Vivian Marlowe
Alcoholics Anonymous (AA) is a global, peer-led fellowship with a focus on an abstinence-based recovery model from alcoholism. AA's twelve-step program is spiritually inclined and emphasises anonymity, a lack of hierarchy, and staying non-promotional, unaffiliated, non-denominational, apolitical, and free. AA was founded in 1935 by Bill Wilson and Bob Smith, two individuals with a shared struggle with alcoholism. The organization is self-supporting through member donations and literature sales and does not accept external funding. AA defines an alcoholic as someone who has a progressive illness that can never be cured but can be arrested. This illness is characterized by a physical sensitivity to alcohol and a mental obsession with drinking that cannot be broken by willpower alone. AA's program has helped over two million members worldwide achieve recovery and continued sobriety.
| Characteristics | Values |
|---|---|
| Definition of an Alcoholic | Alcohol use disorder (AUD) is a chronic medical condition that affects the brain and makes one unable to control alcohol use despite negative consequences on health, work, or social life. |
| Alcoholics Anonymous (AA) | A global, peer-led, mutual-aid fellowship focused on an abstinence-based recovery model from alcoholism through a spiritually inclined 12-step program. |
| AA's View on Alcoholism | Alcoholism is a progressive illness that can never be cured but can be arrested. It is a combination of physical sensitivity to alcohol and a mental obsession with drinking, which cannot be broken by willpower alone. |
| AA's Approach | AA provides a structured and gradual process of recovery through a 12-step program. The program is free and available to anyone with a desire to stop drinking alcohol. |
| AA's Effectiveness | Empirical evidence supports AA's efficacy. A 2020 Cochrane review found that AA and Twelve-Step Facilitation therapy demonstrated higher rates of continuous abstinence compared to alternative treatments. |
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What You'll Learn
Alcohol use disorder (AUD)
The risk of developing AUD depends on various factors, including the amount, frequency, and speed of alcohol consumption. Genetics and family history also play a significant role, with hereditability accounting for approximately 60%. Mental health conditions, such as depression, post-traumatic stress disorder, and attention deficit hyperactivity disorder, are associated with an increased risk of AUD. Additionally, individuals with a history of childhood trauma are also vulnerable to developing AUD.
The treatment for AUD aims to achieve and maintain recovery. It includes behavioural therapies, mutual-support groups, and medications. Behavioural treatments, also known as alcohol counselling or talk therapy, are provided by licensed therapists and focus on changing drinking behaviour. Mutual-support groups, such as Alcoholics Anonymous (AA), offer peer support for stopping or reducing drinking. AA is a global fellowship that follows a spiritually inclined twelve-step program towards abstinence-based recovery from alcoholism. The twelve steps begin with acknowledging powerlessness over alcohol and progress through rigorous honesty, amends, and regular prayer or meditation. The final step emphasises maintaining recovery principles, sharing experiences with other alcoholics, and participating in peer sponsorship.
Medications such as naltrexone, acamprosate, and disulfiram are approved to help reduce drinking and prevent relapse. It is important to note that treatment approaches may vary depending on the individual, and severe cases of AUD may require medical assistance to manage alcohol withdrawal symptoms.
If you think you might have AUD, it is recommended to consult a healthcare provider for an evaluation and appropriate treatment plan.
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AA's 12-step programme
Alcoholics Anonymous (AA) is a global, peer-led, mutual-aid fellowship that focuses on an abstinence-based recovery model from alcoholism through its spiritually inclined 12-step programme. AA is non-hierarchical, apolitical, unaffiliated, non-denominational, and free to all. The 12 steps are outlined in the book Alcoholics Anonymous and are meant to be addressed in sequential order, but there is no "right" way to approach them.
The first step in the 12-step programme is to admit powerlessness over alcohol and the unmanageability of life due to alcoholism. The second step emphasizes seeking help from others and believing that a power greater than oneself can restore sanity. The third step involves making a decision to turn one's life over to the care of a "higher power", which does not have to be a religious entity and can be interpreted in a way that aligns with one's personal beliefs.
