Alcoholics Anonymous (AA): How it Works & What to Expect

What Is Alcoholics Anonymous?

Alcoholics Anonymous (AA) is a free support group where individuals seeking help for their drinking problems come together to achieve sobriety.² AA is built upon the Twelve Traditions and Steps, which incorporate spiritual principles. For those reluctant to engage in a Christianity-based practice, AA focuses more on a “higher power” than a belief in God. AA may be amended to meet the needs of alternative religious and spiritual beliefs.

While the first AA meeting occurred in 1935, its history begins with The Oxford Group, a Christian society established in 1928.³ Bill Wilson and Dr. Bob Smith, the founders of AA, met one another as members of The Oxford Group and became connected through their struggles with alcoholism. They soon began to share their experiences with others, who started participating in the group and recruiting new members.

Upon receiving the support of the Rockefeller family in 1938, AA gained further attention, continuing to grow in membership and diversify. By 1950, more than 100,000 individuals notably recovered from alcoholism due to the influence of AA and its teachings.

When Bill Wilson and Dr. Bob Smith initially developed AA, the core guiding principle was “surrendering to a higher power.” From there came guiding principles grounded in the Twelve Steps that help others get and stay clean. Though AA was created to support individuals recovering from alcoholism, it also proved helpful to those with other substance use disorders.

Who Can Become an AA Member?

One must possess a “desire to stop drinking” to become an AA member.² Even so, if more than two people gather to achieve sobriety, they can be considered a distinct AA group. Another attractive feature of AA is that there are no dues or fees. However, the organization occasionally requests donations and charges for materials such as the Big Book. This is significant, considering that traditional therapy can prove costly, and those struggling with addiction may also suffer financially.

It should be noted that members and attendees are expected to abstain from alcohol before and during meetings. Attending a meeting under the influence of alcohol or any substance of abuse may trigger others, which defeats the purpose of the support being provided.

How Does AA Work?

Recovering from drug or alcohol misuse can be one of the most challenging experiences, especially for those recovering alone. Given the extensive popularity of Alcoholics Anonymous, those with busy schedules or limited accessibility may find a meeting that works for them. Though each group follows the Twelve Traditions, Steps, and Big Book, meeting topics and styles vary. Members share their experiences in sessions typically lasting an hour and a half.

AA traditionally operates by its members for its members. The organization functions independently as a sole entity, ensuring no other mission or objective cloud intentions. However, donations are sometimes accepted, and AA meetings are commonly integrated into various treatment programs, particularly residential ones.

Within each group is a team of leaders. This includes the Chairperson, who oversees the meetings; Secretary, who is responsible for record-keeping and announcements; and the Treasurer, who allocates group funds. Members may partake as sponsors or sponsees, resembling a traditional mentorship relationship. Sponsors are those who have reached the maintenance stage of recovery and hold themselves accountable to their sponsee.

The 12 Steps of Alcoholics Anonymous

The Twelve Steps of Alcoholics Anonymous aim to help people deal with alcoholism, recover from substance misuse, and maintain abstinence.⁴ The idea is when one remains on track with these steps by remaining intentional and consistent, they are less likely to stray off course. The purpose of a sponsor is to uphold and model these principles while holding their sponsee(s) accountable through further education and support.

The Twelve Steps of Alcoholics Anonymous include:²

• We admitted we were powerless over alcohol—that our lives had become unmanageable.
• Came to believe that a Power greater than ourselves could restore us to sanity.
• Made a decision to turn our will and our lives over to the care of God as we understood Him.
• Made a searching and fearless moral inventory of ourselves.
• Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
• We’re entirely ready to have God remove all these defects of character.
• Humbly asked Him to remove our shortcomings.
• Made a list of all persons we had harmed and became willing to make amends to them all.
• Made direct amends to such people wherever possible, except when to do so would injure them or others.
• Continued to take personal inventory and when we were wrong promptly admitted it.
• Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
• Having had a spiritual awakening as the result of these Steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

Maintaining the Twelve Traditions of AA

Founder Bill Wilson initially introduced the Twelve Traditions of AA as part of the “Twelve Points to Assure Our Future” essays in Grapevine Magazine. Essentially, these traditions determine how Alcoholics Anonymous groups function and operate.⁵ The Twelve Traditions keep morals alive and facilitate an environment where members may assist each other in staying sober.

The Twelve Steps of Alcoholics Anonymous include:²

• Our common welfare should come first; personal recovery depends upon AA unity.
• For our group purpose there is but one ultimate authority—a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.
• The only requirement for AA membership is a desire to stop drinking.
• Each group should be autonomous except in matters affecting other groups or AA as a whole.
• Each group has but one primary purpose—to carry its message to the alcoholic who still suffers.
• An AA group ought never endorse, finance, or lend the AA name to any related facility or outside enterprise, lest problems of money, property, and prestige divert us from our primary purpose.
• Every AA group ought to be fully self-supporting, declining outside contributions.
• Alcoholics Anonymous should remain forever non-professional, but our service centers may employ special workers.
• AA, as such, ought never be organized; but we may create service boards or committees directly responsible to those they serve.
• Alcoholics Anonymous has no opinion on outside issues; hence the AA name ought never to be drawn into public controversy.
• Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio, and films.
• Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities.

Is Alcoholics Anonymous Effective?

Alcoholics Anonymous success rate statistics–whether as a solo recovery effort or with professional treatment–are unclear. Numbers are skewed but indicate a positive correlation for those who take participation and recovery seriously.

