Alcoholics Anonymous

Alcoholics Anonymous

Overview

Alcoholics Anonymous is an international mutual aid movement which says its "primary purpose is to stay sober and help other alcoholics achieve sobriety
Sobriety
Sobriety is the condition of not having any measurable levels, or effects from, alcohol or other drugs that alter ones mood or behaviors. According to WHO "Lexicon of alcohol and drug terms..." sobriety is continued abstinence from alcohol and psychoactive drug use...

." Now claiming more than 2 million members, AA was founded in 1935 by Bill Wilson
Bill W.
William Griffith Wilson , also known as Bill Wilson or Bill W., was the co-founder of Alcoholics Anonymous , an international mutual aid fellowship with over two million members belonging to 100,800 groups of alcoholics helping other alcoholics achieve and maintain sobriety...

 and Dr. Bob Smith
Bob Smith (doctor)
Robert Holbrook Smith was an American physician and surgeon who co-founded Alcoholics Anonymous with Bill Wilson, more commonly known as Bill W. He was also known as Dr. Bob. He was born in St. Johnsbury, Vermont, where he was raised, to Susan A. Holbrook and Walter Perrin Smith...

 (Bill W. and Dr. Bob) in Akron, Ohio
Akron, Ohio
Akron , is the fifth largest city in the U.S. state of Ohio and the county seat of Summit County. It is located in the Great Lakes region approximately south of Lake Erie along the Little Cuyahoga River. As of the 2010 census, the city had a population of 199,110. The Akron Metropolitan...

. With other early members, Wilson and Smith developed AA's Twelve Step program of spiritual and character development. AA's Twelve Traditions
Twelve Traditions
The Twelve Traditions of twelve-step programs provide guidelines for relationships between the twelve-step groups, members, other groups, the global fellowship, and society at large. Questions of finance, public relations, donations, and purpose are addressed in the Traditions...

 were introduced in 1946 to help AA stay unified and grow.
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Encyclopedia

Alcoholics Anonymous is an international mutual aid movement which says its "primary purpose is to stay sober and help other alcoholics achieve sobriety
Sobriety
Sobriety is the condition of not having any measurable levels, or effects from, alcohol or other drugs that alter ones mood or behaviors. According to WHO "Lexicon of alcohol and drug terms..." sobriety is continued abstinence from alcohol and psychoactive drug use...

." Now claiming more than 2 million members, AA was founded in 1935 by Bill Wilson
Bill W.
William Griffith Wilson , also known as Bill Wilson or Bill W., was the co-founder of Alcoholics Anonymous , an international mutual aid fellowship with over two million members belonging to 100,800 groups of alcoholics helping other alcoholics achieve and maintain sobriety...

 and Dr. Bob Smith
Bob Smith (doctor)
Robert Holbrook Smith was an American physician and surgeon who co-founded Alcoholics Anonymous with Bill Wilson, more commonly known as Bill W. He was also known as Dr. Bob. He was born in St. Johnsbury, Vermont, where he was raised, to Susan A. Holbrook and Walter Perrin Smith...

 (Bill W. and Dr. Bob) in Akron, Ohio
Akron, Ohio
Akron , is the fifth largest city in the U.S. state of Ohio and the county seat of Summit County. It is located in the Great Lakes region approximately south of Lake Erie along the Little Cuyahoga River. As of the 2010 census, the city had a population of 199,110. The Akron Metropolitan...

. With other early members, Wilson and Smith developed AA's Twelve Step program of spiritual and character development. AA's Twelve Traditions
Twelve Traditions
The Twelve Traditions of twelve-step programs provide guidelines for relationships between the twelve-step groups, members, other groups, the global fellowship, and society at large. Questions of finance, public relations, donations, and purpose are addressed in the Traditions...

 were introduced in 1946 to help AA stay unified and grow. The Traditions recommend that members and groups remain anonymous in public media, altruistically help other alcoholics and include all who wish to stop drinking. The Traditions also recommend that AA members acting on behalf of the fellowship steer clear of dogma, governing hierarchies and involvement in public issues. Subsequent fellowships such as Narcotics Anonymous
Narcotics Anonymous
Narcotics Anonymous is a twelve-step program modeled after Alcoholics Anonymous describing itself as a "fellowship or society of men and women for whom drugs had become a major problem," and it is the second-largest 12-step organization...

 have adopted and adapted the Twelve Steps and the Twelve Traditions to their respective primary purposes.

AA generally avoids discussing the medical nature of alcoholism
Alcoholism
Alcoholism is a broad term for problems with alcohol, and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages, usually to the detriment of the drinker's health, personal relationships, and social standing...