The fourth step involves a rigorous self-assessment, including the acknowledgment of "character defects". The fifth step involves sharing this inventory with a trusted person and admitting one's exact wrongdoings. The sixth step is about being ready to have one's shortcomings removed and humbly asking for help in doing so. The seventh step involves making a list of all the people one has harmed and becoming willing to make amends.
The eighth step is about making direct amends to those one has harmed, except when doing so would cause further injury. The ninth step involves taking personal inventory and promptly admitting when one is wrong. The tenth step emphasizes seeking guidance through prayer and meditation to improve one's conscious contact with a "higher power". The eleventh step focuses on maintaining the principles of recovery and sharing one's experience with other alcoholics.
The twelfth and final step is about having a spiritual awakening as a result of the previous steps and carrying this message to other alcoholics. This step also involves participating in "12th Step work", such as peer sponsorship, organizing meetings, and outreach to institutions. The 12-step programme offers a structured and gradual process of recovery, helping individuals change thoughts, behaviours, and relationships related to addiction. It provides a sense of belonging, support, and a new direction in life.
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AA's approach to anonymity
Alcoholics Anonymous (AA) is a global, peer-led mutual-aid fellowship that focuses on an abstinence-based recovery model from alcoholism through its spiritually inclined twelve-step program. AA's Twelve Traditions emphasize anonymity, lack of hierarchy, staying non-promotional, and non-professional, while also being unaffiliated, non-denominational, apolitical, and free.
The Eleventh Tradition states that AA's public relations policy is based on attraction rather than promotion, and members must maintain personal anonymity at the level of the press, radio, TV, films, and the internet. Anonymity at this level ensures that members do not exploit their AA affiliation to achieve recognition, power, or personal gain. When using social media and other online platforms, members are responsible for their own anonymity and that of others.
The Twelfth Tradition states that anonymity is the spiritual foundation of all AA traditions, reminding members to place principles before personalities. Anonymity serves as a safeguard at the personal level, protecting all members from identification as alcoholics, and is especially important to newcomers. It also serves as a spiritual principle at the public level, stressing the equality of all members and unity in their common bond of recovery from alcoholism.
AA members generally believe that the anonymity of a member should be respected even after their death, and the final decision rests with the family. Members may disclose their identity and speak as recovered alcoholics without revealing their AA membership. They may speak publicly as AA members only if their full names or faces are not revealed, and they speak as individual members, not for AA.
The founding members of AA believed that even appointed leaders of an AA group should keep their individual opinions out of decision-making and instead rely on the "group conscious". This tradition was created to keep members feeling safe, supported, and secure, and to prevent stronger egos from dominating the group. Anonymity in AA is rooted in the principle of humility, reminding members that AA is meant to be shared as a solution to alcoholism through the sharing of lived experiences and storytelling. It seeks to create equity among members by asking them to set aside their personal beliefs, biases, or feelings about specific situations or individuals, remembering that all members share the common goal of recovery.
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AA's history and origins
Alcoholics Anonymous (AA) is a global, peer-led mutual-aid fellowship with a focus on an abstinence-based recovery model from alcoholism. Its spiritually inclined twelve-step program is available to anyone with a desire to stop drinking alcohol. AA was founded in 1935 by Bill Wilson (known as Bill W.) and Robert Smith (Dr. Bob), two individuals who shared a struggle with alcoholism.
In late 1935, a new group of alcoholics began forming in New York, followed by another in Cleveland in 1939. Over four years, these initial groups helped around 100 people achieve sobriety. In 1939, the fellowship published its foundational text, Alcoholics Anonymous, outlining AA's philosophy, introducing the Twelve Steps, and including the case histories of 30 individuals who had achieved recovery. The Twelve Steps were influenced by the Oxford Group's six steps and various readings, including William James's The Varieties of Religious Experience.
The book Alcoholics Anonymous, also known as the "Big Book", describes the AA program of recovery and contains stories from co-founders and a wide range of members who have found recovery in AA. The first part of the book, which details the program, has largely remained intact since the 1939 edition, with minor statistical updates and edits. The second part contains personal stories that are updated with every edition to reflect current AA membership. The Big Book suggests a twelve-step program in which members admit that they are powerless over alcohol and need help from a "higher power".
