Aa how does it work

The person leading the meeting chooses a topic and members to take turns sharing their experience on the topic. Some AA meetings are designated for a specific purpose, such as step study groups or beginners' meetings designed to teach newcomers about the basics of the program.

There are several studies that have shown that people who were involved in mutual support groups were more likely to remain abstinent than those who tried to quit by themselves. There have been several studies that show that people who seek professional treatment or counseling for their drinking problems have better outcomes if they combine participation in AA along with their outpatient or inpatient treatment program.

A new study published in the Cochrane Library found that AA and step groups can lead to higher rates of continuous abstinence over months and years, when compared to treatment approaches like cognitive behavioral therapy. Clearly, faith-based programs such as Alcoholics Anonymous are not for everyone. Although millions of people claim to have found lasting recovery in AA, the spiritual aspect of the program can be a stumbling block for some who wish to stop drinking.

Can AA help you? The only way to find out is to give it a try and see for yourself if you think the help and support from others struggling with the same problem will help you stay sober.

AA has no dues or fees, so it won't cost you anything to visit a meeting. The effect of AA can be best seen when a correct "dose" is given, typically 90 meetings in 90 days. Trying a couple meetings is not an adequate trial. For more mental health resources, see our National Helpline Database. Alcoholics Anonymous is usually listed in the white pages of most local telephone books.

Call your local number for information on meetings in your area. The Central office, intergroup or answering service numbers throughout the world are available on the AA World Services website.

There are also many online meetings available. It's also important to note that meeting effectiveness depends on finding a meeting that's right for you. There are many different types of meetings for different groups of demographics.

For example, an intercity group of AA members who are mostly homeless is not likely to help a struggling young mother with an alcohol problem. You really have nothing to lose by giving it a try. Learn the best ways to manage stress and negativity in your life.

Mendola A, Gibson RL. Addiction, step programs, and evidentiary standards for ethically and clinically sound treatment recommendations: What should clinicians do? AMA J Ethics. History Links. Mitchell K's favorite Alcoholics Anonymous history links and other A.

Updated February Alcoholics Anonymous. Information on Alcoholics Anonymous. Updated Everyone there warned him that he had a chronic, progressive disease and that if he listened to the cunning internal whisper promising that he could have just one drink, he would be off on a bender.

He went back to rehab once more and later sought help at an outpatient center. Evening would fall and his heart would race as he thought ahead to another sleepless night.

I might as well drink as much as I possibly can for the next three days. He felt utterly defeated. And according to AA doctrine, the failure was his alone.

Hospitals, outpatient clinics, and rehab centers use the 12 steps as the basis for treatment. But although few people seem to realize it, there are alternatives, including prescription drugs and therapies that aim to help patients learn to drink in moderation. Unlike Alcoholics Anonymous, these methods are based on modern science and have been proved, in randomized, controlled studies, to work. For J. But in a sense, he was lucky: many others never make that discovery at all.

T he debate over the efficacy of step programs has been quietly bubbling for decades among addiction specialists. But it has taken on new urgency with the passage of the Affordable Care Act, which requires all insurers and state Medicaid programs to pay for alcohol- and substance-abuse treatment, extending coverage to 32 million Americans who did not previously have it and providing a higher level of coverage for an additional 30 million.

Nowhere in the field of medicine is treatment less grounded in modern science. A report by the National Center on Addiction and Substance Abuse at Columbia University compared the current state of addiction medicine to general medicine in the early s, when quacks worked alongside graduates of leading medical schools. The American Medical Association estimates that out of nearly 1 million doctors in the United States, only identify themselves as addiction specialists. The Columbia report notes that there may be additional doctors who have a subspecialty in addiction.

Most treatment providers carry the credential of addiction counselor or substance-abuse counselor, for which many states require little more than a high-school diploma or a GED. Many counselors are in recovery themselves. Alcoholics Anonymous was established in , when knowledge of the brain was in its infancy. It offers a single path to recovery: lifelong abstinence from alcohol. Alcoholics Anonymous is famously difficult to study.