, nonetheless AA is regarded as a proponent and popularizer of the disease theory of alcoholism
Disease Theory of Alcoholism
The modern disease theory of alcoholism states that problem drinking is sometimes caused by a disease of the brain, characterized by altered brain structure and function. The existence of alcoholism as a disease is accepted by some within the medical and scientific communities, although critics...

. The American Psychiatric Association has recommended sustained treatment in conjunction with AA's program, or similar community resources, for chronic alcoholics unresponsive to brief treatment. AA's data states that 64% drop out of AA in their first year, but its program is credited with helping many alcoholics achieve and maintain sobriety
Sobriety
Sobriety is the condition of not having any measurable levels, or effects from, alcohol or other drugs that alter ones mood or behaviors. According to WHO "Lexicon of alcohol and drug terms..." sobriety is continued abstinence from alcohol and psychoactive drug use...

.

The first female member Florence Rankin joined AA in 1936, and the first non-Protestant member, a Roman Catholic, joined in 1939. AA membership has since spread "across diverse cultures holding different beliefs and values", including geopolitical areas resistant to grassroot
Grassroots
A grassroots movement is one driven by the politics of a community. The term implies that the creation of the movement and the group supporting it are natural and spontaneous, highlighting the differences between this and a movement that is orchestrated by traditional power structures...

 movements.

AA's name derived from its first book, informally called "The Big Book", originally titled Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered From Alcoholism
The Big Book (Alcoholics Anonymous)
Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism is a 1939 self-help text on alcoholism, written by the founders of Alcoholics Anonymous, Bill W. & Dr. Bob...


Beginnings


AA sprang from The Oxford Group, a non-denominational movement modeled after first-century Christianity. Most Group members ("Groupers") were not concerned with sobriety, but some, such as Ebby Thacher
Ebby Thacher
Edwin Throckmorton Thacher , was an old drinking friend and later the sponsor of Alcoholics Anonymous co-founder Bill Wilson...

, believed the Group was a critical aid in staying sober. Following the Group's evangelical bent, Thacher sought out former drinking buddy Bill Wilson to tell him he was sober because he had "got religion." Thacher also told Wilson he could get sober too if he set aside his objections to religion and form a personal conception of God, "another power" or "higher power."

Feeling a "kinship of common suffering" and struck that Thacher was sober, Wilson attended his first Group gathering, though he was drunk. Within days Wilson admitted himself for the fourth time to the Charles B.Towns Hospital
Charles B. Towns
Charles B. Towns was an expert on alcoholism and drug addiction who helped draft drug control legislation in the United States during the early 20th century.- Biography :...

 after stopping on the way to drink four beers – the last amount of alcohol Wilson consumed. Under the care of Dr. William Duncan Silkworth
William Duncan Silkworth
William Duncan Silkworth, M.D., was an American medical doctor and specialist in the treatment of alcoholism. He was Director of the Charles B...

 (an early benefactor of A.A.), Wilson underwent a detox treatment which included the deliriant
Deliriant
The deliriants are a special class of acetylcholine-inhibitor hallucinogen. The term was introduced by David F. Duncan and Robert S...

 Belladonna. At the hospital in a state of despair Wilson experienced a bright flash of light which he felt to be God revealing himself.

After his hospital discharge, Wilson joined the Oxford Group and recruited other alcoholics to the Group. Wilson's early efforts to help others become sober were ineffective, prompting Dr. Silkworth to suggest that Wilson place less stress on religion and on more on "the science" of treating alcoholism. Wilson's first success came during a business trip to Akron, Ohio, where he was introduced to Dr. Robert Smith, a surgeon and Oxford Group member who was unable to stay sober. After thirty days of working with Wilson, Smith drank his last drink on June 10, 1935, the date marked by AA for its anniversaries.
While Wilson and Smith credited their sustained sobriety to working with alcoholics under the auspices of the Oxford Group, a Group associate pastor sermonized against Wilson and his alcoholic Groupers for forming a "secret, ashamed sub-group" engaged in "divergent works". By 1937 Wilson separated from the Oxford Group. AA historian Ernest Kurtz explained the split:
...more and more, Bill discovered that new adherents could get sober by believing in each other and in the strength of this group. Men [no women were members yet] who had proven over and over again, by extremely painful experience, that they could not get sober on their own had somehow become more powerful when two or three of them worked on their common problem. This, then—whatever it was that occurred among them—was what they could accept as a power greater than themselves. They did not need the Oxford Group.


