Stanford study finds the most effective path to alcohol abstinence

In a new study, researchers found that Alcoholics Anonymous (AA), the worldwide fellowship of sobriety seekers, is the most effective path to alcohol abstinence.

After evaluating 35 studies—involving the work of 145 scientists and the outcomes of 10,080 participants, they determined that AA was nearly always found to be more effective than psychotherapy in achieving abstinence.

In addition, most studies showed that AA participation lowered health care costs.

AA works because it’s based on social interaction. Members give one another emotional support as well as practical tips to refrain from drinking.

The research was conducted by a team from Stanford School of Medicine.

Although AA is well-known and used by millions around the world, mental health professionals are sometimes skeptical of its effectiveness.

Psychologists and psychiatrists, trained to provide cognitive behavioral therapy and motivational enhancement therapy to treat patients with the alcohol-use disorder, can have a hard time admitting that the lay people who run AA groups do a better job of keeping people on the wagon.

For the review article, the team evaluated both AA and 12-step facilitation counseling.

AA began in 1935 when two men in Akron, Ohio, were searching for a way to stay sober; they found it by forming a support group.

They later developed the 12 steps, the first being accepting one’s inability to control drinking; the last, helping others sustain sobriety by becoming a sponsor of a new member.

The AA model—open to all and free—has spread around the globe, and now boasts over 2 million members in 180 nations and more than 118,000 groups.

Though the fellowship has been around for more than eight decades, researchers have only recently developed good methods to randomize trial participants and measure its effectiveness, Humphreys said.

For this review, the researchers found 57 studies on AA; of those, 35 passed their rigorous criteria for quality.

The studies used various methods to measure AA’s effectiveness on alcohol use disorder: the length of time participants abstained from alcohol; the amount they reduced their drinking if they continued drinking; the consequences of their drinking; and health care costs.

Most of the studies that measured abstinence found AA was significantly better than other interventions or no intervention. In one study, it was found to be 60% more effective. None of the studies found AA to be less effective.

In the studies that measured outcomes other than complete abstinence, AA was found to be at least as effective.

For the studies that considered costs, most showed significant savings associated with AA participation: One found that AA and 12-step facilitation counseling reduced mental health costs by $10,000 per person.

The researchers looked only at studies of AA; they excluded Narcotics Anonymous and organizations focused on addiction to other substances.

While it was beyond the scope of their study, the team says the AA review is certainly suggestive that these methods work for people who use heroin or cocaine.

The researchers noted that the findings were consistent whether the study participants were young, elderly, male, female, veterans or civilians; the studies in the review were also conducted in five different countries.

The lead author of the study is Keith Humphreys, Ph.D., a professor of psychiatry and behavioral sciences.

The study is published in the Cochrane Database of Systematic Reviews.

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