritual values in daily life.

The men supported one another in their struggles with alcoholism and soon began helping others. In 1939 Bill W. wrote the Alcoholics Anonymous guidebook or The Big Book that outlined the 12 Step recovery plan that he and Dr. Bob had developed.

Fellowship, Anonymity & Inclusivity Explained

In 1946, Bill W wrote in the AA’s Grapevine magazine an article titled “Twelve Suggested Points for AA Tradition.” The article outlined guidance for the growing AA organization. These suggestions were adopted in 1950 at AA’s First International Convention. They became known as the Twelve Traditions.

A key concept of the Twelve Traditions is principles before personalities. It means that privacy and stigma free sharing should be prioritized over personal opinions or preferences. This value is evidenced by AA’s growing diversity with women’s groups, LGBTQ groups and BIPOC groups that are now common.

How Alcoholics Anonymous Works

AA operates through fellowship and close bonds with your sponsors and peers. You support each other when temptation strikes and when times get rough. By relying on spiritual and peer guidance, you can overcome inner trauma and the desire to drink.

The 12 Steps Purpose & Overview

AA’s 12 Steps are a set of action steps in a progressive framework that builds toward addiction recovery. Self awareness, daily practice and service to others are emphasized.

12 Step concepts include the following:

• Admit your powerlessness over alcohol which has made your life unmanageable.
• Believe that a Power greater than yourself can restore your sanity. Commit to turning your life over to that Power.
• Make an honest inventory of your character flaws and ask your Higher Power to remove them.
• When possible, make amends to people you have harmed.
• After obtaining a spiritual awakening, help other alcoholics and continue practicing 12-Step principles.

The 12 Traditions – Keeping Groups Healthy

AA’s 12 Traditions provide guidelines for relationships among members and in society.

Key concepts are outlined below:

• Prioritizing AA’s common welfare over personal considerations strengthens AA unity and increases the likelihood of personal success.
• Group autonomy, secured through a non professional, self supporting model, safeguards AA’s primary purpose of helping alcoholics.
• AA’s public relations strategy of “attraction rather than promotion” safeguards anonymity.

Sponsorship: Role, Benefits & Finding a Sponsor

AA sponsors are members who mentor newcomers by often helping with Step work. One-on-one mentorship accelerates Step work, increases accountability and supports relapse prevention.

Formulating clear expectations between a sponsor and the sponsee is crucial. Pairings with same-sex preferences are advisable because this circumvents romantic involvement and allows recovery goals to be prioritized. Members can change sponsors if their needs change.

Service & Giving Back to the Fellowship

AA philosophy advocates recovery through service with no service deemed higher than another. The member making the coffee at meetings is an equal peer to all AA administrative representatives, including group, district or area officers and the general service officer.

The various officers share information and coordinate between groups. The GSO oversees the entire AA organization and handles public relations.

The AA expression “We keep what we have by giving it away” asserts that serving others increases inner resources, improves self esteem, creates a sense of purpose, and fosters long term sobriety.

AA Meeting Formats & Accessibility

While members may be equal, that doesn’t mean that all meetings are the same. Specific dates may be reserved for special occasions or for selected demographic groups. Here are some common types of formats for AA branches.

Open vs. Closed Meetings

Open Alcoholics Anonymous meetings welcome everyone, both members and interested observers. Closed meetings are reserved for AA members and newcomers who desire to stop drinking.

During open AA meetings, visitors should remain on the topic of recovery from alcoholism. Newcomers at closed meetings aren’t required to speak but are welcome to, if they wish.

Common Formats: Speaker, Discussion, Literature, Chips

AA speaker meetings require that members share their personal experiences of recovery to offer hope and inspiration.

Specialized Meetings (Women, LGBTQ+, Young People, Language-Specific)

Specialized meetings provide safe spaces for sharing and can reduce cultural or language barriers. You can find these and other meeting formats on the AA website. Specialty meeting formats may be noted with a symbol or abbreviation.

Directories and community centers that serve shared-affinity groups may be sources of specialized AA meeting information.

In-Person, Online, Phone & Hybrid Options

Alcoholics Anonymous meetings are available in person, online and via teleconferencing using platforms such as Zoom. Asynchronous forums, or online discussion platforms where you can post at different times vs. in real time, can be helpful for people who live in remote areas or have mobility issues.

If using real time teleconferencing, remember to turn your camera on, mute your microphone when not speaking and only use first names to preserve anonymity.

Effectiveness, Research & Criticisms

While AA has had a long history and extensive list of programs, not everyone who has participated in AA succeeded.

