Alcoholics Anonymous 

(AA) is an international mutual aid fellowship[1] with the stated purpose of

enabling its members to "stay sober and help other alcoholics achieve sobriety."[1][2][3]
AA is nonprofessional, non-denominational, self-supporting, and apolitical. Its only membership
requirement is a desire to stop drinking.[1][2][4] The AA program of recovery is set forth in the Twelve
Steps.[4]
AA was founded in 1935 in Akron, Ohio, when one alcoholic, Bill Wilson, talked to another
alcoholic, Bob Smith, about the nature of alcoholism and a possible solution. With the help of other
early members, the book Alcoholics Anonymous: The Story of How More Than One Hundred Men
Have Recovered From Alcoholism was written in 1939. Its title became the name of the organization
and is today commonly referred to as "The Big Book".[5] AA's initial Twelve Traditions were
introduced in 1946 to help the fellowship be stable and unified while disengaged from "outside
issues" and influences.[5]
The Traditions recommend that members remain anonymous in public media, altruistically help other
alcoholics, and that AA groups avoid official affiliations with other organizations. They also advise
against dogma and coercive hierarchies. Subsequent fellowships such as Narcotics
Anonymous have adapted the Twelve Steps and the Twelve Traditions to their respective primary
purposes.[6][7]
AA membership has since spread internationally "across diverse cultures holding different beliefs
and values", including geopolitical areas resistant to grassroots movements.[8] As of 2020, more than
two million people worldwide are estimated to be members of AA.[9]

Contents

 1History

 2The Big Book, the Twelve Steps, and the Twelve Traditions

 3Organization and finances

 4Program

o 4.1Meetings

o 4.2Confidentiality

 5Spirituality

 6Disease concept of alcoholism

 7Canadian and United States demographics

 8Effectiveness

 9Relationship with institutions

o 9.1Hospitals
 o 9.2Prisons

o 9.3United States court rulings

o 9.4United States treatment industry

o 9.5United Kingdom treatment industry

 10Criticism

o 10.1Thirteenth-stepping

o 10.2Moderation or abstinence

o 10.3Cultural identity

 11Literature

 12AA in film

o 12.1Films about Alcoholics Anonymous

o 12.2Films where primary plotline includes AA

 13AA in television

 14See also

 15Notes

 16References

 17External links

History[edit]
Main article: History of Alcoholics Anonymous

Sobriety token or "chip", given for specified lengths of sobriety, on the back is the Serenity Prayer. Here green
is for six months of sobriety; purple is for nine months.
AA sprang from the Oxford Group, a non-denominational, altruistic movement modeled after first-
century Christianity.[10] Some members founded the group to help in maintaining sobriety.
"Grouper" Ebby Thacher was Wilson's former drinking buddy who approached Wilson saying that he
had "got religion", was sober, and that Wilson could do the same if he set aside objections to religion
and instead formed a personal idea of God, "another power" or "higher power".[11][12]
Feeling a "kinship of common suffering" and, though drunk, Wilson attended his first group
gathering. Within days, Wilson admitted himself to the Charles B. Towns Hospital after drinking four
beers on the way—the last alcohol he ever drank. Under the care of William Duncan Silkworth (an
early benefactor of AA), Wilson's detox included the deliriant belladonna.[13] At the hospital, a
despairing Wilson experienced a bright flash of light, which he felt to be God revealing himself.
[14]
 Following his hospital discharge, Wilson joined the Oxford Group and recruited other alcoholics to
the group. Wilson's early efforts to help others become sober were ineffective, prompting Silkworth
to suggest that Wilson place less stress on religion and more on "the science" of treating alcoholism.
Wilson's first success came during a business trip to Akron, Ohio, where he was introduced to
Robert Smith, a surgeon and Oxford Group member who was unable to stay sober. After thirty days
of working with Wilson, Smith drank his last drink on 10 June 1935, the date marked by AA for its
anniversaries.[15]
The first female member Florence Rankin joined AA in March 1937,[16][17] and the first non-Protestant
member, a Roman Catholic, joined in 1939.[18] The first Black AA group was established in 1945 in
Washington, D.C. by Jim S., an African-American physician from Virginia.[19][20]

