Alcoholics Anonymous Research Articles

Alcoholics and narcotics anonymous: A radical movement under threat

In recent decades, the considerable proliferation of the self-help groups (especially those of the Alcoholics Anonymous (AA) and Narcotics Anonymous (NA)) has attracted the interest of those engaged in the social sciences as well as of those responsible for mapping out health policies. This article is based on the 10-year involvement of the authors in a participatory action research project for the promotion of self-help groups in Greece as well as to an extensive literature review of the AA and NA movements. Based on this methodology, the objective of this article is twofold. First, it identifies the radical perspective of self-help groups, as the main source for their effectiveness, while it attempts an assessment of their effect on traditional professional attitudes. Second, it raises concerns over the radical perspective of these initiatives in the framework of their transition from an alternative stance towards their integration in formal Health Systems. This transition process is manifested in the following developments: (1) the constantly increasing number of old members who quit the role of the volunteer sponsor and undertake the financially beneficial role of (para-) professional addiction counselor; (2) the instrumentalization of 12 steps; (3) the increasing number of members who adopt the nosological perspective of addiction 4. The various adverse effects of dominant culture on the internal working of the groups are studied. Moreover, this article attempts a comparative assessment of the produced experience with the AA and NA movements in Greece and abroad.

Freud Meets Bill W: A Model for the Dynamics of Alcoholics Anonymous

Freud Meets Bill W: A Model for the Dynamics of Alcoholics Anonymous

SUBSTANCE USE DISORDERS – A CONCEPTUAL AND TERMINOLOGICAL MUDDLE

SUBSTANCE USE DISORDERS – A CONCEPTUAL AND TERMINOLOGICAL MUDDLE

Women in AA: “Sharing Experience, Strength and Hope” The Relational Nature of Spirituality

This article examines how specific practices within Alcoholics Anonymous (AA) assist women to develop an understanding of spirituality that promotes and sustains sobriety. AA's conceptualization of alcoholism as an illness that only a spiritual awakening can conquer seems outdated and irrelevant to many especially with the pharmacological advances that have been made in the addiction recovery field (Sanders, 2006). Using data from a qualitative exploratory study of women's experiences in AA, this paper reports that for some women in the program it is the spirituality learned and experienced through the relationship of sponsorship that has allowed them to achieve sobriety (Sanders, 2006).

Freud Meets Bill W: A Model for the Dynamics of Alcoholics Anonymous

Historically there has been a lamentably wide gap between Alcoholics Anonymous (AA) and psychodynamic psychotherapy. Although each has a distinct language, they actually utilize parallel principles. This paper is an attempt to integrate the two fields, using clinical examples from an inpatient unit for chemically dependent adolescents. Each of the Twelve Steps is equated with a psychodynamic mechanism. For example, the First Step, admitting powerlessness, is equated with the defense mechanism of denial. Keywords: Adolescents, substance use disorders, alcohol use disorders, therapy, residential treatment, psychoanalytic theory, defense mechanisms, Alcoholics Anonymous, psychodynamic psychotherapy, psychodynamic mechanism

Commentary: Anonymous Encounters: Alcoholics Anonymous, Al-Anon, and Overeaters Anonymous

Full text available. Keywords: Alcoholics, addiction problems, self-destructive habits, AA meetings, Al-Anon, Over-Eaters Anonymous, Group recitations, AA literature, sobriety, psychopharmacology

Book Review: Charting Women’s Journeys: From Addiction to Recovery. By Judith Grant. Lanham, MD: Lexington Books, 2008, 156 pp., $60.00 (cloth). Women in Alcoholics Anonymous: Recovery and Empowerment. By Jolene M. Sanders. Boulder, CO: First Forum Press, 2009, 145 pp., $55.00 (cloth). The Language of the Heart: A Cultural History of the Recovery Movement from Alcoholics Anonymous to Oprah Winfrey.

Book Review: Charting Women’s Journeys: From Addiction to Recovery. By Judith Grant. Lanham, MD: Lexington Books, 2008, 156 pp., $60.00 (cloth). Women in Alcoholics Anonymous: Recovery and Empowerment. By Jolene M. Sanders. Boulder, CO: First Forum Press, 2009, 145 pp., $55.00 (cloth). The Language of the Heart: A Cultural History of the Recovery Movement from Alcoholics Anonymous to Oprah Winfrey.