In 1955 Wilson acknowledged AA's debt, saying "The Oxford Groupers had clearly shown us what to do. And just as importantly, we learned from them what not to do." Among the Oxford Group practices AA retained were informal gatherings, a "changed-life" developed through "stages", and working with others for no material gain. AA's analogs for these are meetings, "the steps", and sponsorship. One legacy not drawn from the Group was anonymity, which came about due to AA wishing to avoid the publicity-seeking practices of the Oxford Group and to not promote, Wilson said, "erratic public characters who through broken anonymity might get drunk and destroy confidence in us."

The Big Book, the Twelve Steps and the Twelve Traditions


In 1937, Wilson and Smith could count 40 alcoholic men they had helped to get sober, and two years later they counted 100 members, including one woman. To promote the fellowship, Wilson and other members wrote the initially-titled book, Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism, from which AA drew its name. Informally known as "The Big Book" (with its first 164 pages virtually unchanged since the 1939 edition), it suggests a twelve-step program in which members admit that they are powerless over alcohol and need help from a "higher power"; seek guidance and strength through prayer and meditation from a god (or Higher Power
Higher Power
Higher Power is a term coined in the 1930s in Alcoholics Anonymous and is used in other twelve-step programs. It is also sometimes referred to as a power greater than ourselves and is frequently abbreviated to HP.-History:...

) of their own understanding; take a moral inventory with care to include resentments; list and become ready to remove character defects; list and make amends to those harmed, and then try to help other alcoholics recover. The second half of the book, "Personal Stories" (subject to additions, removal and retitling in subsequent editions), is made of AA members' redemptive autobiographical sketches.

In 1941, interviews on American radio and favorable articles in US magazines, including a piece by Jack Alexander in The Saturday Evening Post, led to increased book sales and membership. By 1946, as the growing fellowship quarreled over structure, purpose, and authority, as well as finances and publicity, Wilson began to form and promote what became known as AA's Twelve Traditions
Twelve Traditions
The Twelve Traditions of twelve-step programs provide guidelines for relationships between the twelve-step groups, members, other groups, the global fellowship, and society at large. Questions of finance, public relations, donations, and purpose are addressed in the Traditions...

, guidelines for an altruistic, unaffiliated, non-coercive, and non-hierarchical structure that limited AA's purpose to only helping alcoholics on a non-professional level while shunning publicity. Eventually he gained formal adoption and inclusion of the Twelve Traditions in all future editions of the Big Book. At the 1955 St. Louis convention in Missouri, Wilson relinquished stewardship of AA to the General Service Conference, as AA grew to millions of members internationally.

Organization and finances



AA says it is "not organized in the formal or political sense", and Bill Wilson called it a "benign anarchy". In Ireland, Shane Butler said that AA “looks like it couldn’t survive as there’s no leadership or top-level telling local cumann
Cumann
A cumann is the lowest local unit or branch of a number of Irish political parties. The term cumann may also be used to describe a non-political association....

s what to do, but it has worked and proved itself extremely robust.” Butler attributed this to "AA’s 'inverted pyramid' style of governance has helped it to avoid many of the pitfalls that political and religious institutions have encountered since it was established here in 1946."

In 2006 AA counted 1,867,212 members and 106,202 AA groups worldwide. The Twelve Traditions informally guide how individual AA groups function, and the Twelve Concepts for World Service guide how the organization is structured globally.

A member who accepts a service position or an organizing role is a "trusted servant" with terms rotating and limited, typically lasting three months to two years and determined by group vote and the nature of the position. Each group is a self-governing entity with AA World Services acting only in an advisory capacity. AA is served entirely by alcoholics, except for seven "nonalcoholic friends of the fellowship" of the 21-member AA Board of Trustees.

AA groups are self-supporting, relying on voluntary donations from members to cover expenses. AA GSO limits contributions to US$3,000 a year. Above the group level, AA may hire outside professionals for services that require specialized expertise or full-time responsibilities.

AA receives proceeds from books and literature that constitute more than 50% of the income for its General Service Office (GSO). Unlike individual groups, the GSO is not self-supporting and maintains a small salaried staff. It also maintains service centers which coordinate activities such as printing literature, responding to public inquiries, and organizing conferences. They are funded by local members and responsible to the AA groups they represent. Other International General Service Offices (Australia, Costa Rica, Russia, etc.) are independent of AA World Services in New York.