The Big Book, the Twelve Steps, and the Twelve

Traditions[edit]
To share their method, Wilson and other members wrote the initially-titled book, Alcoholics
Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism,
[21]
 from which AA drew its name. Informally known as "The Big Book" (with its first 164 pages virtually
unchanged since the 1939 edition), it suggests a twelve-step program in which members admit that
they are powerless over alcohol and need help from a "higher power". They seek guidance and
strength through prayer and meditation from God or a Higher Power of their own understanding; take
a moral inventory with care to include resentments; list and become ready to remove character
defects; list and make amends to those harmed; continue to take a moral inventory, pray, meditate,
and try to help other alcoholics recover. The second half of the book, "Personal Stories" (subject to
additions, removal, and retitling in subsequent editions), is made of AA members' redemptive
autobiographical sketches.[22]
In 1941, interviews on American radio and favorable articles in US magazines, including a piece by
Jack Alexander in The Saturday Evening Post, led to increased book sales and membership.[23] By
1946, as the growing fellowship quarreled over structure, purpose, and authority, as well as finances
and publicity, Wilson began to form and promote what became known as AA's "Twelve Traditions,"
which are guidelines for an altruistic, unaffiliated, non-coercive, and non-hierarchical structure that
limited AA's purpose to only helping alcoholics on a non-professional level while shunning publicity.
Eventually, he gained formal adoption and inclusion of the Twelve Traditions in all future editions of
the Big Book.[6] At the 1955 conference in St. Louis, Missouri, Wilson relinquished stewardship of AA
to the General Service Conference,[24] as AA grew to millions of members internationally.[25]

Organization and finances[edit]

Main article: Twelve Traditions
A regional service center for Alcoholics Anonymous

AA says it is "not organized in the formal or political sense",[25] and Bill Wilson, borrowing the phrase
from anarchist theorist Peter Kropotkin, called it a "benign anarchy".[26] In Ireland, Shane Butler said
that AA "looks like it couldn't survive as there's no leadership or top-level telling local cumanns what
to do, but it has worked and proved itself extremely robust". Butler explained that "AA's 'inverted
pyramid' style of governance has helped it to avoid many of the pitfalls that political and religious
institutions have encountered since it was established here in 1946."[27]
In 2018, AA counted 2,087,840 members and 120,300 AA groups worldwide.[25] The Twelve
Traditions informally guide how individual AA groups function, and the Twelve Concepts for World
Service guide how the organization is structured globally.[28]
A member who accepts a service position or an organizing role is a "trusted servant" with terms
rotating and limited, typically lasting three months to two years and determined by group vote and
the nature of the position. Each group is a self-governing entity with AA World Services acting only in
an advisory capacity. AA is served entirely by alcoholics, except for seven "nonalcoholic friends of
the fellowship" of the 21-member AA Board of Trustees.[25]
AA groups are self-supporting, relying on voluntary donations from members to cover expenses.
[25]
 The AA General Service Office (GSO) limits contributions to US$3,000 a year.[29] Above the group
level, AA may hire outside professionals for services that require specialized expertise or full-time
responsibilities.[6]
Like individual groups, the GSO is self-supporting. AA receives proceeds from books and literature
that constitute more than 50% of the income for its General Service Office.[30] In keeping with AA's
Seventh Tradition, the Central Office is fully self-supporting through the sale of literature and related
products, and the voluntary donations of AA members and groups. It does not accept donations from
people or organizations outside of AA.
In keeping with AA's Eighth Tradition, the Central Office employs special workers who are
compensated financially for their services, but their services do not include traditional "12th Step"
work of working with alcoholics in need.[31] All 12th Step calls that come to the Central Office are
handed to sober AA members who have volunteered to handle these calls. It also maintains service
centers, which coordinate activities such as printing literature, responding to public inquiries, and
organizing conferences. Other International General Service Offices (Australia, Costa Rica, Russia,
etc.) are independent of AA World Services in New York.[32]