Predictors of Membership in Alcoholics Anonymous in a Sample of Successfully Remitted Alcoholics

This study identifies factors associated with Alcoholics Anonymous (AA) membership in a sample of 81 persons who have achieved at least one year of total abstinence from alcohol and other drugs. Forty-four were AA members, 37 were not. Logistic regression was used to test the cross-sectional associations of baseline demographic, substance-related, spiritual and religious, and personality variables with AA membership. Significant variables from the bivariate analyses were included in a multivariate model controlling for previous AA involvement. Having more positive views of God and more negative consequences of drinking were significantly associated with AA membership. This information can be used by clinicians to identify clients for whom AA might be a good fit, and can help others overcome obstacles to AA or explore alternative forms of abstinence support.

L’influence du réseau social sur la consommation pour des patients toxicomanes présentant une comorbidité psychiatrique

This research used a qualitative methodology and was conducted on a sample of 22 participants with concomitant substance-related and mental health disorders. Today, dual diagnosis patients represent the standard rather than the exception. Our objectives were to consider the elements and processes of the social network to explain variations in consumption of alcohol and drugs. The social network refers to all bonds established by patients, mainly family, couple, friends and therapist relationships. The 22 patients have used a specialized addiction treatment in Montreal (Canada). A focused qualitative interview was conducted with each participant using an audionumeric recording. The analysis follows the method of the mixed approach of Miles and Huberman, which combines the objectives of the grounded theory and the ethnography. All the interviews were transcribed then coded and analyzed with QSR N' Vivo 2.0. The method uses an iterative process making a constant return between verbatim and codes. The qualitative analyses present patients' perceptions on the increases and reductions in alcohol and drug consumption. Family network refers to participants where the family is named as supporting a decrease in drug consumption: couple network refers to intimate relations supporting a decrease in consumption. Mutual help network refers to alcoholics anonymous (AA) or other self-help groups. Several verbatim have been included. We propose strategies for the substance abuse treatment centers based on: (1) the paradox influence of the social network and the importance of clinical evaluation of patients of social networks; (2) emotions management, especially negative feelings, which include training of feeling, recognizing and naming, ability to the express and communicate to others; (3) importance of groups of mutual aid providing periods of sharing, validating individual experiences and pushing away loneliness; (4) function of social support of the clinical professionals as substitute of an overdrawn network.

Harm Reduction and 12 Steps: Complementary, Oppositional, or Something In-Between?

Background: Initially born of the desire to prevent the transmission of HIV among injection drug users, harm reduction presents a relatively new option for assisting individuals who struggle with drug and alcohol use. Twelve-step programs such as Alcoholics Anonymous (AA) are widely recognized as being a representative example of abstinence-based treatment and are often seen as oppositional to harm reduction. Methods: The purpose of this study is to examine the ways in which harm reduction workers interpret the relationship between harm reduction and 12-step approaches to treatment. The study draws upon qualitative interviews with 18 staff members from two harm reduction-based substance use treatment programs. Results: Two central themes emerge from the qualitative data: (1) harm reduction and 12-step approaches can be complementary; and (2) 12-step approaches in high-threshold treatment settings may differ significantly from their original philosophy and intent. A third, much less prominent theme reflects some respondents’ skepticism about the capacity of the two approaches to work together given the resistance to harm reduction by some in the 12-step community. Conclusion: Complementary conceptualizations of harm reduction and 12-step approaches have the potential to broaden the range of options available to people experiencing substance use problems.

Driving While Intoxicated Among Individuals Initially Untreated for Alcohol Use Disorders: One- and Sixteen-Year Follow-Ups

This study examined associations between frequency of driving while intoxicated (DWI) at baseline and obtaining alcohol-related help at follow-up, and between obtaining help and subsequent reductions in DWI. It also examined improvements on personal functioning and life context indices as mediators between obtaining help and reduced occurrences of DWI. A total of 628 individuals who were initially untreated for alcohol use problems completed a baseline inventory; follow-ups were 1, 3, and 16 years later. More extended participation in outpatient treatment and Alcoholics Anonymous (AA) during Year 1 was associated with a lower likelihood of DWI at the 1-year follow-up. More extended participation in AA through Year 3 was associated with a lower likelihood of DWI at the 16-year follow-up. Improvement on personal functioning and life context indices was associated with reduced risk of subsequent occurrences of DWI. Decreases in drinking-related problems, impulsivity, and drinking to reduce tension mediated associations between more AA participation and reductions in DWI at 1 year. Among initially untreated individuals, sustained mutual help may be associated with a reduced number of occurrences of DWI via fewer drinking consequences and improved psychological functioning and coping. Treatment providers should attend to these concomitants of DWI and consider actively referring individuals to AA to ensure ongoing AA affiliation.