Program


The scope of AA's program is much broader than just abstinence from drinking alcohol. Its goal is to effect enough change in the alcoholic's thinking "to bring about recovery from alcoholism" through a spiritual awakening. A spiritual awakening is achieved by following the Twelve Steps, and sobriety is furthered by volunteering for AA and regular AA meeting attendance or contact with AA members. Members are encouraged to find an experienced fellow alcoholic, called a sponsor, to help them understand and follow the AA program. The sponsor should preferably have experience of all twelve of the steps, be the same gender as the sponsored person, and refrain from imposing personal views on the sponsored person. Following the helper therapy principle
Helper theory
Helper theory or the helper therapy principle is a model, first described in 1965 by Frank Riessman, attempting to explain the therapeutic effect for both people in a "helper" and "helpee" relationship within self-help/mutual-aid support groups...

, sponsors in AA benefit as much, if not more, from their relationship than do those they sponsor. Helping behaviors correlate with increased abstinence and lower probabilities of binge drinking.

AA's program is an inheritor of Counter-Enlightenment
Counter-Enlightenment
"Counter-Enlightenment" is a term used to refer to a movement that arose in the late-18th and early-19th centuries in opposition to the 18th century Enlightenment...

 philosophy. AA shares the view that acceptance of one's inherent limitations is critical to finding one's proper place among other humans and God. Such ideas are described as "Counter-Enlightenment" because they are contrary to the Enlightenment
Age of Enlightenment
The Age of Enlightenment was an elite cultural movement of intellectuals in 18th century Europe that sought to mobilize the power of reason in order to reform society and advance knowledge. It promoted intellectual interchange and opposed intolerance and abuses in church and state...

's ideal that humans have the capacity to make their lives and societies a heaven on earth using their own power and reason.

Nevertheless, sociologists David Rudy and Arthur Greil evaluated AA's literature and observed AA meetings for sixteen months. They note that although AA's ideology denies AA is religious in nature, for an AA member to remain sober a high level of commitment is necessary. This commitment is facilitated by a change in the member's world view
World view
A comprehensive world view is the fundamental cognitive orientation of an individual or society encompassing the entirety of the individual or society's knowledge and point-of-view, including natural philosophy; fundamental, existential, and normative postulates; or themes, values, emotions, and...

. To help members stay sober AA must, they argue, provide an all-encompassing world view while creating and sustaining an atmosphere of transcendence in the organization. To be all-encompassing AA's ideology places an emphasis on tolerance rather than on a narrow religious world view that could make the organization unpalatable to potential members and thereby limit its effectiveness. AA's emphasis on the spiritual nature of its program, however, is necessary to institutionalize a feeling of transcendence. A tension results from the risk that the necessity of transcendence, if taken too literally, would compromise AA's efforts to maintain a broad appeal. As this tension is an integral part of AA, Rudy and Greil argue that AA is best described as a quasi-religious organization.

Meetings


AA meetings are "quasi-ritualized therapeutic sessions run by and for, alcoholics". They are usually informal and often feature discussions. Local AA directories list a variety of weekly meetings. Those listed as "closed" are only for those with "a desire to stop drinking", while "open" meetings are available to anyone. At speaker meetings one or two members tell their stories, while discussion meetings allocate the most time for general discussion. Some meetings are devoted to studying and discussing the AA literature. Except for men's and women's meetings, most meetings targeting specific demographics (including newcomers, gays, and young people) do not exclude other alcoholics. While AA has pamphlets that suggest meeting formats, groups have the autonomy to hold and conduct meetings as they wish "except in matters affecting other groups or A.A. as a whole". Different cultures affect ritual aspects of meetings, but around the world "many particularities of the AA meeting format can be observed at almost any A.A. gathering".

Confidentiality


US courts have not extended the status of privileged communication, such as that enjoyed by clergy and lawyers, to AA related communications between members.

Spirituality


The spiritual aspect of Alcoholics Anonymous is identified in the core AA literature to be central for achieving and sustaining sobriety.

Recent research findings suggest that AA leads to better alcohol use outcomes, in part, by enhancing individuals’ spiritual practices and provides support for AA’s own emphasis on increasing spiritual practices to facilitate recovery from alcohol use disorder. As attendance of AA meetings increase, so do the participants spiritual beliefs, especially in those individuals who had low spirituality at the beginning of the study.

The results indicated that there was a robust association between an increase in attendance to AA meetings with increased spirituality and a decrease in the frequency and intensity of alcohol use over time. One of the most interesting aspects of the research was that the same amount of recovery was seen in both agnostics and atheists, which indicates that while spirituality is an important mechanism of behavioral change for AA, it is not the only method used.