Program[edit]
See also: Twelve-step program §  Twelve Steps

AA's program extends beyond abstaining from alcohol.[33] Its goal is to effect enough change in the
alcoholic's thinking "to bring about recovery from alcoholism"[34] through "an entire psychic change,"
or spiritual awakening.[35] A spiritual awakening is meant to be achieved by taking the Twelve Steps,
  and sobriety is furthered by volunteering for AA[37] and regular AA meeting attendance[38] or contact
[36]

with AA members.[36] Members are encouraged to find an experienced fellow alcoholic, called a

sponsor, to help them understand and follow the AA program. The sponsor should preferably have
experience of all twelve of the steps, be the same sex as the sponsored person, and refrain from
imposing personal views on the sponsored person.[37] Following the helper therapy principle,
sponsors in AA may benefit from their relationship with their charges, as "helping behaviors"
correlate with increased abstinence and lower probabilities of binge drinking.[39]
AA's program is an inheritor of Counter-Enlightenment philosophy. AA shares the view that
acceptance of one's inherent limitations is critical to finding one's proper place among other humans
and God. Such ideas are described as "Counter-Enlightenment" because they are contrary to
the Enlightenment's ideal that humans have the capacity to make their lives and societies a heaven
on Earth using their own power and reason.[33] After evaluating AA's literature and observing AA
meetings for sixteen months, sociologists David R. Rudy and Arthur L. Greil found that for an AA
member to remain sober a high level of commitment is necessary. This commitment is facilitated by
a change in the member's worldview. To help members stay sober AA must, they argue, provide an
all-encompassing worldview while creating and sustaining an atmosphere of transcendence in the
organization. To be all-encompassing AA's ideology emphasizes tolerance rather than a narrow
religious worldview that could make the organization unpalatable to potential members and thereby
limit its effectiveness. AA's emphasis on the spiritual nature of its program, however, is necessary to
institutionalize a feeling of transcendence. A tension results from the risk that the necessity of
transcendence if taken too literally, would compromise AA's efforts to maintain a broad appeal. As
this tension is an integral part of AA, Rudy and Greil argue that AA is best described as a quasi-
religious organization.[40]

Meetings[edit]
AA meetings are "quasi-ritualized therapeutic sessions run by and for, alcoholics".[41] They are
usually informal and often feature discussions with voluntary donations collected during meetings.
(AA's 7th tradition encourages groups to be self-supporting, declining outside contributions).[6] Local
AA directories list weekly meetings. Those listed as "closed" are available to those with a self-
professed "desire to stop drinking," which cannot be challenged by another member on any grounds.
[6]
 "Open" meetings are available to anyone (nonalcoholics can attend as observers).[42] At speaker
meetings (also known as gratitude meetings), one or more members who typically come in from a
neighboring town's meeting tell their stories. At Big Book meetings, the group in attendance will
take turns reading a passage from the AA Big Book and then discuss how they relate to it after.
At twelve-step meetings, the group will typically break out into subgroups depending on where they
are in their program and start working on the twelve steps outlined in the program. In addition to
those three most common types of meetings, there are also other kinds of discussion meetings that
tend to allocate the most time for general discussion.[43]

Building for Spanish-speaking AA group in Westlake neighborhood, Los Angeles

AA meetings do not exclude other alcoholics, though some meetings cater to specific demographics
such as gender, profession, age, sexual orientation,[44][45] or culture.[46][47] Meetings in the United States
are held in a variety of languages including Armenian, English, Farsi, Finnish, French,
Japanese, Korean, Russian, and Spanish.[48][45] While AA has pamphlets that suggest meeting
formats,[49][50] groups have the autonomy to hold and conduct meetings as they wish "except in
matters affecting other groups or AA as a whole".[6] Different cultures affect ritual aspects of
meetings, but around the world "many particularities of the AA meeting format can be observed at
almost any AA gathering".[51]

Confidentiality[edit]
US courts have not extended the status of privileged communication, such as that enjoyed by clergy
and lawyers, to AA related communications between members.[52][53]

