Best Alternatives for AA 

What Are Alternatives to AA?

These days, there are plenty of options for non-12-Step recovery. They include therapy, motivational coaching, other support groups, mindfulness-based approaches, online alcohol support groups, and alcohol reduction apps such as Reframe.

You’ve been to most of the church basements in your neighborhood, you’ve recited the Serenity Prayer countless times, and maybe even accidentally introduced yourself as “Hi, my name is so-and-so and I’m an alcoholic” at a PTA meeting (it’s been known to happen). Or maybe it didn’t take very long to feel like you just needed a different option. Whatever the reason, it’s clear that Alcoholics Anonymous (AA), while it works for some, just isn’t the solution for you. No problem! Rest assured, there are many in the same boat. And luckily, today there are many great alternatives to AA. Let’s explore what non-12-Step recovery is all about and check out the best AA alternatives!

Getting Sober Without AA?

First things first: what’s AA all about? The answer goes back almost a century, when stock broker Bill Wilson (known in AA circles as Bill W.) spontaneously recovered from an addiction to alcohol that nearly killed him. The program is based on 12 Steps that guide members through understanding their alcohol problem, cleaning up the aftermath, and living an honest and productive booze-free life while helping others do the same. (Want to learn more? Check out “How Does Alcoholics Anonymous Work?” for a deep dive.)

And while many swear by it, others find that it doesn’t jive with them for a number of reasons. For a detailed analysis, take a look at “Can AA Be Harmful?” For now, here’s the gist of the criticism:

• AA isn’t based on science. This is one of the main drawbacks of AA — its view of alcoholism (or alcohol use disorder, to use the term preferred by the medical community) isn’t all that scientific. AUD is seen as an “allergy” that manifests as a “spiritual malady” that can be treated only with the help of a “Higher Power.” And while that Higher Power is supposedly up to us to define, it’s usually referred to as “God” — an approach some folks find hard to handle.
• Its approach is very “all-or-nothing.” No room for cutting back here — AA sees quitting as the only option. And while it may indeed be the right way to go for some of us, it’s better to come to that conclusion on our own terms. Moreover, the pressure to do recovery “the AA way” can be a bit much for some. 
• It can foster a new type of dependence. Granted it’s better to be dependent on a self-help community rather than on booze, but it’s still not ideal. Plus, feeling that we need meetings, Steps, and sponsors to avoid an otherwise inevitable relapse can be a self-fulfilling prophecy.
• There’s a lot of talk about alcohol. While it’s understandable that a program for “alcoholics” is going to be alcohol-focused, some find that at a certain point in recovery it’s best to leave booze in the past. If true recovery means building a life beyond the bar (or wine cooler), focusing on it too much can hold us back.

If we find that these drawbacks resonate with us, it’s time to look at AA alternatives. Here we go!

Science-Based Alternatives to AA

There are many alternatives to 12-Step programs out there, but they tend to have one thing in common: they’re science-based. And as modern research shows, alcohol use disorder (AUD) is a brain-based condition. Here’s a brief overview:

• Alcohol changes our brain chemistry. Alcohol floods our brain with the reward neurotransmitter dopamine, which creates temporary pleasure and keeps us hooked. It also boosts GABA (an inhibitory neurotransmitter) while lowering glutamate (its excitatory counterpart).
• Misuse leads to dependence. In time, the brain perceives the neurochemical shifts as the “new normal.” It comes to expect them and adjusts its natural neurotransmitter settings to compensate. The result? We drink to feel “normal” and experience negative effects if we stop drinking.
• Withdrawal and cravings keep the cycle going. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) describes a three-stage process that AUD tends to take once dependence sets it. The “binge/intoxication stage” involves the reward circuit of the brain that alcohol triggers. It leads to the “withdrawal/negative affect” stage that activates the amygdala and makes us feel anxious and depressed when we stop drinking. The negative feelings, in turn, trigger powerful cravings and activate prefrontal cortex circuits involved in the “preoccupation/anticipation” stage that drives us back to booze in search of relief.

How do these AA alternatives use science as part of the solution? Let’s take a closer look.

1. Therapy: Beyond the Couch

Gone are the days when therapy meant lying on the couch and talking about our dreams. These days, science-based therapeutic approaches provide practical coping strategies, support, and understanding of AUD. And since what works for one person might not work for another, there are many different types to choose from.

• Cognitive behavioral therapy (CBT). CBT is all about uncovering and changing the subconscious beliefs we have around booze and reframing distorted thoughts. Many of us fall into unhelpful thought patterns about alcohol — for example, we might believe that we need it to have fun, socialize, ask someone out on a date, dance, or relax after a long work day. As it turns out, many of these beliefs turn out to be based on faulty logic when we examine them head-on. The result? Booze becomes less and less appealing, leading to a new, healthier mindset! (Curious to learn more? Check out “How Can Cognitive Behavioral Therapy (CBT) Help With Alcohol Misuse?”)
• Dialectical behavior therapy (DBT). Designed by psychologist Marsha Linehan, DBT uses four core modules to revamp our lives, thoughts, and relationships. The modules focus on mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance. It’s all about balance, both internally and when it comes to dealing with the outside world. (For a deep dive, take a look at “How Can Dialectical Behavior Therapy (DBT) Help With Alcohol Misuse?”)
• Contingency management (CM). Based on operant conditioning principles, CM sets up a system of rewards for certain behaviors. As a result, we build new thought and behavior patterns by associating the desired outcome (for example, drinking less) with pleasure.

Neuroscience fact: All three types of therapy described above promote neuroplasticity — the brain’s ability to make new connections and rewire itself. It allows us to hack our own brain circuitry to create a solid foundation for a sustainable and satisfying booze-free life!