Disease concept of alcoholism


More informally than not, AA's membership has helped popularize the disease concept of alcoholism, though AA officially has had no part in the development of such postulates which had appeared as early as the late eighteenth century. Though AA initially avoided the term "disease", in 1973 conference-approved literature categorically stated that "we had the disease of alcoholism." Regardless of official positions, from AA's inception most members have believed alcoholism to be a disease.

Though cautious regarding the medical nature of alcoholism, AA has let others voice opinions. The Big Book states "we are told that alcoholism "is an illness which only a spiritual experience will conquer." Ernest Kurtz says this is "The closest the book Alcoholics Anonymous comes to a definition of alcoholism." In his introduction to The Big Book, non-member Dr. William Silkworth
William Duncan Silkworth
William Duncan Silkworth, M.D., was an American medical doctor and specialist in the treatment of alcoholism. He was Director of the Charles B...

 suggested that those unable to moderate their drinking have an allergy. However, AA said, "The doctor’s theory that we have an allergy to alcohol interests us. As laymen, our opinion as to its soundness may, of course, mean little." In fact AA later acknowledged that "alcoholism is not a true allergy, the experts now inform us." Wilson explained in 1960 why AA had refrained from using the term "disease":
We AAs have never called alcoholism a disease because, technically speaking, it is not a disease entity. For example, there is no such thing as heart disease. Instead there are many separate heart ailments or combinations of them. It is something like that with alcoholism. Therefore, we did not wish to get in wrong with the medical profession by pronouncing alcoholism a disease entity. Hence, we have always called it an illness or a malady – a far safer term for us to use.

Canadian and United States demographics


AA's New York General Service Office regularly surveys AA members in North America. Its 2004 survey of over 7,500 members in Canada and the United States concluded that, in North America, AA members who responded to the survey were 65% male and 35% female. Average member sobriety is eight years with 36% sober more than ten years, 14% sober from five to ten years, 24% sober from one to five years, and 26% sober less than one year. Before coming to AA, 64% of members received some type of treatment or counseling, such as medical, psychological, or spiritual. After coming to AA, 65% received outside treatment or counseling, and 84% of those members said that that outside help played an important part in their recovery. The same survey showed that AA received 11% of its membership from court ordered attendance.

Research limitations


AA tends to polarize observers into believers and non-believers, and discussion of AA often creates controversy rather than objective reflection. Moreover, a randomized study of AA is difficult: AA members are not randomly selected from the population of chronic alcoholics, with the possible exception of those who are mandated by courts to attend AA meetings; they are instead self-selected. There are two opposing types of self-selection bias: (1) drinkers may be motivated to stop drinking before they participate in AA (2) AA may attract the more severe and difficult cases. Controlled experiments
Scientific control
Scientific control allows for comparisons of concepts. It is a part of the scientific method. Scientific control is often used in discussion of natural experiments. For instance, during drug testing, scientists will try to control two groups to keep them as identical and normal as possible, then...

 with AA versus non-AA subjects are also difficult because AA is so easily accessible. Twelve-step groups, like AA, are not conducive to probability sampling of members. Research on AA is therefore susceptible to sampling bias.

Studies


Studies of AA's efficacy have produced inconsistent results. While some studies have suggested an association between AA attendance and increased abstinence or other positive outcomes, other studies have not. A Cochrane Review of eight studies, published between 1967 and 2005, measuring the effectiveness of AA, found "no experimental studies unequivocally demonstrated the effectiveness of AA" in treating alcoholism, based on a meta-analysis of the results of eight trials involving a total of 3,417 individuals. To determine further the effectiveness of AA, the authors suggested that more studies comparing treatment outcomes with control groups were necessary.

Survey results


Every third year since 1968, AA has issued a pamphlet summarizing its latest triennial survey of meeting attendants. Additional published comments and analysis for academics and professionals have supplemented the survey results from 1970 through 1990. The 1990 commentary evaluated data of triennial surveys from 1977 through 1989 and found that one quarter (26%) of those who first attend an AA meeting are still attending after one year. Furthermore, nearly one third (31.5%) leave the program after one month, and by the end of the third month, over half (52.6%) leave. After the first year, the rate of attrition slows. Only those in the first year were recorded by month. About 40% of the members sober for less than a year will remain another year. About 80% of those sober more than one year, but less than five years will remain sober and active in the fellowship another year. About 90% of the members sober five years or more will remain sober and active in the fellowship another year. Those who remained sober outside the fellowship could not be calculated using the survey results.

