Harm reduction usually implies that you still desire sobriety; however, you seek it in a different fashion. For example, you could be using marijuana to combat an opioid addiction, which is still being assessed by the Food and Drug Administration (FDA) to see if it is an appropriate treatment.2 Another example could be using Vivitrol, Naloxone, or even Antabuse for alcohol use disorder treatment. The GRADE certainty rating for this evidence was very low; we downgraded https://ecosoberhouse.com/ because of study limitations (lack of control of sample selection and non‐randomized nature of the study). Of the 27 included studies, 12 did not report how they handled missing data; 5 used intention‐to‐treat analyses (with worst case scenario); and the remaining 10 studies used a variety of procedures to impute or compensate for any missing data (see Table 9). We examined our four primary outcomes and two secondary outcomes across the included studies.
- Thus, while motivational interviewing styles are popular, people may be more likely to have better outcomes if AA participation is actively prescribed, recommended, and monitored, by clinicians, rather than left for the patient alone to consider and decide.
- Because he is a member of a support group that stresses the importance of anonymity at the public level, he does not use his photograph or his real name on this website.
- Comparison interventions included other psychological clinical interventions (e.g. motivational enhancement therapy (MET), cognitive behavioral therapy (CBT), etc.), other 12‐step program variants (e.g. studies comparing different styles/intensities of 12‐step interventions), and no treatment (e.g. wait‐list control).
- We identified an additional five studies through author correspondence, and three through clinical trial records, making a total of 12,741 articles.
We addressed the domains of sequence generation and allocation concealment (avoidance of selection bias) using a single entry for each study. It is likely that TSF interventions have quite similar change mechanisms, as they have been adapted directly from AA interventions, but, as they are of short duration and AUD is typically chronic, any long‐term impact of TSF would be due less to the intervention itself than to its ability to connect an individual to long‐term participation in AA. During meetings, we share one at a time without interruptions or crosstalk. This pamphlet answers many of the common questions people have about alcoholism and A.A.
Lydecker 2010 published data only
Yet many members do not consider the spiritual aspects of the program central (Alcoholics Anonymous 2018; Humphreys 2004). For alcohol‐related consequences, AA/TSF probably performs as well as other clinical interventions at 12 months (MD ‐2.88, 95% CI ‐6.81 to 1.04; 3 studies, 1762 participants; moderate‐certainty evidence). For longest period of abstinence (LPA), AA/TSF may perform as well as comparison interventions at six months (MD 0.60, 95% CI ‐0.30 to 1.50; 2 studies, 136 participants; low‐certainty evidence). One reason that several of the other trials may not have found positive effects for AA/ TSF is because many individuals randomized to the non-AA/non-TSF conditions also attended AA; thus, the AA or TSF condition ended up being compared to a condition consisting of an alternative treatment plus AA. This was the case in Walsh’s hospital inpatient treatment vs. AA study [23] and in the aftercare arm of Project MATCH [22], and arose because the patients in the non-AA/non-TSF conditions also had attended 12-step-based inpatient treatment, which in turn engendered strong participation in AA.
- For this reason, we judged all studies as being at low risk of performance bias.
- Most of the above studies considered concurrent AA attendance, and thus do not meet the 4th criterion for evidence of causality.
- The GRADE certainty rating for this evidence was very low; we downgraded due to study limitations (risk of attrition bias) and due to imprecision (moderate sample size).
- Published in 1939, the AA Big Book contains 11 chapters that include personal stories and spiritual insights.
- This effect is achieved largely by fostering increased AA participation beyond the end of the TSF intervention.
The GRADE certainty rating for this evidence was moderate; we downgraded due to study limitations (risk of random sequence generation, allocation concealment, and attrition bias). We included two studies in this category (Kaskutas 2009b; Manning 2012). See Table 4 for a summary of the alcoholics anonymous results for our main outcomes and certainty of evidence for each result. We included four studies in this category (Blondell 2011; Bogenschutz 2014; Bowen 2014; Herman 2000). See Table 2 for a summary of the results for our main outcomes and certainty of evidence for each result.
Hailemariam 2018 published data only
Findings also indicate AA/TSF may perform as well as other clinical interventions for drinking intensity outcomes; however, these results are based largely on low certainty evidence and so should be regarded with caution. Also of note, one study with dual diagnosis participants in the Veterans Administration (VA) healthcare system (Lydecker 2010), found a disadvantage for PDA with AA/TSF. This may be because, although participants met criteria for AUD, the primary problem was mood disorder as opposed to AUD, which may represent a poorer fit with AA (Kelly 2003a).