Spirituality[edit]
A study found an association between an increase in attendance at AA meetings with increased
spirituality and a decrease in the frequency and intensity of alcohol use. The research also found
that AA was effective at helping agnostics and atheists become sober. The authors concluded that
though spirituality was an important mechanism of behavioral change for some alcoholics, it was not
the only effective mechanism.[54] Since the mid-1970s, several 'agnostic' or 'no-prayer' AA groups
have begun across the U.S., Canada, and other parts of the world, which hold meetings that adhere
to a tradition allowing alcoholics to freely express their doubts or disbelief that spirituality will help
their recovery, and these meetings forgo the use of opening or closing prayers.[55][56] There are online
resources listing AA meetings for atheists and agnostics.[57]

Disease concept of alcoholism[edit]

Main article: Disease theory of alcoholism

More informally than not, AA's membership has helped popularize the disease concept of alcoholism
which had appeared in the eighteenth century.[58] Though AA usually avoids the term "disease", 1973
conference-approved literature said "we had the disease of alcoholism."[59] Regardless of official
positions, since AA's inception, most members have believed alcoholism to be a disease.[60]
AA's Big Book calls alcoholism "an illness which only a spiritual experience will conquer." Ernest
Kurtz says this is "The closest the book Alcoholics Anonymous comes to a definition of
alcoholism."[60] Somewhat divergently in his introduction to The Big Book, non-member and early
benefactor William Silkworth said those unable to moderate their drinking suffer from an allergy. In
presenting the doctor's postulate, AA said "The doctor's theory that we have an allergy to alcohol
interests us. As laymen, our opinion as to its soundness may, of course, mean little. But as ex-
problem drinkers, we can say that his explanation makes good sense. It explains many things for
which we cannot otherwise account."[61] AA later acknowledged that "alcoholism is not a true allergy,
the experts now inform us."[62] Wilson explained in 1960 why AA had refrained from using the term
"disease":
We AAs have never called alcoholism a disease because, technically speaking, it is not a disease
entity. For example, there is no such thing as heart disease. Instead, there are many separate heart
ailments or combinations of them. It is something like that with alcoholism. Therefore, we did not
wish to get in wrong with the medical profession by pronouncing alcoholism a disease entity. Hence,
we have always called it an illness or a malady—a far safer term for us to use.[63]
Since then medical and scientific communities have generally concluded that alcoholism is an
"addictive disease" (aka Alcohol Use Disorder, Severe, Moderate, or Mild).[64] The ten criteria are:
alcoholism is a Primary Illness not caused by other illnesses nor by personality or character defects;
second, an addiction gene is part of its etiology; third, alcoholism has predictable symptoms; fourth,
it is progressive, becoming more severe even after long periods of abstinence; fifth, it is chronic and
incurable; sixth, alcoholic drinking or other drug use persists in spite of negative consequences and
efforts to quit; seventh, brain chemistry and neural functions change so alcohol is perceived as
necessary for survival; eighth, it produces physical dependence and life-threatening withdrawal;
ninth, it is a terminal illness; tenth, alcoholism can be treated and can be kept in remission.[65]

Canadian and United States demographics[edit]

AA's New York General Service Office regularly surveys AA members in North America. Its 2014
survey of over 6,000 members in Canada and the United States concluded that, in North America,
AA members who responded to the survey were 62% male and 38% female.[66]
Average member sobriety is slightly under 10 years with 36% sober more than ten years, 13% sober
from five to ten years, 24% sober from one to five years, and 27% sober less than one year.
[66]
 Before coming to AA, 63% of members received some type of treatment or counseling, such as
medical, psychological, or spiritual. After coming to AA, 59% received outside treatment or
counseling. Of those members, 84% said that outside help played an important part in their
recovery.[66]
The same survey showed that AA received 32% of its membership from other members, another
32% from treatment facilities, 30% were self-motivated to attend AA, 12% of its membership from
court-ordered attendance, and only 1% of AA members decided to join based on information
obtained from the Internet. People taking the survey were allowed to select multiple answers for
what motivated them to join AA.[66]