How Vital is AA in Alcoholism Recovery?

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Alcoholics Anonymous began in 1935 when two “hopeless alcoholics” met and became sober. Bill W. and Dr. Bob S. had been involved with separate Oxford groups, “a mostly nonalcoholic fellowship that emphasized universal spiritual values in daily living” (Historical Data). After some time of involvement, Bill became sober and started to help other alcoholics while Dr. Bob was still an alcoholic himself. When these two men finally met “[Dr. Bob] found himself face to face with a fellow sufferer who had made good” (Historical Data). Bill had learned from a doctor, of the hospital he had frequently been a patient at, that alcoholism “[is] a malady of mind, emotions and body” (Historical Data). Responding to this new way of thinking Dr. Bob became sober. In 1939, Bill wrote the Alcoholics Anonymous textbook, “[which] explained A.A.’s philosophy and methods, the core of which is the now well-known Twelve Steps of recovery” (Historical Data). Alcoholics Anonymous provides the most efficient, low cost, and multi-dimensional form of recovery for alcoholics of all ages, ethnicities and genders.

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"Alcoholism is a

malady of mind,

emotions, and body." 

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American Addiction Centers reported that, “according to the National Survey on Drug Use and Health (NSDUH), 19.7 million American adults (aged 12 and older) battled a substance use disorder in 2017; 74% of [which] suffered from an alcohol use disorder” (American Addiction Centers). Of this number, more than 1.3 million use(d) Alcoholics Anonymous as a form of recovery from Alcoholism (Estimates of AA Groups and Members). Alcoholics Anonymous focuses on more than one dimension of recovery, making it the most efficient treatment option for a person recovering from alcoholism. Members of Alcoholics Anonymous who maintain sobriety claim the reason this is the case is that through AA members not only, “find a way to live without having a drink, but find a way to live without wanting a drink” (Historical Data). Wondering how exactly this comes to fruition is right in the question; HOW: Honesty, Open-mindedness, and Willingness. The Atlantic reports that approximately 12% of AA members are there by court order, meaning 88% are there by their own free will. Whether it be by final surrender or encouragement of a friend or family member, people believe attending these meetings is a better option than being checked into a rehabilitation facility. 

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If there is any doubt that AA meetings are not the best treatment option, there is a piece of AA literature called Do You Think You’re Different? which addresses various demographics such as atheists, gays, blacks, Jews, teenagers, and elderly folks. Someone volunteered their personal story to represent that demographic and show that yes, AA worked for them so it may work for the person in question. The common belief that brings all these different types of people together is that “alcoholism is a disease that is no respecter of age, sex, creed, race, wealth, occupation, or education. It strikes at random” (Do You Think You’re Different?). By reading this piece of literature the thought of being alone is addressed and it responds to that with “[these are the stories of people who] came to AA and found that Alcoholics Anonymous worked just as well for them as it had for hundreds of thousands of others who thought [they] were different” (Do You Think You’re Different?).

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A vital part to AA membership and success is free will. Diligently attending and working each of the twelve steps with thought and dedication is purely free will; there is no direct punishment in the situation that there is a failure to do one or both of those things. The key to success through this program is making one crucial decision; “[admitting] that you [are] powerless over alcohol” (This is AA). AA defines alcoholism as an illness; not one a doctor or a minister can diagnose, but one the alcoholic themselves must profess. The next step after admission is not necessarily to never touch alcohol ever again, but a process called the 24-hour plan. This plan focuses on “keeping sober just the current 24 hours… merely put off taking that particular drink until tomorrow” (This is AA). 

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"Diligently attending and working each of the twelve steps with thought and dedication is purely free will..."