- Non‐manualized AA/TSF may perform as well as these other established treatments.
- The first part of the assessment process involved describing what was reported to have happened in the study.
- You may find—besides stopping alcohol consumption—other negative behaviors and feelings still exist because they have not been addressed in a healthy way.
- Still, there are some things you should be learning from each Alcoholics Anonymous meeting no matter what, including some insight on the teachings of the AA Big Book (the official guide to the 12 Step program) and other aspects of staying sober.
TSF interventions have been studied to determine whether they succeed at linking individuals with AA, and whether this, in turn, results in better alcohol‐related and other outcomes (Ducharme 2006; Kelly 2013a; Kelly 2017a; Knudsen 2016; Longabaugh 1998; Litt 2007; Mann 2006a; Mann 2006b; Walitzer 2009; Walitzer 2015). In this review, we use the abbreviation 'AA/TSF' to refer to these 12‐step programs and AA interventions in order to reflect both types of 12‐step effects of interest. AA consists of several million members in 181 countries (Humphreys 2004), and is a worldwide, nonprofessional, peer‐to‐peer support organization intended to help those suffering from AUD to achieve abstinence from alcohol and increase quality of life (Alcoholics Anonymous 2001). In North America, for example, it is the most commonly sought source of help for AUD (Caetano 1998; Hedden 2015; Room 2006). Although it was originally an all‐male and white organization, AA now attracts a diverse membership of women and men from a wide range of racial and ethnic backgrounds (Hoffman 2009; Humphreys 1994; Jilek‐Aall 1981; OSG 2018). Given that AUD is highly prevalent worldwide, especially in middle‐ and high‐income countries, and is susceptible to relapse and reinstatement over the long term, the free and widespread availability of AA gives the organization potential to serve large numbers of people for extended periods.
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We analyzed the five observational, prospective, non‐randomized studies we included separately (see Analysis 5.1, Analysis 5.2, Analysis 5.3, Analysis 5.4, Analysis 5.5, Analysis 6.1, Analysis 6.2, Analysis 6.3 and Analysis 6.4). We included studies that compared AA or TSF with other interventions, such as motivational enhancement therapy (MET) or cognitive behavioral therapy (CBT), 12‐step program variants, or no treatment. In three studies, AA/TSF had higher healthcare cost savings than outpatient treatment, CBT, and no AA/TSF treatment. The fourth study found that total medical care costs decreased for participants attending CBT, MET, and AA/TSF treatment, but that among participants with worse prognostic characteristics AA/TSF had higher potential cost savings than MET (moderate‐certainty evidence).
Meetings aren't based on a specific religion, they do include spiritual aspects. Alcoholics Anonymous meetings may be accessible, but do they work? To find Alcoholics Anonymous (AA) meetings near you, you have options. You can start by visiting the official AA website, which includes local listings. You can also contact local community centers, churches, or healthcare facilities for more information on AA and other 12-Step meetings near you. The AA Big Book cites a 50% success rate with 25% remaining sober after some relapses.7 However, since many of the group’s published success rates are provided by AA itself—and because some members choose to remain anonymous or don’t want to admit to relapsing—there isn’t enough impartial data to measure those rates.
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We used random‐effects estimates to account for potential heterogeneity among studied interventions in the included studies. We described any remaining studies in table format and described results in the narrative. These are referred to below in the Results section as Analysis 1.1, Analysis 2.3, and Analysis 6.3, and appear in the 'Data and Analyses' section tables as 'Other Data'.
A fifth experiment randomized convicted drunk drivers to AA, to outpatient treatment, or to a no treatment condition; the study did not report drinking outcomes, but found no differences in recidivism for drunk driving [26] (result not shown). Results are shown using figures, with the percentage abstinent from alcohol along the y axis and the AA exposure along the x axis. Some studies combined alcohol and drug abstinence, or considered 12-step group attendance which would have included Narcotics Anonymous (NA) and other 12-step groups for drugs (in addition to AA). Results from studies that did not report rates of abstinence are not shown. The study sample(s) and citation(s) are summarized at the bottom of each figure. Finally, although this review focused on AA/TSF interventions and alcohol use outcomes, it is plausible that other AUD recovery‐supportive, mutual‐help organizations, such as Self‐Management and Recovery Training (SMART), LifeRing, and Women for Sobriety, that have been growing in recent years, may confer similar benefits (Kelly 2012; Kelly 2009b).
