Effectiveness of Alchoholics Anonymous explored
By GRAHAM JAEHNIG
Alcoholics Anonymous is a worldwide organization that has only one goal, which is stated in the organization’s preamble:
“Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism. The only requirement for membership is a desire to stop drinking.” The preamble goes on to state that the primary purpose of AA is stay sober and help other alcoholics to achieve sobriety. But is A.A. really effective in its mission?
In March 2020, Stanford Medicine News Center released a report addressing that question. A Stanford researcher and two collaborators conducted an extensive review of AA studies. The findings were that the AA fellowship helps more people achieve sobriety than therapy does.
The article, titled Alcoholics Anonymous most effective path to alcohol abstinence, authored by Mandy Erickson, reported that after evaluating 35 studies involving the work of 145 scientists and the outcomes of 10,080 participants, Keith Humphreys, PhD, professor of psychiatry and behavioral sciences, and his fellow investigators determined that AA was nearly always found to be more effective than psychotherapy in achieving abstinence. In addition, most studies showed that AA participation lowered health care costs.
Cochrane Database of Systematic Review published the review, which concluded by saying:
“The evidence suggests that compared to other well-established treatments, clinical linkage using well-articulated Twelve-Step Facilitation (TSF) manualized interventions intended to increase Alcoholics Anonymous (AA) participation during and following alcohol use disorder (AUD) treatment probably will lead to enhanced abstinence outcomes over the next few months and for up to three years.”
As one might expect, the review made national headlines and it met with criticism. Among the criticisms, again is the spiritual component of the AA program.
“Anything in the addiction space is hard to measure,” an online article posted on healthline.com quoted Eric Patterson, LPC, a contributing writer to Choosing Therapy as saying.
Though the Cochrane review found AA was more effective than CBT, said Patterson, that won’t hold true for everyone.
CBT focuses on changing and challenging unhelpful thoughts and patterns. It can be done in one-on-one sessions with a therapist or in small groups.
Healthline stated that Patterson believes CBT can be a helpful tool when done in conjunction with a 12-step program or SMART Recovery, though plenty of people find CBT helpful on its own.
The article goes on state that unlike AA, SMART Recovery does not ask people to admit they’re powerless. There are not any higher powers involved, and addiction tends to be considered a habit rather than a disease.
The last difference, though, can be crucial when considering that addiction, a substance use disorder has been clinically defined as is a complex disease of the brain and body that involves compulsive use of one or more despite serious health and social consequences. Addiction disrupts regions of the brain that are responsible for reward, motivation, learning, judgment, and memory.
As stated on the Partnership to Addiction website, addiction is defined as a disease by most medical associations, including the American Medical Association and the American Society of Addiction Medicine.
“Like diabetes, cancer and heart disease, addiction is caused by a combination of behavioral, psychological, environmental and biological factors,” the website states. Genetic risk factors account for about half of the likelihood that an individual will develop addiction.
The article goes on stat that people with addiction should not be blamed for having a disease, but rather be able to get quality, evidence-based care to address it.
“With the help and support of family, friends and peers to stay in treatment,” the article states,” they increase their chances of recovery and survival.”
At its most basic level, in spite of the criticisms and the decades-long scientific studies that continue to put AA under a microscope, the organization remains a peer support group. As aa.org states: “AA’s program of recovery is built on the simple foundation of one alcoholic sharing with another.”
AA members share their experience with anyone seeking help with a drinking problem, the website goes on to explain. They give person-to-person service or “sponsorship” to the alcoholic coming to AA from any source.
As Keith Humphreys explained in the Stanford Medicine article that AA works because it it based on social interaction, saying that members give one another emotional support as well as practical tips to refrain from drinking. The article quotes Humphreys as saying that “if you want to change your behavior, find some other people who are trying to make the same change.”
For more information on Alcoholics Anonymous, visit https://www.aa.org/what-is-aa.
To read the Partnership to End Addiction article, Is Addiction a Disease?, visit https://drugfree.org/article/is-addiction-a-disease/.
To read the Stanford Medicine review article, go to https://med.stanford.edu/news/all-news/2020/03/alcoholics-anonymous-most-effective-path-to-alcohol-abstinence.html.
The Cochrane review can be found at https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012880.pub2/full