Alcoholics Anonymous: Can AA Be Harmful?

Ever walk by a church and notice an odd medley of folks chatting on the sidewalk? A college football player, a gangly art student covered in tattoos, and an elderly woman with a gray bob in a neatly pressed business pantsuit. What could they possibly have in common? 

Chances are, they might be members of Alcoholics Anonymous catching up after a meeting. Some people swear by AA, other people hate it. But how effective is AA? Is AA just for alcoholics? And, most importantly, what are the reasons why AA is harmful, according to some? Let’s find out!

All About AA

For better or for worse, AA has been synonymous with alcohol misuse recovery for generations. It all goes back to Bill W., a Wall Street hotshot who got caught up in the alcohol trap (which cost him his would-be law career back in the day). Bill tried everything under the sun to stop drinking — including LSD and belladonna with castor oil — with no success. (Apparently the latter gave him a serious case of “purge and puke,” but once he was able to keep things down, he went right back to booze.) 

His situation looked hopeless to everyone around him, including his doctors, until he suddenly … stopped. The rest — including his partnership with “Dr. Bob” who co-founded Alcoholics Anonymous and ironed out the 12 Steps and 12 Traditions with him — is AA history.

Is AA Just for Alcoholics?

Not necessarily, especially these days. While alcohol is the main focus of AA meetings, many of the ideas and methods behind it are “transferable” to other conditions such as (some) eating disorders, gambling, or other forms of substance misuse. Throughout the last few decades, 12-step “offshoot” groups such as NA (Narcotics Anonymous), OA (Overeaters Anonymous), and GA (Gamblers Anonymous) have become increasingly common. However, many (with the exception of NA) are still a bit harder to find and might not be available in all locations. As for friends and family of those in recovery, there’s a place for them too! They can attend open meetings with their loved ones or find support tailored to their needs in Al-Anon or Alateen. 

AA Today: “The Rooms” Around the Globe

In 2021, the number of AA members was reported to be 1,967,613, with as many as 120,455 separate groups around the world. And while many swear by it, others have a very different experience, going as far as to say that AA doesn’t work or that it has actually derailed their recovery. Clearly, there are different experiences out there. Why? Let’s explore!

How Effective Is AA?

Why do people choose to take an hour of their day (sometimes daily for years on end) to sit in a circle, talk about booze and read passages they will have certainly committed to memory? For some people, it’s clearly working (more on that later). However, many find that there are some serious problems with its structure, approach to recovery, and overall philosophy.

What Is the AA Success Rate?

It’s important to acknowledge that measuring the effectiveness of AA — or any recovery program, for that matter — can be tricky. Does “success” mean abstinence? Or is it about building a meaningful life where alcohol is a nonissue? What if we develop a new addiction and swap booze for Xanax, binge-eating disorder, or even shopping? (Transfer addictions are, unfortunately, very common.) And how does AA play into the picture?

The notoriously difficult question about the AA success rate can be addressed in several ways. Here are a few:

• According to the NCBI study mentioned earlier, those who went to a 12-step program were two times as likely to remain alcohol-free a year later. 
• A recent study that surveyed 286 people in recovery and tracked their feelings about AA found roughly the same results when it came to the proportion of people who found that the program worked: 42.3% said AA was helpful, 18.2% had mixed feelings about it, 19.2% said it didn’t help, and 20.3% did not mention AA. Of course, while the previous study tracked abstinence — a more concrete parameter — tracking how someone feels about a program is a slightly different aspect of recovery. Still, how we feel about our treatment matters, so it’s good to look at both.
• Finally, J. Scott Tonigan, a scientist at the University of New Mexico Center on Alcoholism, Substance Abuse, and Addictions (CASAA), argues for a “rule of thirds” in an interview with Vox. He says that “about a third of people maintain recovery from alcohol addiction due to 12-step treatment, another third get something out of the treatment but not enough for full recovery, and another third get nothing at all.”

And while there are still too many variables to comfortably give an exact number when it comes to the AA success rate, it clearly is the “recipe for success” for some.

When AA Doesn’t Work (and Why AA Is Harmful for Some)

That said, the same recipe is definitely not for everyone. While there are many reasons why someone’s experience in AA might have them running for the door (or at least hesitant about entering through it again), there are a few common trends.

1. The “Higher Power” Idea Doesn’t Work for Everyone 

Unlike science-based approaches (such as Reframe), AA is a spiritual program based on a “higher power.” In fact, the first three steps call on us to admit our “powerlessness” around alcohol while coming to an understanding that only a higher power can help us, if we surrender to it. This higher power, in turn, is usually referred to as “God,” bringing a distinctly religious flavor to the program (even though it doesn’t align itself with a particular religion).

