Alcoholics Anonymous
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[[Image:Figure alcoholicsanonymous ingolstadt.JPG|thumb|right|AA meeting sign]]
'''Alcoholics Anonymous''' ('''AA''') is an informal meeting society for recovering [[Alcoholism|alcoholics]]. Its members state their primary purpose as, "to stay sober and help other alcoholics to achieve sobriety."<ref>{{cite web | title = What is AA? Defining "Alcoholics Anonymous" | publisher = The General Service Board of Alcoholics Anonymous (Great Britain) | url =http://www.alcoholics-anonymous.org.uk/geninfo/02whatis.shtml | accessdate = 2006-11-27 }}</ref> AA suggests that alcoholics follow its program and abstain from alcohol in order to recover from alcoholism, and share their experience, strength, and hope with each other that they may solve their common problem.<ref>''AA Preamble''</ref><ref>[http://www.alcoholics-anonymous.org/en_pdfs/m-24_aafactfile.pdf AA Fact File], 'The Recovery Program'</ref><ref name = "bigbook">''Alcoholics Anonymous : the story of how many thousands of men and women have recovered from alcoholism.'' 4th ed. New York : Alcoholics Anonymous World Services, 2001. ISBN 1893007162. Available online at [http://www.aa.org/bigbookonline/ www.AA.org]</ref> AA was the first [[twelve-step program]] and has been the model for similar recovery groups like [[Narcotics Anonymous]]. [[Al-Anon/Alateen]] are programs designed to provide support for relatives and friends of alcoholics.
==History==
{{main|History of Alcoholics Anonymous}}
By 1934, alcoholic [[Bill W.|Bill Wilson]] had ruined a promising Wall Street career with his constant drunkenness. He was introduced to the idea of a spiritual cure by old drinking buddy [[Ebby Thacher]] who had become a member of a Christian movement called the [[Oxford Group]]. Wilson was treated by [[William Duncan Silkworth|Dr. William Silkworth]] who saw alcoholism as an illness, a mental obsession and an allergy rather than a moral failing. <ref> Hartigan, Francis "Bill W. p.50-51, Thomas Dun Books, St. Martins Press , 2000 </ref> While in Towns hospital under Silkworth's care, Wilson claimed a spiritual experience while undergoing an unorthodox drug cure developed by [[Charles B. Towns]] and Dr. Alexander Lambert, which included [[Deliriant]]s in its formula.<ref>Pittman, Bill "AA the Way it Began , Glen Abbey Books 1988</ref> He became convinced of the existence of a healing higher power and he was able to stop drinking. On a 1935 business trip to [[Akron, Ohio]], Wilson felt the urge to drink again and in an effort to stay sober, he sought another alcoholic to help. Wilson was introduced to [[Bob Smith (doctor)|Dr. Bob Smith]], and Smith claimed to have found sobriety through spirtual and religious means.
Wilson and Smith co-founded AA with a word of mouth program to help alcoholics. Smith's last drink on [[June 10]], [[1935]] is considered by members to be the founding date of AA.<ref>''Pass It On'', p 131-149.</ref> By 1937, Wilson and Smith determined that they had helped 40 alcoholics get sober, and two years later, with the first 100 members, Wilson expanded the program by writing a book entitled ''Alcoholics Anonymous'' which the organization also adopted as its name. The book, informally referred to by members as "The Big Book," described a twelve-step program involving admission of powerlessness, moral inventory, and asking for help from a higher power. In 1941 book sales and membership increased after radio interviews and favourable articles in national magazines, particularly by Jack Alexander in The Saturday Evening Post. By 1946, as membership grew, confusion and disputes within groups over practices, finances, and publicity led Wilson to write the guidelines for noncoercive group management that eventually became known as the [[Twelve Traditions]]. AA came of age at the 1955 St. Louis convention when Wilson turned over the stewardship of AA to the General Service Board.<ref>''Pass It On'' p 359</ref> In this era AA also began its international expansion, and by 2001 the number of members worldwide was estimated at two million.
