Does AA Work?

Alcoholics Anonymous, 12-Step Programs, and What We Really Know About Substance Abuse Treatment

BY CATHY J. BOGART

“For every complex question there is a simple answer, and it is wrong.” —H.L. Mencken

Illustration by Simone Rein

IN THE MID-90S I HAD A SEVERE ALCOHOL ADDICTION. When I decided I needed help, the only alternative offered to me was Alcoholics Anonymous (AA). I was told this was the best approach—the most successful way to sobriety. At the time I knew nothing about AA. This is what I soon learned: AA was established in the 1930s based on the experiences of 100 white men. It has remained unchanged since then.

The road to recovery involved identifying myself as an alcoholic (i.e., “My name is Cathy, and I am an alcoholic.”), admitting to powerlessness, and turning myself over to a Higher Power, defined as God, capitalized. People are often told in AA that their higher power can be anything—the group itself or nature, etc. But in the Big Book (the AA bible), the pronouns for god are He/Him, both with a capital “H.” It is also is not uncommon for AA meetings to end with the recitation of the Lord’s Prayer. Sounded pretty Christian to me.

I was told I would always be an alcoholic, that it is a progressive illness and without AA, it will be 100% fatal. People who are addicted and do not go to AA end up in jails or hospitals.

My only choice as a treatment goal was complete abstinence. AA maintains that if an alcoholic consumes any alcohol at all it will trigger an uncontrollable relapse. And since this illness is progressive, those who relapse end up in worse shape than before.