The idea of a higher power — let alone one that we’re supposed to surrender to — doesn’t jibe well with many. And while AA famously says that your higher power doesn’t have to be “God” and can be anything (“the group itself, your cat, or even a doorknob!”) that’s not quite true in practice. It sounds “user-friendly,” but really, are you going to say a prayer to your door (or even Mr. Whiskers)? 

2. Not All AA Meetings Are Created Equal

While most meetings are welcoming, supportive, and nonjudgmental (unless you disagree with or badmouth AA itself — more on that later), it’s not true across the board. Some can be a bit cliquish, some might feel too religious, and some may simply have a crowd that’s hard for us to relate to. That’s okay! Remember, there are thousands of them out there in the world.

3. There Are Some “Bill W. Types” Out There 

They’re rarer these days, but they do show up. Notorious “13th steppers” — older members who make sexual advances towards young (usually female) newcomers — unfortunately exist. Bill W. was known to have done this, and there are certainly others out there who do the same.

4. It’s “Our Way or the Highway”

In some AA communities in particular, there’s next to no wiggle room when it comes to the approach to recovery. And recovery means one thing: staying away from booze completely. Unlike more flexible, individualized approaches (such as one provided by Reframe) doesn’t have any room for those exploring their relationship with alcohol by trying to cut back. Instead of providing members with science-backed information about what alcohol does to the body and mind to let them make their own decisions about what’s right for them, it tells them what to do. And for many, this simply doesn’t work.

5. There’s an Assumption That You Failed (or Will) if You “Stray” 

Those looks of concern we get when we show up after missing a few weeks or meetings (because, you know, life happens) are meant well. Still, there’s a clear message behind them: “You’ve either relapsed or you’re on your way down.” 

Unfortunately, this discouraging take on absenteeism can be harmful. When enough people tell us that we’re sure to relapse if we don’t attend meetings, skip the steps, or (gasp!) leave AA altogether after finding a different path to sobriety, subconscious doubt about the strength of our recovery starts to crop up. And that doubt might very well turn into an actual relapse, becoming a self-fulfilling prophecy.

6. Members Can Be Judgy 

There’s a slight flavor of self-flagellation to the steps, especially when it comes to the fourth — those notorious “character defects.” (“Of course I’m dishonest, untrustworthy, et cetera — I’m an alcoholic.”) That negativity also gets imposed on others (“Lost your job? Had an argument with your next-door neighbor who insists on playing heavy metal at night? Must be your character defect.”) 

Here’s how 44-year-old Montana resident Gerald Zeigler put it: “Everybody has character flaws, but I don’t think that’s the reason for alcoholism … it was a real turn-off for me.” And many others agree.

This is also where things can start to feel a little bit “culty.” No, we’re not saying AA is a cult. However, the tendency to find the character defect responsible for any of life’s many problems is dangerously reminiscent of Scientology’s “auditing” (a practice that’s meant to uncover what you did to cause anything bad that happened to you). Although of course, AA doesn’t take it nearly as far.

7. Sponsors Can Be Sketchy 

Sponsorship is a big part of AA, and in the best scenarios, it’s a mutually enriching, helpful relationship. Checking in when things are going well, calling when we feel the pull of the bar or liquor store down the street, and hearing how someone else made it out of a seemingly hopeless situation can be a recovery goldmine. 

However, that’s not always the case. Sometimes a codependent relationship develops, and we find ourselves unable to make decisions about whether to attend a friend’s wedding, accept a job offer, or go buy a new pair of sneakers without our sponsor’s permission. And that’s really taking it too far. While most mean well, sometimes sponsors might get power-hungry or even emotionally abusive.

8. Reliance on AA Can Foster a New Type of Dependency

While it’s great to know that there’s a supportive group of people waiting for us in at least a couple of church basements in our city on any given day, feeling like we need to attend meetings can be a double-edged sword. There are many who convince themselves that they will relapse if they skip a meeting, fostering a new type of dependency. Sure, it’s not as bad as being dependent on booze. But it’s not great, and it can also work as another self-fulfilling prophecy.

9. Constantly Talking About Alcohol Makes It Harder To Move On

The last two reasons AA doesn’t work for many in the long run (although it could be a life-saver at the beginning) have to do with our overall take on what it means to be “sober.” While conversations inside the AA “rooms” might vary, they inevitably center on one subject: booze. And, while in the first few days, weeks, or even months after quitting alcohol cravings and booze-related thoughts might still be on our mind the majority of the time, there comes a point at which it might be healthier to focus on other things.

10. We’re Waiting for Something Not To Happen

In This Naked Mind, Annie Grace suggests that the main weakness of AA and similar programs is that we end up spending our lives waiting to see if we succeeded in not doing something (drinking): “How will you know when you have succeeded? If you live waiting to see if you ever drink again, you won’t know you are successful until you are dead. Living a life in recovery, yet never recovered, implies you have no greater expectation than for life to be OK.” And that’s ultimately kind of depressing.