Health-care costs


As a volunteer-supported program, AA is free of charge. This contrasts with treatments for alcoholism such as inpatient treatment, drug therapy, psychotherapy and cognitive-based therapy. Still some research has found that institutional use of AA in certain circumstances has reduced health-care expenditures by 45%.

Prisons


In the United States and Canada AA meetings are held in hundreds of correctional facilities. The AA General Service Office has published a workbook with detailed recommendations for methods of approaching correctional-facility officials with the intent of developing an in-prison AA program. In addition, AA publishes a variety of pamphlets specifically for the incarcerated alcoholic. Additionally, the AA General Service Office provides a pamphlet with guidelines for members working with incarcerated alcoholics.

United States Court rulings


United States courts have ruled that inmates, parolees, and probationers cannot be ordered to attend AA. Though AA itself was not deemed a religion, it was ruled that it contained enough religious components (variously described in GRIFFIN v. COUGHLIN below as, inter alia, "religion", "religious activity", "religious exercise") to make coerced attendance at AA meetings a violation of the Establishment Clause of the First Amendment
First Amendment to the United States Constitution
The First Amendment to the United States Constitution is part of the Bill of Rights. The amendment prohibits the making of any law respecting an establishment of religion, impeding the free exercise of religion, abridging the freedom of speech, infringing on the freedom of the press, interfering...

 of the constitution. In September 2007, United States Court of Appeals for the Ninth Circuit
United States Court of Appeals for the Ninth Circuit
The United States Court of Appeals for the Ninth Circuit is a U.S. federal court with appellate jurisdiction over the district courts in the following districts:* District of Alaska* District of Arizona...

 stated that a parole office can be sued for ordering a parolee to attend AA.

American treatment industry


In 1949 the Hazelden
Hazelden
The Hazelden Foundation is a non-profit organization based in Center City, Minnesota. Hazelden has alcohol and drug treatment facilities in Minnesota ; Newberg, Oregon; Chicago, Illinois; Naples, Florida and New York City, New York...

 treatment center was founded by AA members, and since then many alcoholic rehabilitation clinics have often incorporated AA's precepts into their treatment programs. 31% of AA's membership results from treatment centers referrals.

United Kingdom treatment industry


A cross-sectional survey of substance-misuse treatment providers in the West Midlands found fewer than 10% integrated twelve-step methods in their practice and only a third felt their consumers were suited for Alcoholics Anonymous or Narcotics Anonymous membership. Less than half were likely to recommend self-help groups to their clients. Providers with nursing qualification were more likely to make such referrals than those without. A statistically significant correlation was found between providers' self-reported level of spirituality and their likelihood of recommending AA or NA.

Moderation or abstinence

For more details on this topic, see Alcoholism: Management


Stanton Peele
Stanton Peele
Stanton Peele, Ph. D., J.D., is a licensed psychologist, attorney, practicing psychotherapist and the author of books and articles on the subject of alcoholism, addiction and addiction treatment.His awards have included:1989...

 argued that some AA groups apply the disease model
Disease model of addiction
The disease model of addiction describes an addiction as a lifelong disease involving biologic and environmental sources of origin. The traditional medical model of disease requires only that an abnormal condition be present that causes discomfort, dysfunction, or distress to the individual...

 to all problem drinkers, whether or not they are "full-blown" alcoholics. Along with Nancy Shute, Peele has advocated that besides AA, other options should be available to problem drinkers who can manage their drinking with the right treatment. The Big Book, however, acknowledges "moderate drinkers" and "a certain type of hard drinker" are able to stop or moderate their drinking. The Big Book suggests no program for these drinkers, but instead seeks to help drinkers without "power of choice in drink."

Cultural identity


One review of AA warned of detrimental iatrogenic effects of twelve-step philosophy and concluded that AA uses many methods that are also used by cults. A subsequent study concluded, however, that AA's program bore little semblance to religious cults because the techniques used appeared beneficial. Another study found that the AA program's focus on admission of having a problem increases deviant stigma and strips members of their previous cultural identity
Cultural identity
Cultural identity is the identity of a group or culture, or of an individual as far as one is influenced by one's belonging to a group or culture. Cultural identity is similar to and has overlaps with, but is not synonymous with, identity politics....

, replacing it with the deviant identity. A survey of group members, however, found they had a bicultural
Biculturalism
Biculturalism in sociology involves two originally distinct cultures in some form of co-existence.A policy recognizing, fostering or encouraging biculturalism typically emerges in countries that have emerged from a history of national or ethnic conflict in which neither side has gained complete...

 identity and saw AA's program as a complement to their other national, ethnic, and religious cultures.

