The get-togethers can be fantastic outlets for those working on recovery, with groups of others in similar situations offering support through comradery, advice, or even just active listening. Per Tradition 12, Anonymity is the spiritual foundation of all our Traditions. If you repeatedly drink more than you intend or want to, you may be an alcoholic. This pamphlet describes who A.A.s are and what we have learned about alcoholism. We are people who have discovered and admitted that we cannot control alcohol.
(Including or omitting these studies from the review, did not alter the pattern of findings.) It is worth noting that most of the studies were conducted in the USA, where AA originated and is widely available. The extent to which these results are generalizable across other cultures where AA may be less readily available is not clear. Also, studies are needed to determine if there are ethnic or racial differences in the benefits derived from AA/TSF within different societies. In terms of reductions in alcohol‐related consequences and alcohol addiction severity, AA/TSF most often did as well as comparison treatments. Notably, however, three out of four of the TSF variant studies, reflected advantages for more intensive AA/TSF procedures versus less intensive AA/TSF procedures (Brown 2002; Timko 2006; Vederhus 2014), suggesting that better articulated and more intensive TSF strategies (e.g. peer linkage) may produce better results for these outcomes.
The Big Book, the Twelve Steps, and the Twelve Traditions
By default, according to the Cochrane system for grading evidence, all non‐randomized studies are automatically rated as ‘low certainty’, and then downgraded from there based on any of the above‐listed reasons. Evidence from non‐randomized studies can be upgraded for large effects, specifically, evidence of dose response and confounding which alcoholics anonymous would be expected to result in an effect opposite to that observed. We operationalized ‘Risk of bias’ tables to be used for the assessment of RCTs, quasi‐RCTs, and prospective observational studies that included a comparison intervention, according to the criteria recommended by Cochrane Drugs and Alcohol (see Appendix 2 for details).
Measurement in the included studies comprised psychometrically validated assessment tools. 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). We conducted a narrative synthesis and therefore estimates are not precise. We provided a separate rating of bias for economic studies so that they could be rated independently from the clinical outcome analysis. This was done because, even though they came from the same study, the analytic method for each type of analysis is very different. Also, one study was purely an economic study and did not contribute data to the estimate of AA/TSF effects because it did not have a true comparison group (Mundt 2012).
Big Book ASL – Foreword to First Edition
Some research has examined the utility of AA for people suffering from other common substance use disorders (e.g. disorders relating to cocaine, cannabis, opioids use, etc.) either alone or in combination with AUD (Kelly 2014). More research is needed to understand the degree to which these people might benefit from, or be a better fit in, other mutual‐help organizations, such as Narcotics Anonymous, or Cocaine Anonymous (Bøg 2017). Studies also suggest there may be an immense clinical and public health value and economic benefit of AA participation in reducing healthcare costs. Such analyses could be expanded to include the potential gains in economic revenue from increased employment or productivity, or both, and also reductions in criminal justice costs related to lowered criminal activity that might result from increased AA participation. For measures of intensity of drinking, AA/TSF most often performed as well as comparison interventions. This is, perhaps, surprising given that the major focus of AA/TSF interventions is on complete abstinence, rather than reductions in intensity, which may be of a focus in CBT‐oriented relapse prevention interventions.
- We included 27 studies containing 10,565 participants (21 RCTs/quasi‐RCTs, 5 non‐randomized, and 1 purely economic study).
- Although all of the study populations were extremely likely to have had various proportions of participants meeting clinical criteria for other psychiatric disorders (e.g. major depression, anxiety disorders etc.) in addition to alcohol use disorder (AUD), these proportions were rarely explicitly documented.
- If you or someone you know has alcohol use disorder (AUD) and has relapsed, this is a common occurrence.
- 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).
To them, sobriety is something less (and more) than a practice relevant only to clinically determined alcohol abusers. Now it can also just be something cool and healthful to try, like going vegan, or taking an Iyengar yoga class. If you seem to be having trouble with your drinking, or if your drinking has reached the point of where it worries you, you may be interested to know something about Alcoholics Anonymous and the AA programme of recovery from alcoholism. A relapse can be a one-off event or even a short-term situation, but it is a part of your recovery. Most, if not all, people who have relapsed will say that during each relapse they learn something about themselves. Each time you come back to active recovery, you implement what you have learned to continue on your recovery journey.
A Message to Young People
Consequently, by default, we generally judged the evidence of non‐randomized studies (of which there were 5 of 27) to be of low certainty (as recommended by the GRADE system), while we judged RCTs/quasi‐RCTs generally to be of higher certainty. There was some inconsistency in the evidence across studies that could be due to variation in the clinical characteristics of the samples used, follow‐up time points, error in memory recall for certain outcomes, and differences in intervention durations, or therapist effects. There were some small sample sizes and larger variability around mean estimates of the longest periods of abstinence, and high variability around mean estimates of DDD.
The longer you continue to use, the more complicated it can become to stop using, especially if it is a substance on which your body can become physically dependent, such as alcohol. While no path in recovery is a straight line, a person in recovery actively attempts abstinence, harm-reduction education, and application of said education. Most of this research was conducted in the USA; further research is needed to determine the degree to which results observed here differ in other countries. The racial composition varied from 7.3% non‐white participants in Litt 2016 to 54% in Ouimette 1997. The proportion of female participants ranged from 0% in Ouimette 1997 and McCrady 1996 to 49.1% in Humphreys 1996.
Learn More About Treatment and Other 12-Step Support Groups
The common suffering of AA group members may provide a sense of belonging or universality that can help to diminish negative affect, particularly shame, loneliness and guilt, which is similar to some forms of group psychotherapy (Yalom 2008). Furthermore, the observation of others who are sustaining recovery in AA can instill much‐needed hope for a better future. AA also provides an arena for members to learn, and model, effective communication and coping skills, as well as specific strategies for abstaining from alcohol. Members are encouraged to obtain a ‘sponsor’ ‐ a recovery mentor well‐established in sobriety ‐ who can offer guidance, daily support, and accountability to help new members stay sober.
The GRADE certainty rating for this evidence was very low; we downgraded due to imprecision (moderate sample size) and indirectness (comparability of cohorts for baseline characteristics and outcome measures, and protection against contamination). There was no evidence of selective reporting bias of outcomes in any of the reviewed studies; thus, we rated all https://ecosoberhouse.com/ 27 studies as low risk for reporting bias. The total number of participants across the 27 included studies was 10,565, including 2456 participants who contributed to the economic analyses. We included a total of 27 primary studies (21 RCTs/quasi‐RCTs, 5 non‐randomized, and 1 purely economic study) that reported follow‐up results across a total of 36 reports.
This is a small list, but any of the points on it would be good signs that you may need outside intervention. However, you may find that you need professional treatment and intensive care, such as through an inpatient treatment program. If you aren’t sure whether you need treatment or not, a provider can conduct an assessment to determine what level of care you need. You may also put yourself under another kind of harm-reductive model when working toward sobriety by reducing severity or frequency of use. For instance, you might switch from hard alcohol to beer with lower alcohol content or maybe reduce your drinking from six days a week to two.
