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, besides stressing anonymity and the lack of a governing hierarchy, establish AA as free to all, non-promotional, non-professional, unaffiliated, and non-denominational, as well as 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. 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—“program of recovery” in which in divining and following the will of a self-defined “God as we understood Him” is one of the most essential suggestions. The steps have individuals acknowledge shortcomings, and engage in structured self-reflection, admission of faults, correction, and personal growth. Its goal is to facilitate a "spiritual awakening" through ethical acts, prayer and meditation. According to the 12th step, they carry AA’s message to other alcoholics through group meetings, one-on-one interactions, and outreach efforts in hospitals, treatment centers, and correctional facilities.
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.[6][7]
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.
Other addiction recovery fellowships, such as Narcotics Anonymous, Sexual Recovery Anonymous, and Al-Anon—with AA’s permission—have adopted and adapted the twelve steps and traditions.[8]