Some critics and past clients have argued that AA is either ineffective or outmoded in favor of evidence-based practices. Here are some critiques directed toward Alcoholics Anonymous.

Evidence on AA Success Rates

A 2020 Cochrane Statistic review found that Alcoholics Anonymous and other 12 Step programs using manuals with well-defined clinical strategies designed to increase group participation were more effective than cognitive behavioral therapy in promoting abstinence.

A shift in social networks from drinking to non-drinking friendships often occurs when people become engaged with AA. Attending 90 meetings in 90 days and having an active sponsor relationship were predictors of higher one-year sobriety outcomes.

The Cochrane review also noted that AA and similar 12 Step Programs are more cost effective because they use volunteers for group facilitation and have more scalability factors, like online meetings and diverse meeting formats.

Common Critiques & Limitations (Dropouts, Spiritual Objections)

This 40% statistic is possibly due to a perception of religiosity that deters some members. In addition, the small number of controlled studies available on specific subpopulations, like people with co-occurring disorders, is one notable limitation.

Combining AA with Professional Treatment & Medication-Assisted Therapy

Combining medication assisted treatment (MAT) with AA in an integrated care plan is an alternative suggested by many treatment professionals. But AA maintains a neutral stance on this “outside issue,” as outlined in the 12 Traditions.

A recent study suggests that plans that combine MAT with AA should be evaluated on an individual basis by clinicians and their clients as part of the clinician’s role of providing motivational enhancement, referrals, and relapse prevention planning.

Alternatives & Complementary Mutual-Aid Programs

AA doesn’t exist in a vacuum. There are other peer groups available that complement AA or are alternatives. Here are some of the larger networks of peer-based recovery groups.

SMART Recovery (CBT-Based)

This 4-Point Program stresses:

1. Building and maintaining motivation
2. Coping with urges
3. Managing thoughts, feelings, and behaviors
4. Living a balanced life

CBT-based tools include the ABC thought analysis method:

Smart Recovery’s “Cost / Benefit Analysis” worksheets help clients weigh short-term vs. long-term consequences.

Women for Sobriety

This program provides a safe space to explore gender-specific issues like trauma and caregiving as they relate to addiction. Its core principles are outlined in 13 “Acceptance Statements” that focus on self-esteem and self-responsibility.

Secular Organizations for Sobriety (S.O.S.)

S.O.S. provides secular science-based meetings that may have broad appeal for those who don’t want a spiritual component in their recovery program. Members focus on rational strategies to promote abstinence through personal responsibility.

Celebrate Recovery & Faith-Based Options

Celebrate Recovery is a faith-based organization with a Christ-centered focus. Their program addresses “hurts, habits, and hang-ups” using 12-Step strategies and biblical practices. Meetings are church-hosted and include worship elements.

Other faiths also offer 12-Step-style meetings. IFCJ offers programs for those of the Jewish faith. Milati Islami World Services has a 12-Step network for followers of Islam.

Choosing the Right Support Mix

Long-term recovery success often depends on choosing a variety of support tools that fit your needs at various points in your recovery. An addiction recovery support group should be easily accessible while matching your values and co-occurring needs. It must be inclusive and respectful of members’ individuality.

Recovery is not a one-size-fits-all situation. Try out different groups to find your best fit. Remember that you can be a member of more than one recovery group.

Key AA Terms & Concepts Glossary

Below are some common terms used in AA. Knowing these terms can make the program seem more familiar and comfortable.

• Big Book: the AA program guidebook describing AA’s alcohol recovery methods.
• Promises: positive AA statements describing potential benefits of following the 12 Steps.
• Higher Power: a force that one believes to be greater than themselves that is capable and willing to give support and life guidance.
• Sponsor: an AA member who provides personal support and guidance to another member, often helping them work the Steps.
• 12 Steps & 12 Traditions: AA’s foundational principles, outlining steps toward recovery and guidelines regarding the organization’s operational expectations.
• Making Amends: taking responsibility for harm caused to others because of one’s addiction and attempting to repair the damage.
• Dry Drunk: a person who, despite having stopped drinking, continues to exhibit anger or other negative behaviors, due to not having addressed underlying emotional issues.
• One Day at a Time: stresses the need to stay present-focused and make choices each day to remain sober.
• Progress, not Perfection: a reminder to focus on achieving consistent improvement rather than striving for unrealistic goals.

Frequently Asked Questions

Prospective members are understandably apprehensive when considering AA. Some common concerns include the costs, privacy issues and the logistics of attending meetings. Below are some questions that often arise among new members.

Find Treatment Near You

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