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AA is based around the Twelve Steps. For some, it only takes one round and that may work to to enforce abstinence for life, for others it may not work that way. Alcoholics Anonymous Big Book boasts the 50% success rate without relapse, and another 25% success rate with relapse (AA World Service). The first step states, “admit [you are] powerless over alcohol - that [your life has] become unmanageable” (This is AA). Once this step is fully admitted, not partially, but completely admitted then the next step can be addressed. “First Things First” is a popular slogan in AA meaning: as much as one tries, you can not do everything at once, remember, “the prior importance of sobriety in any attempt to rebuild [your] life” (This is AA). The Twelve Steps are faith based; not in the way that it is religious necessarily, but admitting there is a higher power. Not all members are comfortable referring to that higher power as “God” but all agree, eventually, that there is indeed a higher power they need to relinquish control. One man in AA, “allegedly designated a doorknob as his higher power and believed that praying to the doorknob helped him maintain sobriety” (Hall). While these points and statistics are all valid, professionals disagree that Alcoholics Anonymous is the best way to go about curing addiction.

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Constance Scharff, PhD., states, “at least 9 out of 10 people who have tried AA as a treatment for addiction have left and are either not in recovery or used other treatment methods to deal with their addiction problem” (Psychology Today). Mark Willinberg, Psychiatrist from St. Paul, compares AA to losing weight in a clever simile; “you might as well tell a guy who weighs 250 pounds and has untreated hypertension and cholesterol of 300, ‘Don’t exercise, keep eating fast food, and we’ll give you a triple bypass when you have a heart attack'” (Psychology Today). Yes, Alcoholics Anonymous has helped millions of people recover from alcoholism and maintain sobriety. AA is also free and offers support any time of day or night. A struggling alcoholic can pick up a phone or log into an internet source and receive instant assistance and support; “no other recovery program offers this” (Psychology Today). In other words, AA is a better option than no treatment at all, but it does not not compare to professional treatment. 

 

Research verifies that AA is not the most successful treatment option. The Hazelden Betty

Ford Foundation says, “88.64% of patients are alcohol-free one month after rehab” (Alcohol and

Drug Rehab Success Rates). The case is not the same with AA, members could attend for a decade

or more and still not be sober. Quality of life is also another aspect to consider. 80% of patients

who accepted the fact of the need for formal treatment and took steps to receive that treatment 

reported“[an] improved quality of life and health after rehab” (Alcohol and Drug Rehab Success

Rates). Some formal treatment centers recommend attending AA post-treatment as a

supplement but professionals say, “all addicts should have highly personalized attention from a

therapist [to treat] the sources of addiction [because] each addict has very specific needs”

(Scoblic).  While some meetings are open, meaning anyone from the community is welcome,

there are some boundaries. Open meetings exclude physicians, therapists, and psychologists

unless they too struggle with alcoholism. With this lack of professional help there is not a guide

in AA meetings as to how to avoid triggers or prevent relapse. 

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AA has proven “successful” over the years merely because of the lack of options or lack of accessibility. “Highly effective treatment models and therapies have [only] been developed,” in the last 20 years or so (Psychology Today). Gabriel Glaser from The Atlantic says that, “Handbook of Alcoholism Treatment Approaches ranks AA 38th out of 48 methods… at the top of the list are brief interventions by a medical professional; motivational enhancement, a form of counseling that aims to help people see the need to change; and acamprosate, a drug that eases cravings” (Glaser). Tom McLellan, a psychology professor at the University of Pennsylvania School of Medicine and an adviser to the World Health Organization, says that, “while AA and other programs that focus on behavioral change have value, they don’t address what we now know about the biology of drinking” (Glaser). 

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"AA has proven successful merely because of the lack of options or lack of accessibility."

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In conclusion, the only reason AA has been proven remotely

successful is the lack of accessibility to other options.

The Substance Abuse and Mental Health Services Administration

reports that only 10.8% of 21.7 million Americans who needed

formal substance abuse treatment received it (America's Need

for and Receipt of Substance Use Treatment in 2015). That leaves

the other 89.2% untreated. AA is free while formal treatment can

cost up to $60,000 even with insurance partially covering some

(Juergens). Not all Americans have health insurance, let alone

the money to be able to pay for the amount of treatment needed.

Attend an AA meeting, with an open mind, and get a small peek

into the daily struggles in the life of an alcoholic.