Does Alcoholics Anonymous actually work?

When I asked how much all of this cost, Keski-Pukkila looked uneasy. “Well,” he told me, “it’s 2,000 euros.” That’s about $2,500—a fraction of the cost of inpatient rehab in the United States, which routinely runs in the tens of thousands of dollars for a 28-day stay. People with alcohol problems also suffer from higher-than-normal rates of mental-health issues, and research has shown that treating depression and anxiety with medication can reduce drinking. But AA is not equipped to address these issues—it is a support group whose leaders lack professional training—and some meetings are more accepting than others of the idea that members may need therapy and/or medication in addition to the group’s help.

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Just like AA, NA meetings are held almost everywhere and anyone who wants to get clean or stay clean is welcome to attend. NA is also a nonprofit organization, meaning there are no fees or dues as their goal is not to make money, but to help people with addictions. They have an open-door policy, so people can choose to start or stop attending meetings any time. They have found, however, that those who continue to go to meetings regularly stay clean more often than those who skip or stop attending. In the study sample, 12-Step participation was common and intensive after inpatient treatment but fell off over time. However, despite declining attendance, early posttreatment attendance, even in relatively small amounts, predicted long-term helpful outcomes.

1. Conference presenters discussed the relationship between 12-Step participation and abstinence among various populations, including adolescents, women, and urban drug users.
2. Those who said AA was not helpful said they couldn’t relate to others in AA groups, found there was too much negativity and complaining, or felt they could handle the problem on their own.
3. For a long time, medical researchers were unsure whether Alcoholics Anonymous worked better than other approaches to treating people with alcohol use disorder.
4. NA has been instrumental in helping many people overcome their addiction to narcotics and other drugs.
5. “Sobriety is their decision, based on their own discovery,” she told me.

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The only sure indicator of the program’s success in attracting members is the rapid growth in the number of registered Narcotics Anonymous meetings in recent decades and the rapid spread of Narcotics Anonymous outside North America. In addition, the ultimate guide to alcohol recovery books many NA groups were not following the 12 traditions very closely (which were quite new at the time). These groups were at times accepting money from outside entities, conflating AA with NA, or even adding religious elements to the meetings.

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Literature review, summary, and synthesis of studies examining AA’s MOBC. This study was supported by grants from the National Institute on Drug Abuse (#sDA13814, DA016090, and DA020138). In the last decade or so, researchers have published a number of very high-quality randomized trials and quasi-experiments.

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The use of these programs with teens is not yet prevalent, though they do not explicitly exclude teens. Future research should explore whether there is increasing interest and efficacy of these other self-help programs with teens. Considering the discussion above regarding correlates of AA/NA teen participation, and reasons for not participating, other novel means to motivate attendance might be examined.

Still, the combination of naltrexone and therapy doesn’t work for everyone. Some clients opt to take Antabuse, a medication that triggers nausea, dizziness, and other uncomfortable reactions when combined with drinking. And some patients are unable to learn how to drink without losing control. In those cases (about 10 percent of patients), Castrén recommends total abstinence from alcohol, but she leaves that choice to patients.

In thinking about new directions, I considered the Survey of Readiness for Alcoholics Anonymous (SYRAAP) literature by Kingree, Simpson, Thompson, McCrady, and Tonigan (2006) and Kingree, Simpson, Thompson, McCrady, Tonigan, and Lautenschlager (2007). This assessment device was found to predict AA participation (frequency of meeting attendance, involvement with AA activities and experiences) at a 6-month follow-up assessment among 217 adults (37% that were 18–29 years old at baseline). The measure consists of three factor components, each consisting of five items. These three components may map quite well onto the research material on correlates of teen AA/NA participation and reasons for not participating. The benefits component would seem to be related to youths’ having friends that do not use, need for support related to less parental involvement, being motivated for abstinence, and being open to spirituality (connection, meditation/prayer, spiritual way of life). The severity component would seem to be related to youths’ feeling hopeless, experiencing prior treatment, being involved in relatively long treatment, having worse drug use problems, having worse problems at school, and suffering legal problems.

NA was called a “hip pocket program” because the entire literature could fit into a person’s hip pocket. This booklet was republished in 1966 as the NA White Book and included the personal stories of many addicts. Alcoholics Anonymous was originally intended for chronic, severe drinkers—those who may, indeed, be powerless over alcohol—but its program has since been applied much more broadly. Today, for instance, judges routinely require people to attend meetings after a DUI arrest; fully 12 percent of AA members are there by court order. NA believes in an abstinence model of recovery, which means being completely drug free. But if you’re addicted to opioids, you may be taking buprenorphine maintenance therapy (BMT).

For many different reasons, people turn to these addicting substances without fully understanding the detrimental consequences they bring. What’s worse is that the more they take it, the more they get trapped in the habit, until it becomes an addiction. Eventually, it becomes too late for them to realize that getting out of it is harder than ever. Generally, alcoholics are more comfortable in AA because most in the room have a problem with alcohol and understand the subtleties and unique problems that come with alcohol addiction.

Because AA was designed to assist alcoholics, those who used recreational or prescription drugs weren’t included. As an answer to this dilemma, Narcotics Anonymous (or NA) was formed. Like AA, NA also utilizes the support group model of therapy because it has shown dilaudid hydromorphone injection side effects to be very effective in treating addictions of all kinds. Their focus is also on coming to terms with the pain they have caused themselves as well as others in their lives, healing broken relationships and working to help others overcome their addictions.

Because that fellowship did not want to follow the 12 traditions written by AA, the two NA fellowships never united. NA literature suggests that service work is an essential part of a program of recovery. Service is “doing the right thing for the right reason,” and is the best example of “goodwill,” which is the basis for the freedom only from active addiction by the NA program. Service work is usually chairing a meeting, but may be as simple as cleaning up after the meeting, putting away chairs, or answering a phone.

The group’s official position is that the only criteria for membership is a desire to stop using drugs. NA started in California in the 1950s as an offshoot of Alcoholics Anonymous (AA). Today, it holds more than 70,000 regular meetings in 144 countries.

This includes electing members to serve on the World Board, approving all new NA Literature, service material, and making policy decisions that affect the fellowship including the organizational structure. Some Zonal Forums actively participate in “Fellowship Development” alcohol and the brain to help NA fellowships grow in new countries and geographic areas where NA is still forming. Zonal Forums help NA groups, areas, or regions to work together to translate literature, inform the local community about NA and create new service committees.