2. Mindfulness: Magic of the Moment

Mindfulness — the practice of being aware of the present moment — has been a buzzword in wellness circles for years. But did you know that there’s solid science behind it? Yoga, meditation, deep breathing, mindful walking, and dozens of other practices that allow us to observe the moment (including our own thoughts) without judgment can work wonders for recovering from AUD. Here’s why:

• Mindfulness reduces stress. For one thing, these practices calm down the “mental chatter” that fuels obsessive thoughts about booze. We get a much-needed break from our own thoughts, along with physical relaxation thanks to a decrease in cortisol levels. It’s a natural way to reduce anxiety!
• It helps us manage our emotions. Studies show that mindfulness engages the prefrontal cortex — the decision-making hub of the brain that gets deactivated when we drink. At the same time, it reduces our brain’s reliance on the “default mode network” (DMN), which is involved in rumination and self-referential thoughts that fuel addictive behaviors.
• It reduces cravings. Observing our own thoughts while gaining more control over our behavior is a powerful craving buster! We can choose which thoughts we want to jump on board with and which ones to simply let go.
• It boosts “happy” neurochemicals. A study of subjects practicing Transcendental Meditation showed that their serotonin levels were higher after a meditation session. That’s right — we can create measurable physical change with our own mind!

Want to learn more? Take a look at “Practical Tips for Incorporating Mindful Living Practices to Support Sobriety.

Neuroscience fact: In addition to changing brain connectivity, mindfulness actually changes the physical structure of our brain! One study showed that meditators had a notably thicker prefrontal cortex compared with controls.

3. SMART Recovery: Science Meets Sobriety

AA isn’t the only self-help recovery support group out there! SMART Recovery (Self-Management and Recovery Training) is another option. The main difference? It’s secular and based on science. Those who struggle with the AA “Higher Power” concept can breathe easy — there won’t be any talk of prayer, “spiritual maladies,” or absolution from “character defects.” 

Instead, SMART Recovery is based on CBT. It’s all about changing harmful thoughts and behaviors in a more user-friendly, practical, and nonjudgmental way. Plus, we get the social support of others in the same (or similar) boat!

Neuroscience fact: One study showed that perceived social support had a specific neural “signature”: participants who experienced it had more activity in the left middle temporal gyrus, an area of the brain also associated with psychological well-being.

4. Motivational Coaching: Power of Positivity

Interested in therapy that focuses on the positive side of things? Motivational coaching uses motivational interviewing, goal-setting, and accountability techniques to inspire change. 

One of the major downsides of AA is that it can feel a bit negative at times. Listening to others’ stories is powerful, but there’s only so much we can handle when it comes to looking at how things fall apart. Instead, motivational coaching is all about putting our lives back together! The key is to find a person we really jibe with so that we can develop a strong and trusting relationship with our coach. They’ll motivate us to keep going when things get rough, provide useful insights, and, most importantly, cheer us on along the way.

Neuroscience fact: As we know, alcohol hijacks the reward circuit by flooding our brain with dopamine, making it difficult to stop. Motivational coaching can reverse the process! It engages the brain’s reward center and stimulates dopamine release in a healthy way.

5. Technology and Apps: Best of All Worlds

Finally, we come to the latest AA alternative on the recovery scene — technology. Alcohol reduction apps such as Reframe and online support groups have changed the landscape of addiction recovery, providing a state-of-the-art toolbox that’s customized to our needs and is always with us, right in our pocket! Here are some of the benefits:

• Apps such as Reframe are based on solid science. Reframe uses CBT principles to build a customized program that allows you to change your relationship with alcohol in the way that’s right for you. It’s all about shifting your mindset in a way that aligns with your goals!
• They offer a personalized program to fit our needs. The technology behind these apps allows for a customized approach. You set the goals that are right for you, whether that means quitting or cutting back for now. You might find that as you learn more about the effects of booze on the body and mind, your goals evolve. That’s great! Watch your recovery progress to a new level with you in the driver’s seat.
• They’re a treasure trove of urge-surfing tools. Science says that an average craving lasts about 20 minutes. Sometimes it’s all about riding it out, and what better tool to use than one that you can take and use anywhere? Whether it’s playing a game, doing a meditation, or performing a set of tasks, watch the craving magically vanish. And there’s even better news: each time we surf through an urge without giving in to it, it gets easier thanks to the power of neuroplasticity!
• They provide us with the latest neuroscience research about alcohol. Another benefit of apps? They are constantly updated, providing you with the latest research about alcohol and the way it affects the body and brain. You’ll be an expert before you know it!
• They connect us to professional coaches and a thriving community of other users. Social support is key in recovery, and apps such as Reframe provide it! Try our 24/7 Forum where others just like you share stories, give advice, and lend a sympathetic ear to each other. Online support groups connect people from all over the world who share one thing in common: they’re trying to drink less or kick alcohol to the curb for good. And there’s power in numbers — try it out for yourself and see!

Neuroscience fact: Apps can use real-time data to help us track our progress, get timely feedback, and stay on track with daily reminders. This continuous monitoring and personalized support can strengthen neural pathways associated with healthy behaviors and reduce the risk of relapse.

Summing Up

In the end, the most important thing is this: you made a decision about changing your relationship with alcohol. Congrats! That’s by far the most important step. In the wise words of Buddha, “No one saves us but ourselves. No one can and no one may. We ourselves must walk the path.” And simply by making this decision, you’re well on your way. The rest — planning your journey, charting your course, and choosing the trusty team to bring along with you — is details.

There are many options for finding help to stay on track in your alcohol journey, and listening to your intuition is important. Try out a few, give them a fair chance, and listen to that inner voice that knows what’s right for you. Whatever course you choose, know that there’s so much joy, health, and inspiration waiting for you in a life with less alcohol (or no alcohol at all). Approach these new opportunities with excitement and curiosity.