==Organization==
{{ main|Twelve Traditions }}
[[Image:Alcoholics Anonymous Regional Service Center by David Shankbone.jpg|thumb|left|A regional service center for Alcoholics Anonymous.]]
In 2006 there were a reported 1,867,212 AA members in 106,202 AA groups worldwide.<ref name="AAFACTFILE">[http://www.aa.org/en_information_aa.cfm?PageID=2 AA Fact File]</ref> The [[Twelve Traditions]] informally guide how AA groups function, and the Twelve Concepts for World Service guide how AA is structured globally.<ref>The AA Service Manual/Twelve Concepts for World Service (BM-31).</ref>
A member who accepts a service position or an organizing role is a "trusted servant" with terms rotating and limited, typically lasting three months to two years and determined by group vote. Each group is a self-governing entity with AA World Services acting only in an advisory capacity. AA is served entirely by alcoholics, except for seven "nonalcoholic friends of the fellowship" out of twenty-one members of the AA Board of Trustees.<ref>The [http://www.alcoholics-anonymous.org/en_pdfs/m-24_aafactfile.pdf AA Fact File], 'The Structure of AA'</ref>
AA groups are self-supporting and not charities, and they have no dues or membership fees. Groups rely on member donations, typically $1 collected per meeting in America, to pay for expenses like room rental, refreshments, and literature.<ref>[http://alcoholism.about.com/library/weekly/aa980408.htm Once Upon A Time...] Mitchel K. 04/08/98</ref> No one is turned away for lack of funds.<ref>[http://www.alcoholics-anonymous.org/en_pdfs/m-24_aafactfile.pdf]AA Fact File p 17</ref>
AA receives proceeds from books and literature which constitute more than 50% of the income for the General Service Office (GSO),<ref>[http://www.aa.org/en_gso05_operresults.cfm GSO 2005 Operating Results], 'Gross Profit from Literature ~$6.7M (55%), Contributions ~$5.4M (45%)'</ref> which unlike individual groups is not self-supporting and maintains a small salaried staff. It also maintains service centers which coordinate activities like printing literature, responding to public inquiries, and organizing conferences. They are funded by local members and responsible to the AA groups they represent.
==Program==
{{see also|Twelve-step program#The Twelve Steps|l1=Twelve-step program: The Twelve Steps}}
The suggested AA recovery program for alcoholics includes abstaining from alcohol one day at a time, following [[Twelve Steps]],<ref name="THISISAA">http://www.alcoholics-anonymous.org/en_pdfs/p-1_thisisAA.pdf This is AA pamphlet</ref> helping with duties and service work in AA,<ref>http://www.alcoholics-anonymous.org/en_services_for_members.cfm?PageID=98&SubPage=119 Sponsorship-A Vital Stepping Stone to Service & Sobriety</ref> and regular AA meeting attendance<ref>http://www.alcoholics-anonymous.org/en_is_aa_for_you.cfm?PageID=14 A Newcomer Asks pamphlet</ref> or contact with AA members.<ref name="THISISAA"/> Members are encouraged to ask their group for help in finding an experienced fellow alcoholic called a sponsor to help them follow the AA program, ideally one that has enjoyed sobriety for at least a year and is of the same sex as the sponsee, and who does not impose personal views on sponsees but only teaches the suggested AA program.<ref name="SPONSORPAMPHLET">http://www.alcoholics-anonymous.org/en_pdfs/p-15_Q&AonSpon.pdf Questions and Answers on Sponsorship pamphlet</ref>
====Meetings====
