The Effectiveness of Alcoholics Anonymous

Clinical lore has suggested that regular attendance at Alcoholics Anonymous meeting promotes abstinence and assists in achieving recovery from alcohol use disorders. Empirical evidence has supported this view over the past 37 years.

In 1983 we published one of the first independent studies that documented that regular AA attendance after treatment for substance use disorders was associated with abstinence (Hoffmann, Harrison, & Belille, 1983 in The International Journal of the Addictions). We documented that 73% of weekly AA meeting attenders reported continuous abstinence during the six months after discharge from residential care as compared to 33% for those who did not attend.

From that publication on during the 1980s and 1990s CATOR (Comprehensive Addiction Treatment Outcome Registry) consistently documented that AA attendance was associated with abstinence over the course of a year after completion of treatment for substance use disorders. Despite the consistent findings, critics did not appear to be convinced.

The major persistent criticism of such findings was the contention that selection bias rather than AA attendance itself was responsible for higher abstinence. The argument was that those committed to abstinence simply were more likely to attend AA and would have been more likely to be abstinent anyway. Keith Humphreys and colleagues at Stanford University refuted this argument in 2014 (Humphreys, et al., 2014 in Alcoholism: Clinical and Experimental Research). They found that the association of AA attendance with days of abstinence could not be explained by selection bias. In other words the improved outcomes associated with AA attendance could not be explained by self-selection.

In 2019, findings from the National Association of Addiction Providers (NAATP) pilot outcome project continued to document that AA attendance was associated with greater probability of abstinence during the 12 months following intake into residential treatment programs (

Some research on other peer-support groups has also documented that regular contact with other recovering individuals seems to be related to a higher probability of achieving remission. It may not be the specific steps or philosophy underpinning attendance that accounts for success but the contact itself. That is, staying in touch with others striving for remission and recovery may be the key to succeeding in achieving remission. This was a cardinal concept espoused by the founders of AA.

Whatever the mechanisms involved, the evidence over the course of almost four decades has been consistent for AA. Regular AA attendance after successful completion of a quality treatment program is related to higher rates of remission.

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