Alcoholics Anonymous

Alcoholics Anonymous

Nickname	AA
Formation	1935; 89 years ago (1935)
Founders	Bill Wilson Dr. Bob Smith
Founded at	Akron, Ohio
Type	Mutual aid addiction recovery twelve-step program
Headquarters	New York, New York
Membership (2021)	1,967,613
Website	aa.org

Alcoholics Anonymous (AA) is a global, peer-led mutual-aid fellowship dedicated to abstinence-based recovery from alcoholism through its spiritually inclined twelve-step program.^[1] AA's Twelve Traditions stress anonymity and the lack of a governing hierarchy, and establish AA as free to all, non-promotional, non-professional, unaffiliated, non-denominational, and apolitical.^[1][2][3] In 2021, AA reported a presence in approximately 180 countries with nearly two million members—73% in the United States and Canada.^[4][5]

AA dates its beginning to Bill Wilson's (Bill W.) and Bob Smith's (Dr. Bob) first commiseration alcoholic-to-alcoholic in 1935. Meeting through the Christian revivalist Oxford Group, they and other alcoholics helped each other until forming what became AA. In 1939, the new fellowship published Alcoholics Anonymous: The Story of How More than One Hundred Men Have Recovered from Alcoholism. The amended sub-title in later editions referred to “Thousands of Men and Women”. Debuting AA's 12 steps, it is informally known as the “Big Book”. It is also the origin of AA's name.

AA's Twelve Steps are a suggested—but not required—ongoing recovery program in which divining and following the will of a self-defined “God as we understood Him” is central. The Twelve Steps begin with admitting to powerlessness over alcohol and recognizing the unmanageability of one's life due to alcoholism. Subsequent steps require "rigorous honesty" to undertake a "searching and fearless moral inventory," and to thereby identify "character defects;" to share this moral inventory with one's AA sponsor or another trusted person; to make amends to people harmed; and to engage in regular prayer snd meditation, seeking "conscious contact with God ... for knowledge of His will." The steps result in a "spiritual awakening" and a resolve to carry AA's message of recovery to other alcoholics.

Such "12th Step work" includes peer-to-peer sponsorship of alcoholics, forming AA groups, holding meetings, and through outreach to hospitals, prisons and other institutions. ^[6]

AA meetings vary in format, with some focusing on personal stories, readings from the Big Book, or open discussion. Meetings may cater to specific demographics, but they generally welcome anyone who desires to stop drinking. AA is self-supporting, with donations from members covering expenses, and it operates through an "inverted pyramid" structure, where individual groups function autonomously. The organization does not accept outside contributions and relies heavily on literature sales.

Many studies and reviews show AA as an effective and cost-efficient method for achieving abstinence in individuals struggling with alcohol addiction. A 2020 Cochrane review found that AA and Twelve-Step Facilitation (TSF) significantly increased rates and durations of abstinence compared to other treatments like cognitive-behavioral therapy, while being more cost-effective.^[7][8]

AA has faced criticism for various reasons. Critics have questioned its overall success rate, and others have criticized the religious or cult-like aspects of its program. There have also been concerns about "thirteenth-stepping," where older members pursue new members romantically, as well as lawsuits regarding safety and the religious nature of AA in court-mandated treatment.