Anyone is allowed to attend "open" AA meetings, while "closed" meetings are reserved to those who have a desire to stop drinking. <ref>http://www.alcoholics-anonymous.org/en_information_aa.cfm?PageID=10 AA at a Glance pamphlet</ref> There are groups restricted to men or women, groups angled at gay people, and groups for speakers of minority languages. Most AA meetings begin with socializing. Formats vary between meetings, for example, a beginner's meeting might include a talk by a long-time sober member about his or her personal experience of drinking, coming to AA and what was learned there of sobriety. A group discussion on topics related to alcoholism and the AA program might follow.<ref>[http://www.alcoholics-anonymous.org/en_pdfs/mu-1_begmeetings.pdf] Suggestions for Leading Beginners Meetings pamphlet</ref>
In a standard meeting, the chairperson starts by calling the meeting to order and offering a short prayer, meditation, and/or period of silence. Then, a section from "The Big Book" may be read aloud, typically the beginning of Chapter Five, entitled "How It Works". Announcements from the leader and/or group members follow. Many groups celebrate newcomers, visitors, and sobriety anniversaries with rounds of applause. Following the announcements, donations are collected, usually by passing a basket around the room. Depending on the type of meeting, there follows either a talk by a speaker relating their personal experience with alcoholism and AA or a discussion session with topics chosen by the chairperson, the speaker, and/or the attendees.<ref> Kirkpatrick, Kayla EJ. "Interpreting AA (and other 12-step) Meetings." American Sign Language Interpreting Resources, 10 December 1999. <http://asl_interpreting.tripod.com/situational_studies/kejk1.htm>. 12 March 2008. </ref> A hallmark of these types of AA meeting is the "no crosstalk" rule, whereby responding to another member's comments is discouraged. After the discussion period, appreciation may be expressed to the speaker and the meeting is ended with a prayer, usually the [[Serenity_prayer|Serenity Prayer]] or often in the US, the [[Lord's Prayer]]. These ending prayers are often undertaken by the entire group forming a circle and holding hands. More socializing typically follows the formal meeting, and it is common for members to gather at nearby coffee shops.
Other meeting formats also exist where specific AA related topics are discussed in more detail. A common example is a Step Study meeting where one or more of the 12 steps are discussed at length.
==Disease of alcoholism==
{{main|Disease theory of alcoholism}}
The disease theory is generally accepted by the medical community, which argues that genetic, neurological and behavioral studies distinguish those with [[physical dependence|alcohol dependence]] from problem drinkers.<ref>[http://www.cdc.gov/alcohol/faqs.htm#12 Alcohol - Frequently Asked Questions], US Centers for Disease Control and Prevention (CDC)</ref> AA also regards alcoholism as a disease<ref>''[http://www.aa.org/en_is_aa_for_you.cfm?PageID=14 ''A Newcomer Asks]'' (AA pamphlet)</ref><ref>''[http://www.aa.org/en_information_aa.cfm?PageID=17&SubPage=63 The Alcoholic Can Recover]'' (AA pamphlet)</ref> (though Bill Wilson once stated that it was more comparable to an illness or malady),<ref> {{cite web | last = | first = | authorlink = | coauthors = | title = A Conversation with Bill W. | work = | publisher = | date = 2003 | url = http://www.nccatoday.org/conversation.htm | format = | doi = | accessdate = 2006-10-20 }}
</ref> and uses the concept to challenge the belief of chronic, compulsive drinkers that they can stay sober by willpower alone.<ref name="BIGBOOKCHAPTER3">{{cite book | last = Alcoholics Anonymous | title = Alcoholics Anonymous | publisher = Alcoholics Anonymous World Services | year = 2001 | month = June | edition = 4th edition | chapter = Chapter 3: More About Alcoholism | pages = 30 - 43 | location = [[New York, New York]] | isbn = 1893007162 | oclc = 32014950 | url = http://www.aa.org/bigbookonline/en_BigBook_chapt3.pdf | format = PDF}}</ref>