Other criticisms

  • "Thirteenth-stepping" is a pejorative term for AA members approaching new members for dates or sex. The Journal of Addiction Nursing reported that 50% of the women that participated in a survey (55 in all) experienced 13-stepping behavior from others. To avoid this type of behavior, AA suggests that typically men be sponsored by men and women be sponsored by women.

  • In 1964 Arthur H. Cain – by his own count – had attended over 500 AA meetings since 1947. Cain insisted that "I do not suggest for a moment that a single A.A. quit the fellowship. On the contrary, I strongly urge sticking with it. To anyone who is having trouble with alcohol I say: try A.A. first; it's the answer for most people". Even so Cain thought that AA had become the domain of irreligious misfits "Dogmatic and opinionated in their nonbeliefs", who scorned other societies such as the Kiwanis Club
    Kiwanis
    Kiwanis International is an international, coeducational service club founded in 1915. It is headquartered in Indianapolis, Indiana. Current membership is 240,000 members in 7,700 clubs in 80 nations...

    . Cain said AA had come to rely heavily on dogmatic slogans and the group. Without referencing or fashioning a definition of the term, Cain called AA a "cult" and "a hindrance to research, psychiatry, and to many alcoholics who need a different kind of help".

Literature



Alcoholics Anonymous publishes several books, reports, pamphlets and other media, including a periodical known as the AA Grapevine. Two books are used primarily: Alcoholics Anonymous (the "Big Book") and Twelve Steps and Twelve Traditions, the latter explaining AA's fundamental principles in depth.

AA in film

  • My Name Is Bill W.
    My Name is Bill W.
    My Name Is Bill W. is a 1989 CBS Hallmark Hall of Fame television movie directed by Daniel Petrie, starring James Woods, JoBeth Williams and James Garner. William G. Borchert, who wrote the film for television, based it on the true story of William Griffith Wilson and Dr. Robert Holbrook Smith,...

     – dramatized biography of co-founder Bill Wilson
  • When a Man Loves a Woman
    When a Man Loves a Woman (film)
    When a Man Loves a Woman is a 1994 American romantic drama film written by Al Franken and Ronald Bass, starring Andy García, Meg Ryan, Tina Majorino, Mae Whitman, Ellen Burstyn, Lauren Tom and Philip Seymour Hoffman....

     – an airline pilot's wife attends AA meetings in a residential treatment facility
  • Clean and Sober
    Clean and Sober
    Clean and Sober is a 1988 American drama film directed by Glenn Gordon Caron starring Michael Keaton as a real estate agent and his trouble with substance abuse. This film was a dramatic departure from comedies for Keaton. The cast also includes Kathy Baker, M...

     – a cocaine addict visits an AA meeting to get a sponsor
  • The Answer Man – AA meeting at 0:59 ("burning desire", "newcomer")
  • When Love Is Not Enough: The Lois Wilson Story
    When Love Is Not Enough: The Lois Wilson Story
    When Love Is Not Enough: The Lois Wilson Story is a 2010 American film that premiered on CBS on April 25, 2010. The film was produced by Terry Gould, directed by John Kent Harrison and written by William G. Borchert, who based the script from his novel of the same name. The film is similar to...

     – a 2010 film about the wife of founder Bill Wilson, and the beginnings of Alcoholics Anonymous and Al-Anon.
  • Days of Wine and Roses
    Days of Wine and Roses (film)
    Days of Wine and Roses is a film directed by Blake Edwards with a screenplay by JP Miller adapted from his own 1958 Playhouse 90 teleplay of the same name....

     – a 1962 film about a married couple struggling with alcoholism. Jack Lemmon's
    Jack Lemmon
    John Uhler "Jack" Lemmon III was an American actor and musician. He starred in more than 60 films including Some Like It Hot, The Apartment, Mister Roberts , Days of Wine and Roses, The Great Race, Irma la Douce, The Odd Couple, Save the Tiger John Uhler "Jack" Lemmon III (February 8, 1925June...

     character attends an AA meeting in the film.
  • The Morning After
    The Morning After
    The Morning After may refer to:* "The Morning After" , a 1937 song recorded by Tommy Dorsey and His Orchestra*"The Morning After" , a 1969 episode of The Avengers* The Morning After , a 2010 album by James...

     – a 1974 made for television movie starring Dick van Dyke as a successful business and family man whose drinking progressively worsens to the point of no control.

