For those struggling with an alcohol use disorder, Alcoholics Anonymous (AA) is often touted as the best support option. With more than 123,000 groups in 180 countries Worldwide, AA’s model—free and open to the public—guides people through addiction since it started in 1935. And in recent decades, a growing body of research has shown that it can be incredibly effective.
“I think that’s the power of peers,” says John Kelly, a professor of psychiatry at Harvard Medical School. Kelly led a 2020 Analysis that reviewed the scientific evidence of the effectiveness of AA in 35 studies—including the work of 145 scientists and the results of 10,080 participants.
The Science of Alcoholics Anonymous
AA has been around for more than 85 years, but scientific evidence for its effectiveness didn’t begin to accumulate until about 1990, Kelly says.
“Anecdotally, we knew AA was very large, influential, and attended by millions of people,” he adds. “But we had no idea from a scientific public health perspective about its real clinical utility.”
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Kelly and his team examined studies published over the past few decades in which people were randomly assigned to AA or other 12-step programs by health professionals. They found that such programs had results similar to other treatments, but were “drastically better when we’re talking about remission, sustained remission, and complete abstinence over many years,” Kelly says. In short, AA is often superior to other types of therapies or interventions, such as cognitive behavioral therapy.
“Organizations like AA are well-suited to the long-term, bumpy course of addiction recovery,” Kelly adds. “In terms of AA’s ability to maintain remission over time, that’s what really stands out: 20 to 60 percent higher remission rates.”
Other benefits of Alcoholics Anonymous
Researchers are also learning more about how AA’s approach benefits those suffering from alcohol dependence. Kelly explains that it can increase cognitive and behavioral coping skills that are key to staying abstinent.
“It can also reduce desire, reduce impulsivity, and massively change social networks,” he says. “It can also increase spirituality, which can help people reframe stress and find meaning and purpose.”
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While the evidence shows that AA is broadly effective, it is of course not for everyone. Some who are recommended may never attend, while others may drop out after trying it.
“We know that no one treatment works for everyone,” Kelly says. That’s why it’s important to explore different options to find what works for those going through addiction. “The question is how we can identify the exact, precise fit for patients in different types of treatments who will benefit from a particular approach.”
Fighting alcohol addiction
Alcohol use disorder is a leading cause of death worldwide. According to World Health Organization, “harmful use of alcohol” is responsible for about 3 million deaths per year, which equates to about 5.3% of all deaths. This is especially acute in people in their 20s and 30s. In the US alone, approximately 95,000 people die annually due to “alcohol-related causes.”
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In the face of such a widespread public health problem, Kelly says, “at AA we have a free resource in the community that can save lives, sustain remission, and reduce health care costs for individuals and the health care system. This is good news from a public health perspective as it can help people achieve long-term remission and reduce the burden on the healthcare system.”