Dr William Silkworth introduced to Wilson and AA the idea that alcoholism is a disease consisting of an obsession to drink alcohol, and an allergy, which was the compulsion to continue drinking once the first drink had been taken.<ref name="littledoctor">Dale Mitchel, ''Silkworth: The Little Doctor Who Loved Drunks''. Hazelden, 2002.</ref> Alcoholics, he argued, can never safely use alcohol in any form at all, since once forming the habit, they cannot break it.<ref>''Alcoholics Anonymous'' ''The Doctor's Opinion'' page xxviii.</ref>
== Demographics ==
AA's 2004 survey of over 7500 members in Canada and the United States concluded that AA is composed of 89.1% white, 65% male, and 35% female members. Average member sobriety is eight years with 36% sober more than ten years, 14% sober from five to ten years, 24% sober from one to five years, and 26% sober less than one year. Before coming to AA, 64% of members received some type of treatment or counselling, such as medical, psychological, or spiritual. After coming to AA, 65% received outside treatment or counselling, and 84% of those members said that that outside help played an important part in their recovery.<ref name = "ogfaaa">http://www.alcoholics-anonymous.org/en_pdfs/p-48_04survey.pdf AA 2004 Membership Survey</ref>
==Influences on US treatment industry==
Since 1949 when [[Hazelden]] treatment center was founded by members of Alcoholics Anonymous, some alcoholic rehabilitation clinics have frequently incorporated precepts of the AA program into their own treatment programs.<ref>N. Roberson, ''Getting Better:Inside Alcoholics Anonymous'' (London: Macmillan, 1988), p 220</ref> A reverse influence has also occurred with AA receiving 31% of its membership from treatment center referrals.<ref name = "ogfaaa"/> However, Alcoholics Anonymous does not endorse and is not allied with any rehabilitation center or outside facility.
==Court rulings==
In the [[United States]], Since [[1996]] the Courts in a number of different cases have ruled that inmates, parolees, and probationers cannot be ordered to attend a religious based program such as AA or other recovery programs that have substantial religious components since such coercion is in violation of the [[Establishment Clause]] of the [[First Amendment to the United States Constitution|First Amendment]] of the Constitution.<ref name="EGELKO2007">{{cite news | last = Egelko | first = Bob | title = Appeals court says requirement to attend AA unconstitutional | date = 2007-09-08 | accessdate = 2007-10-08 | publisher = [[San Francisco Chronicle]] | url = http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/09/08/BA99S1AKQ.DTL}}</ref><ref>[http://www.ca9.uscourts.gov/ca9/newopinions.nsf/6FA63303852632AC8825734F0059D078/$file/0615474.pdf?openelement Inouye vs. Kemna page 11889]</ref> AA receives 11% of its membership from court ordered attendance.<ref name = "ogfaaa"/>
==Effectiveness==
{{See main|Effectiveness of Alcoholics Anonymous}}
===Limitations on research===
The study of AA tends to polarize observers into believers and non-believers,<!--<ref>Vaillant, 1995, p 255.</ref>--> and discussion of AA often creates argument rather than objective reflection.<!--<ref>Vaillant, 1995, p 265.</ref>--> Many researchers take a skeptical view of AA because some of AA's methods are spiritual, not scientific.<ref name="VAILLANT1995CHAPTER4">{{cite book |last = Vaillant| first = George Eman | authorlink = George Eman Vaillant | title = The Natural History of Alcoholism Revisited | publisher = Harvard University Press | edition = 2nd edition | month = May | year = 1995 | chapter = Chapter 4: Paths into Abstinence | pages = 231 - 277 | isbn = 0674603788 | oclc = 31605790}}</ref> A randomized trial of AA is very difficult because members are self-selected, not randomly selected.