Criticisms of Alcoholics Anonymous state that success rates of AA are nominal, but addiction specialists cite success rates between 8% and 12%.^6,7. Another source states that up to 75% of AA members stay abstinent.^6,8 Furthermore, the Big Book touts about a 50% success rate and states that another 25% remain sober after experiencing relapses.^6,9

In terms of long-term recovery, a study conducted by AA in 2014 showed that 14% of participants were still sober after 10-20 years, and 22% for more than 20.^6,10 Other research of formally treated, informally treated (AA), and untreated individuals found that 46% of those who chose formal treatment were abstinent after eight years, while 49% of AA members remained abstinent.¹¹ The results concluded that AA attendance may be an effective source of recovery.

Given the efficacy of therapy conducted by a trained professional, it is recommended that individuals seek professional help while supplementing with AA support groups. For those who decide to engage in treatment, recovery rates are often higher than AA alone. Overcoming alcohol misuse can be challenging, so one may benefit from as much support as possible.

Drawbacks & Benefits of AA

Like any form of treatment, there are benefits and drawbacks to Alcoholics Anonymous that vary based on the individual and the particular group. For example, some individuals may struggle with the spiritual aspect or troublesome group members. In other cases, it can be challenging for members to maintain meeting attendance due to several factors. Individuals interested in AA should find a group that works for them.

The benefits of AA meetings include:

• It is readily available.
• Groups may be offered online.
• Attendance is free.
• Individuals recover with others who have shared experiences.
• Membership and offerings continue growing annually.
• It can be a meaningful supplement to traditional therapy.
• Members have a sponsor who is well-versed in recovery and available at any time.
• Sobriety coins are provided to commemorate recovery milestones.

The drawbacks of AA meetings include:

• Co-occurring disorders can make attendance difficult.
• Taking full responsibility may be difficult.
• It does not address the physical aspects of alcohol withdrawal that come from recovery.
• Some members may not take recovery seriously and arrive to meetings intoxicated, romanticize past use, or sell.
• There is a risk of being matched with an ill-equipped sponsor.
• Groups are not led by a trained mental health or addiction counselor.
• There is inconsistency from one group to the next, especially if one group does not follow the Twelve Traditions.
• One may feel judged by other members who see recovery differently (e.g., not believing that medically-assisted treatment or necessary psychotropic medication is “abstinence”).

Is AA Right for Me?

Alcoholics Anonymous is best suited for those who are ready for recovery. Unlike traditional therapy, where some clients work with their therapist toward abstinence or harm reduction strategies, AA members should be sober and wanting help remaining sober or addressing dry drunk symptoms. One may benefit from attending therapy with a professional and transitioning into AA when ready.

AA may prove challenging for those who do not practice Christianity or believe in God. However, variations of the Twelve Steps meet various spiritual and religious needs. Some may also think that succumbing to a higher power removes personal accountability. Rather than doing the work themselves, the thought is that their higher power will provide some divine intervention, which is inaccurate.

The best way to find out if AA helps you maintain alcohol abstinence is to attend a meeting. Consider finding another group if one does not seem like a good fit. You can always divert from AA to something else, such as SMART Recovery or Secular Organizations for Sobriety (S.O.S.).

How to Find an AA Meeting

Alcoholics Anonymous meetings may be easily found by conducting a simple search online. Fortunately, even in locations where face-to-face meetings are limited, numerous options are available online. One may attend meetings in-person when available and online when not. Combined, one may access meetings daily.

It is important to consider how severe your alcohol use disorder is when contemplating the frequency of attendance. While meetings do provide more support, this might not be feasible. A common practice for individuals with more severe conditions hoping to jumpstart their recovery is to attend “90 meetings in 90 days.” From there, one may determine the most appropriate frequency.

Alternatives to AA

If AA is not a good fit for you, that is okay. Fortunately, various other options are available to help you achieve and maintain sobriety. Whether you are seeking traditional treatment or another variation of group therapy, the most effective treatment for alcohol dependence suits your needs.

SMART Recovery

SMART Recovery (Self-Management and Recovery Training) is a network of support groups based on evidence-based treatment methods.¹² Unlike AA, SMART Recovery meetings are facilitated by a trained mental health or addiction counselor. For quick access to resources, online communities, and otherwise, one can visit their website for more information.

Secular Organizations for Sobriety (S.O.S)

Founded by James Christopher in 1985, Secular Organizations for Sobriety (S.O.S) takes the religious aspect out of recovery. Local groups are facilitated by non-professional leaders dedicated to helping members achieve sobriety from any number of addictions.¹³

Therapy

The earlier one seeks help for their struggles, the better. Alcoholism, along with other addictions, is pervasive if allowed to continue. When one has arrived at the self-awareness that their issue has exceeded their ability to contain it, it is time to seek support. Many forms of psychotherapy continually assist individuals in achieving sobriety. Finding the right therapist can be done using an online therapist directory.

Therapy options for substance misuse may include:

• Cognitive behavioral therapy (CBT)
• Dialectical behavioral therapy (DBT)
• Person-centered therapy (PCT)
• Motivational interviewing (MI)
• Acceptance and commitment therapy (ACT)
• Medically-assisted treatment (MAT)
• Community reinforcement approach
• Mindfulness-based relapse prevention
• Combined behavioral intervention

Final Thoughts

Alcoholics Anonymous (AA) has helped millions of people maintain sobriety and make a permanent change in their lives. Finding an AA community can make a difference if you have struggled to control your addiction. Remember, if AA is not for you, it is okay. Recovery is about finding what works for you and sticking with it. Your well-being is worth it, and there is always hope.