How safe are adolescents at Alcoholics Anonymous and Narcotics Anonymous meetings? A prospective investigation with outpatient youth

Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) have proven to be cost-effective recovery resources for adults and also appear helpful for youth. However, anecdotal concerns about adolescents' safety at meetings have dampened enthusiasm regarding youth participation. Unfortunately, little information exists to evaluate such concerns. Outpatients ( N = 127; 24% female) were assessed at intake and at 3, 6, and 12 months regarding perceived safety at AA/NA, experience of negative incidents, and reasons for nonattendance/discontinuation. By 12-month follow-up, 57.5% reported some AA/NA attendance with a combined lifetime exposure of 5,340 meetings. Of these, 21.9% reported at least one negative experience, which was more common among NA than AA attendees. Overall, youth reported feeling very safe at meetings, and ratings did not differ by age or gender. Reasons for discontinuation or nonattendance were unrelated to safety or negative incidents. Weighing risks against documented benefits, these preliminary findings suggest that referral to AA/NA should not be discouraged, but, similar to adults, youth experiences at meetings should be monitored.

Gay, Lesbian, Bisexual, and Transgendered People and Chemical Dependency: Exploring Successful Treatment

This exploratory and quantitative study presents a model of treatment success of the nation's oldest and largest chemical dependency treatment provider for the gay, lesbian, bisexual, and transgender (GLBT) population. The main purpose is to examine the potential ability of the predictor variables’ degree of affiliation with Alcoholics Anonymous (AA), the severity of chemical use, the strength of a higher power relationship, attitudes about sexual orientation, and length of time in treatment to predict length of time clean and sober. The proposed model demonstrated the ability to explain 29% of the variance in time clean and sober. Results lend tentative support for culturally competent treatment and include specific intervention recommendations for professionals, including social workers, chemical dependency counselors, and therapists.

Sponsorship and service as mediators of the effects of Making Alcoholics Anonymous Easier (MAAEZ), a 12-step facilitation intervention

A recent trial (n=508) of “Making Alcoholics Anonymous Easier” (MAAEZ), a group-format 12-step facilitation program, showed that MAAEZ participants had increased odds of abstinence (OR=1.58; p=0.063). Effects were especially marked in several subgroups, including those with more prior AA/NA/CA exposure, and those with severe psychiatric problems. This paper examines whether the effects of MAAEZ were explained by higher engagement in particular Alcoholics Anonymous (AA) and other 12-step organization activities. Mediation analyses were performed, estimating MAAEZ effects attributable to AA/NA/CA meeting attendance, overall AA/NA/CA involvement, having a sponsor, and engaging in 12-step service. The only variable that appeared to mediate MAAEZ effects in the sample overall was doing service at either 6 months or at both 6 and 12 months. Among those with high prior AA/NA/CA attendance, both having a sponsor and doing service emerged as mediators, with having a sponsor explaining approximately 25% of the MAAEZ effect. Doing service also partially explained the MAAEZ effect among those with high psychiatric severity. Results highlight the value of studying specific AA/NA/CA activities as mediators of treatment effects, and demonstrate the importance of exploring subgroups when trying to understand treatment mechanisms. Findings also suggest that treatment programs should emphasize specific activities for particular clients. For example, individuals may have attended many AA/NA/CA meetings, but never known how to ask for a sponsor or get involved in service; doing service may represent a non-threatening way of connecting with 12-step members for clients with psychiatric problems such as social anxiety.

How Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) Work: Cross-Disciplinary Perspectives

Evidence from multiple lines of research supports the effectiveness and practical importance of Alcoholics Anonymous and Narcotics Anonymous. Conference presenters discussed the relationship between 12-Step participation and abstinence among various populations, including adolescents, women, and urban drug users. Insight from the arts and humanities placed empirical findings in a holistic context.

Therapeutic Communities:Can-DoAttitudes forMust-HaveRecovery

The therapeutic community (TC) in the United Kingdom was built out of a merging of the democratic TC tradition pioneered by Maxwell Jones and others immediately after the Second World War and after the American drug-free TC originating in the Synanon experiment in the late 1950s. This latter tradition traces its roots back through the mutual-aid fellowship Alcoholics Anonymous (AA). This article examines how AA principles were adapted for the TC and how this new approach impacted upon the early drug treatment network in the United Kingdom. The evidence base for TC methodology is briefly described along with a short analysis of the marginalization of the approach in the past two decades and the future possibilities for modified TCs for special populations.