<ref name="EDWARDSCHAPTER8">{{cite book | last = Edwards | first = Griffith | authorlink = Griffith Edwards | title = Alcohol: The World's Favorite Drug | publisher = Thomas Dunne Books | edition = 1st edition | month = April | year = 2002 | chapter = Chapter 8: Alcoholics Anonymous | pages = 103 - 117 | isbn = 0312283873 | oclc = 48176740}}</ref> Two opposing types of self-selection bias are that drinkers may be motivated to stop drinking before they attend AA, and AA may attract the more severe and difficult cases.<ref name="HUMPHREYS2003">{{cite book | last = Humphreys | first = Keith | title = Recent Developments in Alcoholism | chapter = Alcoholics Anonymous and 12-Step Alcoholism Treatment Programs | volume = 16 | publisher = Springer US | doi = 10.1007/b100495 | year = 2002 | pages = 149 - 164 | pmid = 12638636 | isbn = 978-0-306-47258-9}}</ref> Control groups with AA versus non-AA subjects are also difficult because AA is so easily accessible.<ref name="HUMPHREYS2003"/>
===Studies===
Many studies have demonstrated an association between AA attendance and increased abstinence or other positive outcomes.<ref name="MOOS2006A">{{cite journal | last = Moos | first = Rudolf H. | coauthors = Moos, Bernice S. | title = Participation in Treatment and Alcoholics Anonymous: A 16-Year Follow-Up of Initially Untreated Individuals | journal = Journal of Clinical Psychology | month = June | year = 2006 | pages = 735 - 750 | doi = 10.1002/jclp.20259 | pmid=16538654}}</ref><ref name="MOOS2006B">{{cite journal | last = Moos | first = Rudolf H. | coauthors = Moos, Bernice S. | title = Rates and predictors of relapse after natural and treated remission from alcohol use disorders | journal = Addiction | volume = 101 | issue = 2 | pages = 212 – 222 | year = 2006 | month = February | doi = 10.1111/j.1360-0443.2006.01310.x | id = PMID 16445550}}</ref><ref name="MOOS2004">{{cite journal | last = Moos | first = Rudolf H. | coauthors = Moos, Bernice S. | title = Long-Term Influence of Duration and Frequency of Participation in Alcoholics Anonymous on Individuals with Alcohol Use Disorders | journal = Journal of Consulting and Clinical Psychology | year = 2004 | month = February | volume = 72 | issue = 1 | pages = 81 - 90 | doi = 10.1037/0022-006X.72.1.81 | pmid=16445550}}</ref><ref name="HUMPHREYS2001">{{cite journal | last = Humphreys | first = Keith | coauthors = Moos, Rudolf | month = May | year = 2001 | title = Can encouraging substance abuse patients to participate in self-help groups reduce demand for health care? A quasi-experimental study | journal = Alcoholism: Clinical and Experimental Research | volume = 25 | issue = 5 | pages = 711-716 | doi = 10.1111/j.1530-0277.2001.tb02271.x | pmid = 11371720 | issn = 1530-0277}}</ref><ref name = "wxjacx">J. Morgenstern et al. "Affiliation with Alcoholics Anonymous after treatment: a study of its therapeutic effects and mechanisms of action." (Department of Psychiatry, Mount Sinai School of Medicine, New York, 1997 Oct;65(5):768-7)</ref><ref>J. Scott Tonigan PhD. "Benefits of Alcoholics Anonymous Attendance" (University of New Mexico, 2001) pp 67 - 77</ref><ref>(August 1967). "A Controlled Experiment on the Use of Court Probation for Drunk Arrests". American Journal of Psychiatry 124 (2): Abstract.</ref><ref name="ATKINS2007">Atkins, R. G. & Hawdon, J. E. Journal of Substance Abuse Treatment "Religiosity and participation in mutual-aid support groups for addiction", Vol. 33, Issue 3, Oct. 2007, pp. 321-331 available online at www.sciencedirect.com </ref> Other studies have concluded that AA attendance can lead to poorer outcomes than other therapies.