The Effectiveness of Alcoholics Anonymous and Other 12‐step Programs for Alcohol Use Disorder

Study Background and Objectives

Alcohol use disorder, more commonly referred to as AUD, has major social and economic impacts beyond what the average citizen might consider. AUD is a mental health condition that is frequently left untreated – not because help isn’t available and accessible, but because there are many widespread misconceptions revolving around AUD. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) listed 11 symptoms of AUD. In order for one to be considered an alcoholic, he or she must be struggling with two or more of the following symptoms:

1. Alcohol is often taken in larger amounts or over a longer period than was intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
3. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
4. Craving, or a strong desire or urge to use alcohol. 
5. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
7. Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
8. Recurrent alcohol use in situations in which it is physically hazardous.
9. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
10. Tolerance, as defined by either of the following: a) A need for markedly increased amounts of alcohol to achieve intoxication or desired effect; b) A markedly diminished effect with continued use of the same amount of alcohol.
11. Withdrawal, as manifested by either of the following: a) The characteristic withdrawal syndrome for alcohol (refer to criteria A and B of the criteria set for alcohol withdrawal); b) Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.

Keep in mind that this list of symptoms was taken directly from the DSM-5. There are varying degrees of AUD, ranging from mild to severe. Those who are exhibiting two symptoms are thought to be suffering from a mild AUD. Those suffering from between four and five symptoms are thought to have a moderate AUD, and those suffering from six or more symptoms are in need of intensive professional help in order to overcome what is likely a life-threatening disorder.

The economic costs of untreated AUDs include alcohol-related violence, accidents related to excessive drinking, incarceration and increased costs of healthcare relating to alcohol use disorders. Alcoholics Anonymous, which was first started 80 years ago, has been helping men and women of all ages and demographics overcome AUD and maintain long-term sobriety. Alcoholics Anonymous and other 12 step programs have saved millions of lives but in-depth scientific research wasn’t conducted until very recently. The objective of the study was to determine whether or not professional treatment centers that utilized 12 step programs had more positive outcomes than those that did not, and to examine what exactly the positive outcomes entailed. The specific areas that were looked at included long-term abstinence, reduced symptoms of AUD, offset costs of healthcare related to AUD and a reduction of consequences related to excessive drinking and alcohol abuse. Common personal consequences of AUD include damaged interpersonal relationships, legal issues, financial insecurity and a lack of motivation to engage in activities that were previously enjoyed.

As far as data collection, the study collected data from a number of detailed scientific reports, ranging from unpublished studies conducted by the World Health Organization to information published by Cochrane, like Cochrane Drugs and Alcohol Group Specialized Register and the Cochrane Central Register of Controlled Trials. The three researchers combed through extensive data reports and gathered all pertinent information. Overall, there were 27 studies included in the report that detailed the experiences of 10,565 participants.