In 1938, Dr. Bob and Bill created The Alcoholic Foundation in New York, bringing in friends of John D. Rockefeller Jr. as board members. Rockefeller advised that large contributions might jeopardize the Fellowship. The foundation opened a small office in New York, primarily funded by AA members, to handle inquiries and distribute the Alcoholics Anonymous book. Rockefeller also organized a dinner to promote AA in 1939, which further increased inquiries and led to the establishment of many new AA groups. By the end of 1940, membership had grown to 2,000.
AA's Twelve Traditions emphasize anonymity, a lack of hierarchy, non-promotion, and non-professionalism, while also remaining unaffiliated, non-denominational, apolitical, and free. As of 2021, AA is active in 180 countries with an estimated membership of nearly two million. AA's efficacy has been supported by empirical evidence, with a 2020 Cochrane review finding that manualized AA and Twelve-Step Facilitation (TSF) therapy demonstrated higher rates of continuous abstinence compared to alternative treatments.
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The progressive nature of alcoholism
Alcoholism, or Alcohol Use Disorder (AUD), is a chronic, progressive, and potentially fatal disorder characterised by excessive, compulsive drinking that leads to psychological and physical dependence or addiction. It is considered a progressive disease, meaning that without intervention, it tends to worsen over time.
The stages of alcoholism progress from experimental use, where a person first tries alcohol, often due to peer pressure or curiosity, to recreational use, where a person consumes alcohol occasionally and without excess. As a person continues drinking, they move from drinking for social reasons to drinking for psychological reasons. This is the pre-alcoholic stage, which is difficult to identify because alcohol has yet to cause any problems and drinking has not become compulsive. However, even at this stage, the individual may be unable to recognise that their drinking may progress into something more serious. As the person continues to drink, their body becomes increasingly dependent on ethanol to release certain neurotransmitters, leading to physical dependence on alcohol.
The middle stage of alcoholism is marked by increased tolerance, where the individual may notice a marked improvement in alcohol tolerance, drinking to calm their nerves or during stressful situations. They may also experience lapses in memory and recall, especially after periods of heavy consumption. At this stage, the individual may begin to exhibit defensive behaviours when confronted about their drinking by family and friends. As the middle stage progresses, alcohol intake becomes compulsive and physically necessary, and the individual's ability to regulate their use diminishes.
The late stage of alcoholism is characterised by a complete loss of control over drinking, increased negative consequences, and potential severe physical and mental health complications. The individual may experience conflicts with family members, attendance problems at work, severe hangovers, DUIs, and other negative encounters with law enforcement. Untreated alcoholism can lead to devastating consequences, including liver disease, heart problems, neurological damage, and even death. Additionally, individuals with untreated alcoholism are at a higher risk for co-occurring mental health conditions such as depression and anxiety.
Alcoholism is not a choice or a moral failing but a complex interplay of genetic, psychological, and environmental factors. Recognising the signs of alcoholism and seeking help early on is crucial in managing the disease.
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Frequently asked questions
An alcoholic is someone who suffers from alcohol use disorder (AUD). This is a common medical condition where people are unable to control their alcohol consumption despite the negative consequences on their health, work, or social life.
Alcoholics Anonymous is a global, peer-led fellowship that supports recovery from alcoholism through a spiritually inclined twelve-step program. AA is free and open to anyone with a desire to stop drinking alcohol. The program emphasizes anonymity, mutual aid, and abstinence from alcohol.
Signs and symptoms of alcoholism or AUD include craving alcohol, spending excessive time drinking or recovering from hangovers, failing to meet obligations due to drinking, giving up important activities because of alcohol, drinking in hazardous situations, experiencing withdrawal symptoms, and having a high tolerance for alcohol.
Treatment for alcoholism or AUD typically includes medication and behavioural therapy. The twelve-step program offered by Alcoholics Anonymous has been successful in helping over two million people achieve and maintain sobriety.