<ref>Brandsma, Jeffrey, Phd. , Maultsby , Maxie, Welsh, M.D. Richard, M.S.W. ''The OutPatient Treatment of Alcoholism </ref><ref name = "wxjacx"/><ref name="LARIMER1999">{{cite journal | last = Larimer | first = Mary E | coauthors = Palmer, Rebekka S; Marlatt, G. Alan | title = Relapse prevention. An overview of Marlatt's cognitive-behavioral model | year = 1999 | volume = 23 | issue = 2 | pages = 151-160 | pmid = 10890810 | journal = Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism | issn = 1535-7414 | oclc = 42453373}}</ref><ref>Two-Year Outcome of Alcohol Interventions in Swedish University Halls of Residence: A Cluster Randomized Trial of a Brief Skills Training Program, Twelve-Step-Influenced Intervention, and Controls Authors: Ståhlbrandt, Henriettæ1; Johnsson, Kent O.1; Berglund, Mats1 Source: Alcoholism Clinical and Experimental Research, Volume 31, Number 3, March 2007, pp. 458-466(9) Publisher: Blackwell Publishing http://www.ingentaconnect.com/content/bsc/acer/2007/00000031/00000003/art00014</ref><ref>[http://www.informaworld.com/smpp/content?content=10.1080/10550490701756393 Do Alcoholics Anonymous Groups Really Work? Factors of Adherence in a Brazilian Sample of Hospitalized Alcohol Dependents - American Journal on Addictions: The official Journal of the American Academy of Addiction Psychiatry<!-- Bot generated title -->]</ref>
Harvard professor of psychiatry [[George Eman Vaillant|George E. Vaillant]], a member of the Board of Trustees of Alcoholics Anonymous World Services, described his investigations into the effectiveness of AA in his book, ''[[The Natural History of Alcoholism Revisited]]''.<ref name="VAILLANT1995THEPROBLEM">{{cite book |last = Vaillant| first = George Eman | authorlink = George Eman Vaillant | title = The Natural History of Alcoholism Revisited | publisher = Harvard University Press | edition = 2nd edition | month = May | year = 1995 | chapter = Introduction: The Problem | pages = 1 - 11 | isbn = 0674603788 | oclc = 31605790}}</ref> Vaillant's research and literature surveys suggested indirect evidence that AA is an effective treatment for alcohol abuse,<ref name="VAILLANT1995CHAPTER4"/> partly because it is a cheap, community-based fellowship with easy access.<ref name="VAILLANT2005">{{cite journal | last = Vaillant | first = George E. | title = Alcoholics Anonymous: cult or cure? | journal = Australian and New Zealand Journal of Psychiatry | volume = 39 | issue = 6 | month = June | year = 2005 | pages = 431-436 | doi = 10.1111/j.1440-1614.2005.01600.x | id = PMID 15943643}}</ref>
[[Project MATCH]] was designed to determine which types of alcoholics responded best to different forms of treatment. The programs were administered by psychotherapists and, although twelve-step methods were incorporated into the therapy, actual AA meetings were not included.<ref name = "match">[http://www.niaaa.nih.gov/NewsEvents/NewsReleases/match.htm NIAAA Reports Project MATCH Main Findings], Press release from National Institute on Alcohol Abuse and Alcoholism, Dec 1996. Retrieved 2007-05-25.</ref><ref>Project Match Research Group. (1997). "Matching alcoholism treatments to client heterogeneity: Project MATCH Posttreatment drinking outcomes." ''Journal of Studies on Alcohol'', 58(1), 7-29.</ref> The study concluded that patient-treatment matching is not necessary in alcoholism treatment because the three techniques tested are equal in effectiveness. Although it is acknowledged that the TSF treatment group used in the Match study was not a true implementation of Alcoholics Anonymous some investigators believe that it represents the most rigorous investigation of this group to date.<ref>J. Scott Tonigan, Gerard J. Connors, and William R. Miller. "Participation and involvement in Alcoholics Anonymous", in Thomas Babor, Frances K. Del Boca, eds, ''Treatment Matching in Alcoholism'', Cambridge University Press: 2003, p 184.</ref>
