Alcoholics Anonymous (AA) is an autonomous, nonprofessional organization with a focus on helping problem drinkers remain sober through a combination of self-help and mutual support. Founded in the United States in 1935, AA now counts more than 2 million members in over 100,000 AA groups worldwide.
The AA platform treats alcoholism as an incurable disease. Thus, AA maintains that the only way to manage the disease is through ongoing sobriety. Understanding there is no shortcut to becoming sober, nor to remaining sober, the AA philosophy encourages continued reliance on the organization and its peer group support.
A collection of articles published in a volume titled Alcoholics Anonymous in 1939, now generally referred to as “the Big Book,” continues to be a primary source of information and guidance for AA members. This volume contains the “12 Steps” that form the plan for becoming and remaining sober. The 12 Steps provide a sequence of stages toward recovery that embody AA’s main principles. Two of the earlier steps include admitting being powerless over the disease of alcoholism and acknowledging the need to rely on a higher power for guidance. While originally the higher power was assumed to be God, the definition of a higher power has been relaxed over time as AA membership has grown in numbers and expanded to include various cultural groups. Further steps require a moral inventory of one’s life, including identifying personal mistakes, identifying those one has wronged, and making amends. The final steps involve a commitment to continued self-assessment, with the 12th step calling for service to assist other alcoholics with the 12-Step philosophy. The AA 12 Steps are often linked to the 12 Traditions, which provide the overarching maxims for how AA should operate at the institutional level.
The only requirement for membership is a desire to stop drinking. Peer group support is offered at regular meetings and through more individualized attention by a sponsor who acts as a member’s guide. There are open meetings that families and friends may attend, and closed meetings that are just for alcoholics. Members are encouraged at meetings to publicly identify themselves as alcoholics and to tell the group their personal stories. The introduction generally follows the path of “Hi, I’m Jane, and I’m an alcoholic.” Consistent with the 12 Steps, this open acknowledgment of being an alcoholic serves as an identity transformation that also reinforces membership in the group.
While lifetime sobriety is a goal of the organization, a relapse into drinking is common. The occurrence of relapse is generally not considered an offense warranting exclusion. Rather, a relapse tends to garner an increase in support by other group members and a reaffirmation of the group’s goal of sobriety.
Critics complain of certain inadequacies of the AA program. Empirical studies on the efficacy of AA have been mixed, with results showing no impact or a negative impact of AA on certain groups. Others complain that AA is too heavily religious and is limited to a perspective involving a single higher (and male) authority. There is also concern that long-term membership restricts members to maintaining a deviant identity as alcoholics that may become and remain their primary identity.
- Alcoholics Anonymous. (2002). Alcoholics Anonymous—Big book (4th ed.). New York: Alcoholics Anonymous World Service. (Original work published 1939)
- Bufe, C. (1991). Alcoholics Anonymous: Cult or cure? (2nd ed.). San Francisco: See Sharp Press.
- Kownacki, R. J., & Shadish, W. R. (1999). Does Alcoholics Anonymous work? The results from a meta-analysis of controlled experiments. Substance Use and Abuse, 34, 1897–1916.
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