Alcoholics Anonymous

DEFINITION: Alcoholics Anonymous is a worldwide voluntary association that promotes a program of total abstinence, adherence to a twelve-step program for personal reformation, attendance at meetings, volunteer service to recover from alcohol use disorder, and volunteer service to help others achieve recovery.

DATE: Established June 1935

Background

Alcoholism, the compulsion to consume alcohol in quantities that seriously undermines physical health and normal functioning, has long been an enormous social issue without a quick or clear solution. Up until the mid-1930s, few options were available. In the United States, Prohibition, which attempted to combat alcohol abuse by making alcohol illegal, had been repealed after proving to be a failure.

Physicians and psychiatrists, using the best knowledge available, had scant success keeping alcoholics sober, and they increasingly refused to treat them. The only faith-based programs that had much success were those that demanded unswerving allegiance and major lifestyle changes.

In 1934, a stockbroker in New York named Bill Wilson, who had a history of failed treatment for alcohol abuse, became involved with the Oxford Group, a movement of personal transformation that was nonsectarian but explicitly Christian. The Oxford Group followed a series of six steps for reforming one’s life. Wilson achieved sobriety and had a profound spiritual experience during his last bout of detoxifying from alcohol. He wanted to share his experience with other people struggling with alcoholism.

In Akron, Ohio, one year later, discouraged and once again tempted to drink, Wilson tried the only thing he knew that would keep him sober: reaching out to another alcoholic. Alcoholics Anonymous (AA) dates its foundation from Wilson’s meeting with surgeon Bob Smith, another alcoholic, in the spring of 1935.

AA as such did not actually take shape until 1939, when the newly established Alcoholic Foundation published the first edition of the book Alcoholics Anonymous, consisting of Wilson’s personal story, a description of the issue of alcoholism, an outline of the program’s twelve-steps process, advice to employers and families, advice on how to spread the program’s message, and thirty-nine personal stories of recovery from alcoholism gleaned from a membership of roughly one hundred persons. Wilson approached businessman John D. Rockefeller Jr., hoping for major philanthropic support, which was not forthcoming. Rockefeller did, however, offer advice on making the organization self-supporting. He also underwrote some expenses during the early years and provided valuable publicity. AA soon established an office in New York to field inquiries and to provide support to people wanting to form new AA groups.

After an article in the Saturday Evening Post provided nationwide exposure to AA, membership in AA rose from about two thousand persons in 1940 to about six thousand persons in 1941. Membership continued to rise, reaching about one hundred thousand in 1950, the year of the first international convention of AA in Cleveland, Ohio. Though it would continue to fluctuate into the twenty-first century, membership passed the one million mark around 1970 and spread further worldwide; by the 2020s, it was available in some form in around 180 countries.

The organizational structure of AA dates from 1951, when Wilson turned over directorship to a general service conference consisting of delegates elected by representatives of AA groups. This body determines AA policy. Between annual conferences, a board of trustees determines the day-to-day running of the central organization. Individual groups have a high degree of autonomy, and the higher levels have no coercive power over them.

Mission and Goals

The mission and goals of AA are neatly summarized in a statement that appears in most literature distributed by AA’s General Service Office. The statement is read at the beginning of many meetings:

Alcoholics Anonymous is a fellowship of people who share their experience, strength, and hope with each other that they may solve their common problem and help others to recover from alcoholism. The only requirement for membership is a desire to stop drinking. There are no dues or fees for AA membership; we are self-supporting through our own contributions. AA is not allied with any sect, denomination, politics, organization or institution; does not wish to engage in any controversy, neither endorses nor opposes any causes. Our primary purpose is to stay sober and help other alcoholics to achieve sobriety.

Throughout its years of operations, AA has adhered closely to its primary purpose: avoiding involvement in politics and leaving to treatment programs any recovery concerns for other addictions and compulsions. AA has remained entirely self-supporting, and it has received no funding from government agencies or private foundations while also refusing large contributions from individual members. Operating expenses have remained low because volunteers perform most functions.