===Attrition===
In a 1989 internal AA report based on an average of five surveys, it was estimated that of those who attended AA for the first time, 19% remained in AA after one month and 5% remained after twelve months. After the first year, the rate of attrition continues at a slower rate. About 40% of the members sober for less than a year will remain another year, About 80% of those sober less than five years will remain sober and active in the fellowship another year. About 90% of the members sober five years or more will remain sober and active in the fellowship another year, however the survey states that this information does not predict the number that will remain sober, and those who remain sober but not in the fellowship cannot be calculated. These figures have been repeated within a few percentage points using the same calculations since 1974.<ref name="AAInternalSurvey">[http://www.scribd.com/doc/3264243/Comments-on-AAs-Triennial-Surveys "Comments On A.A. Triennial Surveys" (PDF, 2 MB)], Dec. 1990, Alcoholics Anonymous World Services.</ref>
==Criticism and controversy==
{{see also|Twelve-step program#Criticism|l1=Twelve-step program: Criticism}}
===Moderation or abstinence===
AA acknowledges that not all drinkers are alcoholics, but advocates total abstinence for those who are.<ref>{{cite book | last = Alcoholics Anonymous | title = Alcoholics Anonymous | publisher = Alcoholics Anonymous World Services | year = 2001 | month = June | edition = 4th edition | location = [[New York, New York]] | isbn = 1893007162 | oclc = 32014950 | url = http://www.aa.org/bigbookonline/en_BigBook_chapt2.pdf | format = PDF}}</ref> Critics believe that more options should be available to problem drinkers who can manage their drinking with the right treatment.<ref name="SHUTE1997">{{cite journal | last = Shute | first = Nancy | title = The drinking dilemma: by calling abstinence the only cure, we ensure that the nation's $100 billion alcohol problem won't be solved | journal = [[U.S. News & World Report]] | volume = 123 | issue = 9 | month = September | year = 1997 | pages = 54–64}}[http://silkworth.net/magazine_newspaper/us_news_world_report_sep_8_1997.html]</ref>
A 2002 U.S. study by the [[National Institute on Alcohol Abuse and Alcoholism]] (NIAAA) showed that 17.7% of individuals diagnosed as alcohol dependent more than one year prior returned to low-risk drinking. However, this group showed fewer initial symptoms of dependency.<ref>Dawson DA, Grant BF, Stinson FS, Chou PS, Huang B, Ruan WJ. 2005. Recovery from DSM-IV alcohol dependence: United States, 2001-2002. : Addiction. Mar;100(3):281-92 </ref> A follow-up study, using the same NESARC subjects that were judged to be in remission in 2001-2002, examined the rates of return to problem drinking in 2004-2005. The major conclusion made by the authors of this NIAAA study was "Abstinence represents the most stable form of remission for most recovering alcoholics". <ref>Dawson DA, Goldstein RB, Grant BF. 2007. Rates and correlates of relapse among individuals in remission from DSM-IV alcohol dependence: a 3-year follow-up. Alcohol Clin Exp Res. 2007 Dec;31(12):2036-45. </ref> A long-term (60 year) follow-up of two groups of alcoholic men concluded that "return to controlled drinking rarely persisted for much more than a decade without relapse or evolution into abstinence."<ref>Vaillant GE. A 60-year follow-up of alcoholic men. Addiction. 2003 98, 1043-51. PMID: 12873238</ref>
===Other notable criticism===
*Psychologist [[Stanton Peele]], an opponent of the disease model, argues that AA groups apply the disease model to all problem drinkers, whether or not they are full-blown alcoholics.<ref>[[Stanton Peele]]. ''The Diseasing of America''. Lexington, MA: Lexington Books, 1989, http://www.peele.net/lib/diseasing.html</ref>