By necessity, it keeps no records of who attends meetings; members come and go and are, of course, anonymous. No conclusive data exist on how well it works. During that time, I encountered disbelief from doctors and psychiatrists every time I mentioned that the Alcoholics Anonymous success rate appears to hover in the single digits.

But think about it: How many celebrities can you name who bounced in and out of rehab without ever getting better? Why do we assume they failed the program, rather than that the program failed them? Alcoholics Anonymous has more than 2 million members worldwide, and the structure and support it offers have helped many people.

But it is not enough for everyone. The history of AA is the story of how one approach to treatment took root before other options existed, inscribing itself on the national consciousness and crowding out dozens of newer methods that have since been shown to work better. A meticulous analysis of treatments, published more than a decade ago in The Handbook of Alcoholism Treatment Approaches but still considered one of the most comprehensive comparisons, ranks AA 38th out of 48 methods.

At the top of the list are brief interventions by a medical professional; motivational enhancement, a form of counseling that aims to help people see the need to change; and acamprosate, a drug that eases cravings. An oft-cited study found step facilitation—a form of individual therapy that aims to get the patient to attend AA meetings—as effective as cognitive behavioral therapy and motivational interviewing.

But that study, called Project Match, was widely criticized for scientific failings, including the lack of a control group. As an organization, Alcoholics Anonymous has no real central authority—each AA meeting functions more or less autonomously—and it declines to take positions on issues beyond the scope of the 12 steps. But many in AA and the rehab industry insist the 12 steps are the only answer and frown on using the prescription drugs that have been shown to help people reduce their drinking.

People with alcohol problems also suffer from higher-than-normal rates of mental-health issues, and research has shown that treating depression and anxiety with medication can reduce drinking. Paul and a former director of treatment and recovery research at the National Institute on Alcohol Abuse and Alcoholism, told me.

He threw up his hands. Part of the problem is our one-size-fits-all approach. Alcoholics Anonymous was originally intended for chronic, severe drinkers—those who may, indeed, be powerless over alcohol—but its program has since been applied much more broadly. Today, for instance, judges routinely require people to attend meetings after a DUI arrest; fully 12 percent of AA members are there by court order.

Whereas AA teaches that alcoholism is a progressive disease that follows an inevitable trajectory, data from a federally funded survey called the National Epidemiological Survey on Alcohol and Related Conditions show that nearly one-fifth of those who have had alcohol dependence go on to drink at low-risk levels with no symptoms of abuse.

The new term replaces the older alcohol abuse and the much more dated alcoholism , which has been out of favor with researchers for decades. Only about 15 percent of those with alcohol-use disorder are at the severe end of the spectrum.

The rest fall somewhere in the mild-to-moderate range, but they have been largely ignored by researchers and clinicians. Both groups—the hard-core abusers and the more moderate overdrinkers—need more-individualized treatment options. It also costs the country hundreds of billions of dollars in expenses related to health care, criminal justice, motor-vehicle crashes, and lost workplace productivity, according to the CDC.

Have they been proved effective? And for whom—only those at the extreme end of the spectrum? Or also those in the vast, long-overlooked middle? For a glimpse of how treatment works elsewhere, I traveled to Finland, a country that shares with the United States a history of prohibition inspired by the American temperance movement, the Finns outlawed alcohol from to and a culture of heavy drinking.

I met with Sinclair in Helsinki in early July. He was battling late-stage prostate cancer, and his thick white hair was cropped short in preparation for chemotherapy. Sinclair expected that after several weeks without booze, the rats would lose their desire for it. Instead, when he gave them alcohol again, they went on week-long benders, drinking far more than they ever had before—more, he says, than any rat had ever been shown to drink.