Alcoholics Anonymous and the Minnesota Model of Treatment in Iceland

ABSTRACT This study was undertaken to provide an initial characterization of the current status of patients admitted to an alcoholism treatment program in Iceland. Consistent with the Minnesota Model, 12-step facilitation has been a central component of the program since its inception. Of the 94 patients assessed in this study, 67% were male and 40% had attended over 90 AA meetings prior to admission. The mean number of drinking days during the month prior to admission was 15.51 days and the mean length of hospital stay was 12.32 days. At time of hospital discharge, 39% were referred to residential treatment. Significant predictors of referral to residential treatment included having attended less than 90 AA meetings prior to admission and length of stay.

Spirituality in recovery: a lagged mediational analysis of alcoholics anonymous' principal theoretical mechanism of behavior change.

Evidence indicates Alcoholics Anonymous (AA) can play a valuable role in recovery from alcohol use disorder. While AA itself purports it aids recovery through "spiritual" practices and beliefs, this claim remains contentious and has been only rarely formally investigated. Using a lagged, mediational analysis, with a large, clinical sample of adults with alcohol use disorder, this study examined the relationships among AA, spirituality/religiousness, and alcohol use, and tested whether the observed relation between AA and better alcohol outcomes can be explained by spiritual changes. Adults (N = 1,726) participating in a randomized controlled trial of psychosocial treatments for alcohol use disorder (Project MATCH) were assessed at treatment intake, and 3, 6, 9, 12, and 15 months on their AA attendance, spiritual/religious practices, and alcohol use outcomes using validated measures. General linear modeling (GLM) and controlled lagged mediational analyses were utilized to test for mediational effects. Controlling for a variety of confounding variables, attending AA was associated with increases in spiritual practices, especially for those initially low on this measure at treatment intake. Results revealed AA was also consistently associated with better subsequent alcohol outcomes, which was partially mediated by increases in spirituality. This mediational effect was demonstrated across both outpatient and aftercare samples and both alcohol outcomes (proportion of abstinent days; drinks per drinking day). Findings suggest that AA leads to better alcohol use outcomes, in part, by enhancing individuals' spiritual practices and provides support for AA's own emphasis on increasing spiritual practices to facilitate recovery from alcohol use disorder.

Alcoholics Anonymous and Hazardously Drinking Women Returning to the Community After Incarceration: Predictors of Attendance and Outcome

The number of women incarcerated within the United States has risen dramatically in recent decades, and high rates of alcohol problems are evident among this population. Although little is known about the patterns of help utilization and efficacy for alcohol problems, preliminary evidence suggests that Alcoholics Anonymous (AA) is a widely available resource for this population. Data were collected as part of a study evaluating the effect of a brief intervention to reduce alcohol use among hazardously drinking (i.e., score of 8 or above on the Alcohol Use Disorders Identification Test or 4 or more drinks at a time on at least 3 days in prior 3 months) incarcerated women. The current study characterized demographic, clinical, and previous AA attendance variables associated with AA attendance in the 6 months following incarceration. Associations between frequency of AA attendance and drinking outcomes following incarceration were also evaluated. Among the 224 participants who provided data about AA attendance, 54% reported some AA attendance during the follow-up assessment period. AA attendance in the year prior to study entry (OR = 4.02; 95% CI: 3.32 to 4.71) and greater baseline consequences of alcohol use (OR = 2.09; 95% CI: 1.73 to 2.44) were associated with increased odds of higher frequency of AA attendance following incarceration. Weekly or greater AA attendance was associated with reductions in negative drinking consequences (B = -0.45; p < 0.01) and frequency of drinking days (B = -0.28; p < 0.01) following incarceration. Findings from this study suggest that AA is frequently utilized by hazardously drinking women following incarceration. Alcohol outcomes may be enhanced by AA attendance at a weekly or greater frequency is associated with better alcohol outcomes relative to lower levels of AA attendance. Evaluation of clinical guidelines for prescribing AA attendance for incarcerated women remains a task for future research.

Alcoholics Anonymous: Still Sober After 75 Years

The article discusses the 75-year history of the self-help group Alcoholics Anonymous (AA) cofounded by physician Bob Smith and stockbroker Bill Wilson in 1935. The article discusses the underlying tenets of AA that extend from a Christian religious sect called the Oxford Group. Addiction research studies of AA that have been conducted in the past are noted. Commentary is provided on AA's 12-step program and its effectiveness. The 12 steps and 12 traditions of AA are delineated. Other self-help programs modeled after AA are noted including Narcotics Anonymous.