Effectiveness of Alcoholics Anonymous

The effectiveness of Alcoholics Anonymous in treating alcoholism is a subject of ongoing interdisciplinary research and debate in a multitude of academic and non-academic contexts.

There are two principal ways to measure the effectiveness of Alcoholics Anonymous:

While newer studies have suggested an association between AA attendance and increased abstinence or other positive outcomes, older studies and studies done outside of the United States have not.

Experimental studies into the effectiveness of Alcoholics Anonymous (AA) have been based either on results obtained from individuals attending meetings run under the umbrella of the AA organization itself, or from similar twelve-step recovery programs based on the twelve-step approach run externally from the AA organization; generically termed, in this latter case, as twelve-step facilitation (TSF).

Studies of both implementations of the therapeutic model have not yielded conclusive evidence of effectiveness when assessed in terms of long-term prevention of problem drinking as compared with other treatments, although limitations are widely acknowledged in obtaining acceptable data due to the difficulty in applying experimental controls to clinical analyses of AA, such as adequate placebo control and uniformity of the delivered therapy.

In 2006 Cochrane systematic review that reviewed studies published between 1966 and 2005 that investigated the efficacy of AA and twelve step facilitation (TSF) found no significant difference between the results of AA and twelve-step participation compared to other treatments, stating that "experimental studies have on the whole failed to demonstrate their effectiveness in reducing alcohol dependence or drinking problems when compared to other interventions." This conclusion was based on a meta-analysis of the results of eight trials involving a total of 3,417 individuals; the authors note that further efficacy studies are needed, and mention the presence of flaws in one included study regarding the definition of success of interventions.

John Kelly, who is working on the updated version of the Cochrane review concerning Alcoholics Anonymous, says that there are "positive results in favor of Twelve-Step Facilitation treatments that have emerged from the numerous NIH-sponsored randomized clinical trials completed since the original review published in 2006."

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