Sinclair called this the alcohol-deprivation effect, and his laboratory results, which have since been confirmed by many other studies, suggested a fundamental flaw in abstinence-based treatment: going cold turkey only intensifies cravings. This discovery helped explain why relapses are common. Sinclair published his findings in a handful of journals and in the early s moved to Finland, drawn by the chance to work in what he considered the best alcohol-research lab in the world, complete with special rats that had been bred to prefer alcohol to water.

He spent the next decade researching alcohol and the brain. Sinclair came to believe that people develop drinking problems through a chemical process: each time they drink, the endorphins released in the brain strengthen certain synapses. The stronger these synapses grow, the more likely the person is to think about, and eventually crave, alcohol—until almost anything can trigger a thirst for booze, and drinking becomes compulsive.

To test this hypothesis, he administered opioid antagonists—drugs that block opiate receptors—to the specially bred alcohol-loving rats. He found that if the rats took the medication each time they were given alcohol, they gradually drank less and less. He published his findings in peer-reviewed journals beginning in the s. Subsequent studies found that an opioid antagonist called naltrexone was safe and effective for humans, and Sinclair began working with clinicians in Finland.

He suggested prescribing naltrexone for patients to take an hour before drinking. As their cravings subsided, they could then learn to control their consumption. Numerous clinical trials have confirmed that the method is effective, and in Sinclair published a paper in the journal Alcohol and Alcoholism reporting a 78 percent success rate in helping patients reduce their drinking to about 10 drinks a week.

Some stopped drinking entirely. I visited one of three private treatment centers, called the Contral Clinics, that Sinclair co-founded in Finland. In the past 18 years, more than 5, Finns have gone to the Contral Clinics for help with a drinking problem. Seventy-five percent of them have had success reducing their consumption to a safe level. He poured coffee and showed me around the clinic, in downtown Helsinki.

The most common course of treatment involves six months of cognitive behavioral therapy, a goal-oriented form of therapy, with a clinical psychologist. Treatment typically also includes a physical exam, blood work, and a prescription for naltrexone or nalmefene, a newer opioid antagonist approved in more than two dozen countries. When I asked how much all of this cost, Keski-Pukkila looked uneasy. When I told Keski-Pukkila this, his eyes grew wide.

I listed some of the treatments offered at top-of-the-line rehab centers: equine therapy, art therapy, mindfulness mazes in the desert. As I researched this article, I wondered what it would be like to try naltrexone, which the U. Food and Drug Administration approved for alcohol-abuse treatment in I asked my doctor whether he would write me a prescription. Not surprisingly, he shook his head no. I ordered some naltrexone online and received a foil-wrapped package of 10 pills about a week later.

The first night, I took a pill at An hour later, I sipped a glass of wine and felt almost nothing—no calming effect, none of the warm contentment that usually signals the end of my workday and the beginning of a relaxing evening. I finished the glass and poured a second. By the end of dinner, I looked up to see that I had barely touched it. Among the many ways that participation in Alcoholics Anonymous AA helps its members stay sober, two appear to be most important — spending more time with individuals who support efforts toward sobriety and increased confidence in the ability to maintain abstinence in social situations.

In a paper that will appear in the journal Addiction and has been released online, researchers report the first study to examine the relative importance to successful recovery of the behavior changes associated with participation in AA. While subsequent studies have documented the short- and long-term benefits of AA participation, only recently have researchers investigated how those benefits are conferred.

A broad range of factors associated with AA participation have been identified as contributing to recovery including changes in social networks, maintaining motivation, confidence in the ability to cope with the demands of recovery, decreased depression symptoms, and increased spirituality — but no study as yet has been able to determine the relative importance of those mechanisms.

To meet that goal, the current study analyzed data from more than 1, study participants who had been enrolled at nine U. Almost 1, were recruited into the study directly from the community, and another had received prior inpatient treatment, indicating a greater degree of alcohol dependence.

Along with the treatment approaches being tested in Project MATCH — cognitive behavioral therapy, motivational enhancement therapy, and a step therapy — participants were free to attend AA meetings. At follow-up sessions three, nine, and 15 months after completing the Project MATCH therapies, participants received several assessments.