Alcoholics Anonymous

Alcoholics Anonymous

Nickname	AA
Formation	1935; 90 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	1,967,613 (2021)
Website	aa.org

Alcoholics Anonymous (AA) is a global, peer-led mutual-aid fellowship focused on an abstinence-based recovery model from alcoholism through its spiritually inclined twelve-step program.^[1] The organization adheres to Twelve Traditions that emphasize anonymity, the absence of a hierarchical structure, and principles of being free to all, non-promotional, non-professional, unaffiliated, non-denominational, and apolitical.^[1][2][3] As of 2021^[update], AA reported a presence in approximately 180 countries with an estimated membership of nearly two million individuals—73% of whom reside in the United States and Canada.^[4][5]

AA traces its origins to a 1935 meeting between Bill Wilson (commonly referred to as Bill W.) and Dr. Bob Smith (Dr. Bob), two individuals seeking to address their shared struggles with alcoholism. Their collaboration, influenced by the Christian revivalist Oxford Group, evolved into a mutual support group that eventually became AA. In 1939, the fellowship published Alcoholics Anonymous: The Story of How More than One Hundred Men Have Recovered from Alcoholism, colloquially known as the "Big Book." This publication introduced the twelve-step program and provided the basis for the organization's name. Later editions of the book expanded its subtitle to reflect the inclusion of "Thousands of Men and Women."

The Twelve Steps outline a suggested program of ongoing drug rehabilitation and self-improvement. A key component involves seeking alignment or divining with a personally defined concept of "God as we understood Him."^[a] The steps begin with an acknowledgment of powerlessness over alcohol and the unmanageability of life due to alcoholism. Subsequent steps emphasize rigorous honesty, including the completion of a "searching and fearless moral inventory," acknowledgment of "character defects," sharing the inventory with a trusted person, making amends to individuals harmed, and engaging in regular prayer or meditation to seek "conscious contact with God" and guidance in following divine will. The final step, the 12th, focuses on maintaining the principles of recovery, sharing the message with other alcoholics,^[6] and participating in "12th Step work," such as peer sponsorship, organizing meetings, and outreach to institutions like hospitals and prisons.^[7]

AA meetings differ in format, with variations including personal storytelling, readings from the Big Book, and open discussions. While certain meetings may cater to specific demographic groups, attendance is generally open to anyone with a desire to stop drinking. The organization is self-supporting through member donations and literature sales. Its operations follow an "inverted pyramid" structure, allowing local groups significant autonomy. AA does not accept external funding or contributions.

Empirical evidence supports AA's efficacy. A 2020 Cochrane review found that manualized AA and Twelve-Step Facilitation (TSF) therapy demonstrated higher rates of continuous abstinence compared to alternative treatments, such as cognitive-behavioral therapy, with added healthcare cost savings over time.^[8][b]

Criticism of AA has addressed various aspects of its program and operations. Concerns have been raised about its overall success rate, the perceived religious nature of its approach, and allegations of cult-like elements. Additional critiques include reports of "thirteenth-stepping," where senior members engage romantically with newer members, and legal challenges related to safety and the religious content of court-mandated participation in AA programs.

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