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year, counts two million members who participate in some 115,000 groups
worldwide, about half of them in the U.S. How well does it work?
Anthropologist William Madsen, then at the University of California, Santa
Barbara, claimed in a 1974 book that it has a nearly miraculous success
rate, whereas others are far more skeptical. After reviewing the literature,
we found that AA may help some people overcome alcoholism, especially if
they also get some professional assistance, but the evidence is far from
overwhelming, in part because of the nature of the program.
In AA, members meet in groups to help one another achieve and maintain
abstinence from alcohol. The meetings, which are free and open to anyone
serious about stopping drinking, may include reading from the Big Book,
sharing stories, celebrating members sobriety, as well as discussing the 12
steps and themes related to problem drinking. Participants are encouraged
to work the 12-step program, fully integrating each step into their lives
before proceeding to the next. AA targets more than problem drinking;
members are supposed to correct all defects of character and adopt a new
way of life. They are to accomplish these difficult goals without professional
help. No therapists, psychologists or physicians can attend AA meetings
unless they, too, have drinking problems.
A for Abstinence?
Most studies evaluating the efficacy of AA are not definitive; for the most
part, they associate the duration of participation with success in quitting
drinking but do not show that the program caused that outcome. Some of
the problems stem from the nature of AAfor example, the fact that what
occurs during AA meetings can vary considerably. Further, about 40
percent of AA members drop out during the first year (although some may
return), raising the possibility that the people who remain may be the ones
who are most motivated to improve.
The AA-based approach seemed to work and compared favorably with the
other therapies. In all three groups, participants were abstinent on roughly
20 percent of days, on average, before treatment began, and the fraction of
alcohol-free days rose to about 80 percent a year after treatment ended.
What is more, 19 percent of these subjects were teetotalers during the entire
12-month follow-up. Because the study lacked a group of people who
received no treatment, however, it does not reveal whether any of the
methods are superior to leaving people to try to stop drinking on their own.
Other research suggests that AA is quite a bit better than receiving no help.
In 2006 psychologist Rudolf H. Moos of the Department of Veterans Affairs
and Stanford University and Bernice S. Moos published results from a 16-
year study of problem drinkers who had tried to quit on their own or who
had sought help from AA, professional therapists or, in some cases, both.
Of those who attended at least 27 weeks of AA meetings during the first
year, 67 percent were abstinent at the 16-year follow-up, compared with 34
percent of those who did not participate in AA. Of the subjects who got
therapy for the same time period, 56 percent were abstinent versus 39
percent of those who did not see a therapistan indication that seeing a
professional is also beneficial.
Constructive Combination
https://www.scientificamerican.com/article/the-just-do-it-trap/