  • Drunks – a 1995 film starring Richard Lewis as an alcoholic who leaves an AA meeting and relapses. The film cuts back and forth between his eventual relapse and the other meeting attendants.
  • "Desperate Housewives
    Desperate Housewives
    Desperate Housewives is an American television comedy-drama series created by Marc Cherry and produced by ABC Studios and Cherry Productions. Executive producer Cherry serves as Showrunner. Other executive producers since the fourth season include Marc Cherry, Bob Daily, George W...

    "*(Staring season 2) Bree Van de Kamp has a drinking problem, after falling down in the yard drunk (among other incidents) she decides to attend AA meetings
  • Come Back, Little Sheba
    Come Back, Little Sheba
    Come Back, Little Sheba may refer to:* Come Back, Little Sheba , a play by William Inge* Come Back, Little Sheba , a film based on the play, starring Burt Lancaster and Shirley Booth...

     – A 1952 film about a loveless marriage where the husband played by Burt Lancaster
    Burt Lancaster
    Burton Stephen "Burt" Lancaster was an American film actor noted for his athletic physique and distinctive smile...

     is an alcoholic who gets help from 2 members of the local AA chapter.
  • The Simpsons Movie
    The Simpsons Movie
    The Simpsons Movie is a 2007 American animated comedy film based on the animated television series The Simpsons. The film was directed by David Silverman, and stars the regular television cast of Dan Castellaneta, Julie Kavner, Nancy Cartwright, Yeardley Smith, Hank Azaria, Harry Shearer, Tress...

     - Barney and a few other people were drinking coffee at the local AA when a book is thrown in from the book club.
  • I'll Cry Tomorrow
    I'll Cry Tomorrow
    I'll Cry Tomorrow is a biopic which tells the story of Lillian Roth, a Broadway star who rebels against the pressure of her domineering mother and reacts to the death of her fiancé by becoming an alcoholic...

     – A 1955 film about singer Lillian Roth
    Lillian Roth
    Lillian Roth was an American singer and actress.-Early life:Roth was born in Boston, Massachusetts. She was only 6 years old when her mother took her to Educational Pictures, where she became the company's trademark, symbolized by a living statue holding a lamp of knowledge...

     played by Susan Hayward
    Susan Hayward
    Susan Hayward was an American actress.After working as a fashion model in New York, Hayward travelled to Hollywood in 1937 when open auditions were held for the leading role in Gone with the Wind . Although she was not selected, she secured a film contract, and played several small supporting...

     who goes to AA to help her stop drinking.
  • My Zinc Bed – A 2008 TV Drama, the antagonist challenges the protagonist Paul, an AA member, that AA makes Paul dependant on the group.
  • "Knots Landing
    Knots Landing
    Knots Landing is an American primetime television soap opera that aired from December 27, 1979 to May 13, 1993 on CBS. Set in a fictitious coastal suburb of Los Angeles in California, the show centered on the lives of four married couples living in a cul-de-sac, Seaview Circle...

    " - the two-part Season One finale Bottom Of The Bottle (1980) is an account of Gary Ewing's relapse into alcoholism, culminating in his attendance at an AA meeting. His attendance of AA meetings is referenced several times over the course of the series, and we actually see his attendance at meetings and his relationship with his sponsor and potential sponsee in the second season.

See also

  • Addiction recovery groups
    Addiction recovery groups
    Addiction recovery groups are voluntary associations of people who share a common desire to overcome drug addiction. Different groups use different methods, ranging from completely secular to explicitly spiritual. One survey of members found active involvement in any addiction recovery group...

  • Alcoholism
    Alcoholism
    Alcoholism is a broad term for problems with alcohol, and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages, usually to the detriment of the drinker's health, personal relationships, and social standing...

  • List of twelve-step groups
  • Recovery model
    Recovery model
    The Recovery Model as it applies to mental health is an approach to mental disorder or substance dependence that emphasizes and supports each individual's potential for recovery...

  • Self-help groups for mental health
    Self-help groups for mental health
    Self-help groups for mental health are voluntary associations of people who share a common desire to overcome mental illness or otherwise increase their level of cognitive or emotional wellbeing. There are several international mental health self-help organizations including Emotions Anonymous, the...

  • Stepping Stones (home)
    Stepping Stones (home)
    Stepping Stones is the historic home of Alcoholics Anonymous co-founder Bill W. and his wife Lois Burnham Wilson, founder of Al-Anon/Alateen, in Bedford Hills, New York. It is a Colonial Revival structure built in 1920....

  • Substance abuse
    Substance abuse
    A substance-related disorder is an umbrella term used to describe several different conditions associated with several different substances .A substance related disorder is a condition in which an individual uses or abuses a...


External links