Instead, she proposes an alternative: “When you completely change your mental (conscious and unconscious) perspective on alcohol, you begin to see the truth about drinking. When this happens, no willpower is required, and it becomes a joy not to drink.” In other words, once we see through our cognitive distortions and realize we don’t need alcohol to relax or enjoy life, letting it go is no longer a struggle. The sobriety journey becomes fun!

Why AA Works for Some

That said, AA does have some notable strengths that deserve to be mentioned. Here’s an overview:

• There’s some scientific evidence that backs it. Over the decades, studies have shown that AA does seem to do it for some people. For example, an NCBI study reviewing the effectiveness of AA points out that abstinence rates for those who attended AA were about twice as high as those who didn’t. On top of that, the attendees who were more involved experienced greater benefits. In fact, a 1990s study by Project MATCH placed patients into a 12-step program, CBT-based therapy, and motivational enhancement therapy. The results? All three ranked about the same, with a 12-step treatment actually showing a “possible slight advantage” in reducing overall drinking. 
• It’s free. Is AA free? Yes — always. And that’s another one of its strengths. There’s a collection basket that gets passed around toward the end of the meeting. We can feel free to put anything we want in it (as long as it’s money) or simply pass it on.
• It’s anonymous. If the name didn’t give it away already, rest assured that the program is all about anonymity. So unless our face is on the cover of magazines on the newsstand or we’re a regular on TV, we can be reasonably sure that we’ll remain, well, anonymous.
  
  Plus, knowing that everyone is in the same boat helps. If we do happen to see our boss or our coworker at a meeting, chances are they’re just as concerned about staying under the radar as we are — after all, we’re all there for the same reason.
• It’s welcoming and supportive. Having a group of people who will unconditionally welcome us no matter what we did in the past (or that morning) is priceless. Studies show that a strong social network is crucial in overcoming alcohol misuse, and AA certainly provides that.
• Stories are powerful, especially when shared. A powerful aspect of AA has to do with the personal stories that people share. The stories are different, yet the common threads that run among them are so similar that many newcomers often find it surprisingly reassuring. (“I thought I was the only one who hid beer cans in my sock drawer, blamed the smell of booze on acid reflux, swallowed mouthwash, or counted a bottle of wine as ‘one drink.’ Go figure!”) 
  
  While many stories are disturbing or heartbreaking, lots of them have good endings. That publishing CEO was once a daily drinker? That neuroscience PhD student was once forced to leave grad school and spent five years in an out of rehab? Seeing these folks happy and thriving is the best “proof of the pudding” there ever was, when it comes to showing that recovery is possible.

All in all, the steps — as well as the practice of going to meetings, reaching out, and helping others do the same — provides a structure for responsible and productive daily living that can be invaluable, especially in early recovery. 

Still, while these reasons make AA a good choice for some, there are many others who find that the cons outweigh the pros or are simply looking for something different. Now, let’s take a brief look at alternative approaches that foster this positive point of view.

AA Alternatives

Are there alternatives to AA out there? You bet! Here’s an overview:

• Therapy. These days, therapy has many individualized and practical options. For example, cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) work wonders for habit change. While the former is all about changing negative thought patterns, the latter focuses on developing skills to manage emotions, navigate social interactions, and be present in our daily lives.
• Mindfulness and meditation-based approaches. Any practice that lets us observe our mind from an external perspective gives us greater control over which thoughts we jump on board with and which ones we simply release. You don’t have to believe your thoughts! (Check out “How Can Yoga Help Us Drink Less Alcohol?” and “Practical Tips for Incorporating Mindful Living Practices to Support Sobriety” for more information.)
• Other support groups. There are many other support groups out there that offer a CBT-based, science-backed approach (such as SMART Recovery), or just a place to go when you need help. Check out this list of other support groups besides just AA, or do a Google search of “alcohol support groups near me.”
• Digital apps. Apps such as the Reframe app are a digital treasure trove of information, a supportive community, a craving-busting tool, and a motivational coach all wrapped in a palm-sized package that fits in your pocket. With millions of users around the world who find that its science-based approach has helped them achieve their particular goals around alcohol better than any other program could, it’s emerging as a leader in the field. Give it a try!

All in all, while AA can be helpful in many ways, there’s a higher level of recovery we can reach. A successful approach is about changing how you actually feel about alcohol, making it irrelevant and small rather than something you have to work to avoid. It’s also about making room in your life for things other than booze (and, for that matter, meetings). It’s about thriving rather than surviving. And that’s what Reframe is all about!

Building a Life

In the end, forming habits that stick is all about building, constructing, and creating a life that excites you and makes you look forward to the next day. It’s about creating rather than avoiding, and is based on joy rather than fear. 

As Annie Grace puts it, “Don’t dwell on past experiences. Your past is in the past … Forgive yourself. You are the hero of this story. There is no reason to dwell on the negativity of the past and every reason to forgive yourself. Look forward to an incredible future.” We believe in you!