*AA undertakes no external restriction, screening, or vetting of its members.<ref>[http://www.aa.org/bigbookonline/en_appendiceI.cfm The A.A. Tradition<!-- Bot generated title -->]</ref>
*"Thirteenth-stepping" is a euphemistic term describing the practice of targeting new AA members for dates or sex.<ref name="BOGART2003">{{cite journal |journal=Journal of Addictions Nursing: A Journal for the Prevention and Management of Addictions |title='13th-Stepping:' Why Alcoholics Anonymous Is Not Always a Safe Place for Women |last=Bogart |first=Cathy J. |coauthors=Pearce, Carol E. |year=2003 |volume=14 |issue=1 |pages=43–47 |doi=10.1080/10884600305373 |issn=1548-7148 |oclc=34618968}}</ref>
*Although a statement is read during meetings that what is said there should remain confidential, AA members, unlike lawyers or clergy, are not legally bound to maintain confidentiality.<ref name="COLEMAN2005">{{cite journal | last = Coleman | first = Phyllis | title = Privilege and Confidentiality in 12-Step Self-Help Programs: Believing The Promises Could Be Hazardous to an Addict's Freedom | journal = The Journal of Legal Medicine | volume = 26 | issue = 4 | month = December | year = 2005 | pages = 435–474 | doi = 10.1080/01947640500364713 | issn = 0194-7648 | oclc = 4997813}}</ref> As communication between AA members is not covered under client, patient, or clergy privilege, they can be called upon to testify against other AA members in a court of law. Even though two people may promise not to disclose a shared confidence, the courts are not bound to honor that promise.<ref> New York Times, Jan Hoffman June 15, 1994 ["Faith in Confidentiality of Therapy Is Shaken" http://query.nytimes.com/gst/fullpage.html?res=9F0CE4D81F3AF936A25755C0A962958260&sec=&spon=&pagewanted=all]</ref><ref>Associated Press ["Federal Appeals Court backs Use of AA confessions to convict man" http://www.freedomforum.org/templates/document.asp?documentID=16575&printerfriendly=1]</ref>
== Literature ==
* {{cite book | last = Alcoholics Anonymous | title = Alcoholics Anonymous | publisher = Alcoholics Anonymous World Services | date = 1976-06-01 | isbn = 0916856593 | oclc = 32014950 | url = http://www.aa.org/bigbookonline}}
* {{cite book | last = Alcoholics Anonymous | title = Twelve Steps and Twelve Traditions | publisher = Alcoholics Anonymous World Services | date = 2002-02-10 | isbn = 0916856011 | oclc = 13572433}}
* {{cite book | last = Alcoholics Anonymous | title = Pass It On | publisher = Alcoholics Anonymous World Services | date = 1984 | isbn = 0916856011 |oclc=13572433}}
==See also==
{{Col-begin}}
{{Col-2}}
* [[History of Alcoholics Anonymous]]
* [[Addiction recovery groups]]
* [[Al-Anon/Alateen]]
* [[Drunkenness]]
* [[Alcoholism]]
{{Col-2}}
* [[Self-help groups for mental health]]
* [[List of twelve-step groups]]
* [[Twelve-step program]]
* [[Substance abuse]]
* [[Recovery model]]
{{Col-end}}
==References==
{{reflist|2}}
==External links==
* [http://www.aa.org/ AA official website]
[[Category:Alcohol abuse]]
[[Category:Addiction and substance abuse organizations]]
[[Category:Twelve-step programs]]
[[Category:Organizations established in 1935]]
[[Category:Non-profit organizations]]
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[[it:Alcolisti Anonimi]]
[[lt:Anoniminiai alkoholikai]]
[[nl:Anonieme Alcoholisten]]
[[ja:アルコホーリクス・アノニマス]]
[[no:Anonyme alkoholikere]]
[[pl:Anonimowi Alkoholicy]]
[[pt:Alcoólicos Anónimos]]
[[ru:Анонимные алкоголики]]
[[sr:Анонимни алкохоличари]]
[[szl:Anůńimowe Alkoholiki]]
[[fi:AA-liike]]
[[sv:Anonyma Alkoholister]]
[[tr:Anonim Alkolikler]]
[[uk:Спільнота анонімних алкоголіків]]
[[zh:戒酒無名會]]