AA Still Best to Beat Problem Drinking: Review

AA certainly helps people, according to Brennan. “It would’ve died out years ago if it didn’t,” he said.

But, Brennan added, many people struggling with their drinking do not even know there are treatment options — and they should.

“Over the years, we’ve come to realize that addictions are medical conditions,” Brennan said.

His recommendation to people who feel their drinking is out of control: First, see a health care professional for an evaluation. Many people, for example, drink to “self-medicate” depression or other mental health issues, and it’s important to address those conditions.

An estimated 15 million Americans have alcohol use disorder, according to the U.S. National Institutes of Health. Of those who get treatment, the agency says, about one-third have no symptoms a year later; many others reduce their drinking.

With AA, the goal is complete abstinence from drinking. But behavioral counseling — such as cognitive behavioral therapy (CBT) and motivational enhancement therapy — generally has a different view, Brennan said. It aims to change drinking behavior and its consequences.

With CBT, for example, the goal is to change the thought processes that lead to excessive drinking and to develop ways to cope with everyday situations that trigger problem drinking.

Across the studies that Humphrey and colleagues analyzed, AA was — on average — more effective than CBT and other therapies at helping people become abstinent. The longest studies followed participants out to five years; most were clinical trials where people were randomly assigned to a particular treatment.

The abstinence finding is not necessarily surprising, given the goal of AA, Brennan said. But the support group was also on par with professional therapies in helping people drink less and reduce the harm their drinking was causing.

According to Brennan, it makes sense that many people benefit from AA.

“Often times,” he said, “simply being with other people who are going through the same thing you are — knowing you’re not alone — can be deeply meaningful.”

Beyond that, Humphreys said, AA is free, widely available, and has no time limit — with some people sticking with it for years.