Does AA Actually Work?

In a 2014 survey by the National Survey on Drug Use and Health, about 27.9 million people in the United States had Alcohol Use Disorder (AUD) [1]. AUD is defined as an addictive disorder where people depend on alcohol for everyday functioning, despite negative consequences that affect their physical and mental wellbeing [2]. According to the DSM-5, some of the diagnostic criteria for AUD include “recurrent alcohol use resulting in a failure to fulfill rote obligations”, “recurrent alcohol use in situations in which it is physically hazardous”, and “a great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects” [3]. In addition to its burden on mental health and hindrance of life obligations, AUD can cause a variety of chronic health complications such as alcohol-induced cardiomyopathy, cirrhosis of the liver, and delirium tremens [2]. 

Alcoholics Anonymous (AA) has become one of the most popular forms of treatment for patients with AUD. AA serves as a low-cost way for people suffering from AUD to get support in their recovery. AA programs can be found all across the United States and have no membership requirements other than someone who wants to get help for their unhealthy relationship with alcohol. AA runs on a “twelve steps and twelve traditions” process where people in the program will work through steps built on honesty, courage, and humility. This functions to build a community for individuals with AUD in recovery through sponsorship programs with others who had previously suffered with AUD and share wisdom from their road to recovery [4].

Despite its ability to foster this community, is AA actually effective in initiating and sustaining cessation of alcohol use? Although it is often difficult to get accurate data about the efficacy of AA because of the program’s anonymity policy, there have been a multitude of studies completed to attempt to understand how well AA works. Throughout many studies, a positive correlation has been found between continued abstinence and attendance of AA. Additionally, there has been a lot of support for the increase in people staying sober and the number of AA meetings that they consistently attend [5]. While retention rates remain low at nearly 40%, the AA reported that only about 27% of consistent members stayed sober for less than a year, with over 22% being sober for more than 20 years [6]. However, the efficacy of each individual step within AA has been contested, indicating that the effectiveness of AA does not lay in the actual groundwork of the program, but instead from the stability and community the program builds for participants [5]. For many AA participants, being able to develop a sense of identity with people who have similar struggles in AA helps them stay sober [7].

In a 2020 review study by Stanford spanning over 10,000 participants, AA was found to be at least equally effective as psychotherapy in helping patients achieve sobriety [8]. The professor who ran the study at Stanford, Dr. Keith Humphreys, attributes the success of AA to the social interaction that it emphasizes, with many participants highlighting the importance of the sponsorship program [4, 8]. This is promising for patients struggling with AUD because of AA’s easy access, especially in comparison to psychotherapy which includes cost and access barriers. For instance, “X” study showed that treatment costs were reduced by approximately $10,000 per person when choosing AA over traditional therapy [8]. 

While  AA may not work for everyone, it is clear that, for many people, it has become the right program they need to get and stay sober from alcohol. AA’s effectiveness appears to lay within the community building the program allows and the low barrier to entry. With this in mind, other programs focused on helping people with different forms of addiction could help improve their effectiveness by attempting to imitate AA’s emphasis on interconnectivity and availability. 

Reviewed By: Clare Williams

Designed By: Devin Mulcrone

References

[1] National Institute on Alcohol Abuse and Alcoholism. (2025). Prevalence of Past-Year Alcohol Use Disorder (AUD) https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics/alcohol-facts-and-statistics/alcohol-use-disorder-aud-united-states-age-groups-and-demographic-characteristics

[2] Cleveland Clinic. (2025). Alcohol Use Disorder https://my.clevelandclinic.org/health/diseases/3909-alcoholism

[3] RAND Corporation. (2021). Diagnostic Criteria Checklist https://www.rand.org/content/dam/rand/pubs/tools/TLA900/TLA928-1/resources/step-2/AUD/RAND_TLA928-1.diagnostic-checklist_AUD.pdf

[4] Alcoholics Anonymous. (2026). What is A.A.? https://www.aa.org/what-is-aa

[5] Kaskutas, Lee Ann. (2009). Alcoholics Anonymous Effectiveness: Faith Meets Science. Journal of Addictive Diseases Vol 28, Issue 2. Doi: 10.1080/10550880902772464

[6] Wagener, Dan. (2025), Alcoholics Anonymous: The 12 Steps of AA & Success Rates American Addiction Centers https://americanaddictioncenters.org/rehab-guide/12-step/whats-the-success-rate-of-aa

[7] Bulumac, Adriana Lavinia. (2024). Affiliation to the Alcoholics Anonymous (AA) community: A qualitative study on differences between highly affiliated and low/non-affiliated individuals. Nordic Studies on Alcohol and Drugs. Vol 41, Issue 6. Doi: 10.1177/14550725241278089

[8] Erickson, Mandy. (2020). Alcoholics Anonymous most effective path to alcohol abstinence. Stanford Medicine Psychiatry & Mental Health https://med.stanford.edu/news/all-news/2020/03/alcoholics-anonymous-most-effective-path-to-alcohol-abstinence.html