AA Meetings

Critical to the success of AA has been that it remains open to anyone wishing to make use of its services. The fundamental unit of AA has remained the meeting, offered one or more times each week, free of charge, and open to anyone seeking support. Meetings are available in all but the most remote communities, and urban areas offer many types of groups, including those in foreign languages. Meeting participants elect representatives who act as a sort of legislature. In urban areas, meetings form an intergroup to maintain an office and answering service, handle public information, and carry the AA message to prisons and other institutions. During the COVID-19 pandemic that began in 2020, many AA groups that could not meet in person held virtual meetings. The organization developed an app allowing users to locate both in-person and online meetings, and it continued to offer this app and virtual meetings as COVID-19 restrictions lifted in following years.

With the rise of the treatment-center industry, AA is no longer the first entry into recovery for the majority of alcoholics, although many still follow this route exclusively. AA cooperates with treatment programs, providing literature and holding meetings in facilities when requested to do so.

A valuable feature of AA that is not provided by many treatment programs is ongoing sobriety support, which can last a lifetime. Those who remain sober but who continue to go to meetings are at these meetings not necessarily because they are tempted to drink; often, they find the ongoing social support of a group of like-minded people to be helpful in meeting life’s challenges.

There is a saying that AA is for people who want AA, not for those who need AA. The organization does not conduct interventions or engage in high-pressure advertising, and it deals directly with the person struggling with alcoholism rather than with family members, employers, or the courts. Meetings and attendees differ a good deal on the degree to which they will work with outside agencies on a particular case. The principle of anonymity dictates that meetings and sponsors not keep records of attendees’ progress. This anonymity and the spiritual aspect of the program have led many court diversion programs, for example, to avoid AA and to embrace professional counseling.

The core of a person’s recovery program in AA is working the twelve steps, usually with a sponsor who is an experienced AA member. These steps involve admission of powerlessness over alcohol (step 1), reliance on a higher power (steps 2, 3, 6, 7, and 11), examination of conscience (steps 4, 5, and 10), identifying people one has harmed and then making amends (steps 8 and 9), and working with others (step 12).

The spiritual aspect, based on a higher power of the member’s understanding, is flexible enough to accommodate a wide range of religious beliefs but has proven a stumbling block both to atheists and to religious fundamentalists. Other critics have questioned the program’s efficacy in treating alcohol use disorders; rigorous experimental evidence for the efficacy of AA in the treatment of alcoholism has been mixed. Members may also be addicted to illicit drugs and are encouraged to attend Narcotics Anonymous. In some cases, AA participants may also be addicted to prescription medications and/or are being treated for major psychiatric disorders.

Though not a panacea or cure for alcohol addiction on a societal level, AA has helped thousands of people at the individual level achieve sobriety. AA’s success has spawned more than one hundred anonymous-type twelve-step programs of varying utility.

Bibliography

Alcoholics Anonymous. Alcoholics Anonymous World Services, 2013.

Alcoholics Anonymous Comes of Age: A Brief History of AA. Alcoholics Anonymous World Services, 1985.

Dick B. The Oxford Group and Alcoholics Anonymous. Glen Abbey, 1992.

Dodes, Lance, and Zachary Dodes. Debunking the Bad Science behind 12-Step Programs and the Rehab Industry. Beacon, 2014.

Glaser, Gabrielle. "The Irrationality of Alcoholics Anonymous." The Atlantic, Apr. 2015, www.theatlantic.com/magazine/archive/2015/04/the-irrationality-of-alcoholics-anonymous/386255/. Accessed 30 Oct. 2015.

Hartigan, Francis. Bill W.: A Biography of Alcoholics Anonymous Cofounder Bill Wilson. St. Martin’s, 2000.

Kaskutas, Lee Ann. "Alcoholics Anonymous Effectiveness: Faith Meets Science." Journal of Addictive Diseases, vol. 28, no. 2, 2009, pp. 145–57.

Lee, Nicole. "Does Alcoholics Anonymous Actually Work?" The Conversation, 4 Apr. 2022, theconversation.com/does-alcoholics-anonymous-actually-work-179665. Accessed 17 Dec. 2024.

"The Start and Growth of A.A." Alcoholics Anonymous, www.aa.org/the-start-and-growth-of-aa. Accessed 17 Dec. 2024.

Wilson, William. Twelve Steps and Twelve Traditions. Alcoholics Anonymous World Services, 1952.