Ever found yourself saying “I hate AA”? Alcoholics Anonymous (AA) is one of the most well-known recovery programs, with over 2 million members.
Many credit it with saving their lives. On the other hand, there are doubters, critics, and even addiction experts who believe the AA program shouldn’t be considered a viable therapy.
Despite the AA’s obvious success, why do so many people find themselves loathing AA meetings? To answer that, let’s start with a bit of history.
The religious roots of AA
Alcoholics Anonymous (AA) has deep religious influences, tracing back to the Oxford Group, a Christian evangelical movement in the 1930s. The founders of AA incorporated some of the group’s principles into their recovery framework, laying the foundation for the 12-step program.
- Bill W.’s involvement: Bill Wilson, one of AA’s founders and a New York stockbroker, attended Oxford Group meetings to battle his alcohol addiction.
- The historic meeting: Bill, who believed alcoholism was a disease, met Dr. Bob, a physician who had never considered addiction a medical condition. This conversation became a turning point, leading Dr. Bob to begin his recovery.
- Shared experiences: Bill emphasized that alcoholism affected the mind, emotions, and body, a concept he had learned from Dr. William D. Silkworth of Towns Hospital in New York.
How religion shaped AA’s philosophy
- A spiritual, not religious approach: Though AA has religious roots, its founders sought to create a program that focused on spirituality rather than any religious doctrine.
- Faith-based principles: The Oxford Group promoted personal accountability, making amends, and admitting faults—ideas that later became key elements of AA’s 12-step program.
- The shift to a higher power: While the Oxford Group centered around the Christian concept of God, AA adapted this to a broader, more inclusive “higher power” to appeal to people of all beliefs.
Higher power in the 21st century
Many struggling alcoholics resist attending AA meetings because of the phrase “higher power.” Despite the pleas of their loved ones, they refuse help, citing reasons such as:
- “Simple. I’m an atheist.”
- “It won’t work – I don’t believe in God.”
- “I don’t go to church, so why should I go to an AA meeting?”
For many, this remains a barrier to seeking help. In response, AA’s Big Book includes a chapter titled “We Agnostics”, emphasizing that belief in a religious God is not required.
Instead, members can define their higher power in any way that makes sense to them—whether it’s the power of community, nature, or something beyond personal willpower.
AA makes it clear that the only requirement for membership is a desire to stop drinking. However, some still find the idea of a higher power difficult to accept, leading them to seek alternative recovery programs.
The role of God and the 12 Steps
While AA allows personal interpretation of a higher power, the language in the 12 Steps frequently refers to God. In fact, 6 out of the 12 Steps explicitly mention “God” or a power greater than oneself, including:
- Step 2: We came to believe that a Power greater than ourselves could restore us to sanity.
- Step 3: We made a decision to turn our will and our lives over to the care of God as we understood Him.
- Step 5: We admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- Step 6: We were entirely ready to have God remove all these defects of character.
- Step 7: We humbly asked Him to remove our shortcomings.
- Step 11: We sought through prayer and meditation to improve our conscious contact with God as we understood Him.
AA insists it is spiritual, not religious, but the wording of the steps has led some to feel otherwise. While this approach works for many, it can alienate atheists, agnostics, or those who prefer a secular approach to recovery.
For those who are comfortable with the concept of God or a higher power, AA can be an effective path to sobriety. For others, alternative recovery programs may provide a better fit.
Is AA the only path to recovery?
Alcoholics Anonymous (AA) is one of the most well-known recovery programs in the world, with over 2 million members. Many who have successfully recovered through AA view it as the only true path to sobriety. However, its one-size-fits-all approach does not account for individual needs; for some, it may not be the right fit.
Limitations of AA in addressing dual diagnosis
Many with alcohol use disorder (AUD) also have mental health conditions like depression, anxiety, PTSD, or bipolar disorder—known as dual diagnosis.
While AA offers peer support, it lacks trained mental health professionals at meetings.
AA may not be enough for those who:
- Need mental health support: AA meetings do not provide therapy or psychiatric care for conditions like PTSD or bipolar disorder.
- Rely on medication for treatment: AA’s traditional views may discourage individuals from taking necessary psychiatric drugs.
- Struggle with past trauma: Without therapy, some find it difficult to heal through peer support a
For individuals with a dual diagnosis, AA may not be enough without additional mental health treatment.
Court-ordered AA: does mandatory attendance work?
The U.S. judicial system often requires individuals convicted of alcohol-related offenses, such as DUIs, to attend AA meetings. Studies estimate that 1 in 8 people at an AA meeting is there because of a court order.
While AA can be beneficial for voluntary members, forcing participation may not be effective for everyone. Concerns about court-mandated AA include:
- Lack of personal motivation: Recovery is most successful when individuals actively choose treatment.
- Religious concerns: Some object to AA’s references to God or a higher power.
- Limited options: Court systems often default to AA rather than offering alternatives like therapy-based programs or medical treatment.
What the research says about AA
Despite criticisms, research confirms that AA is an effective treatment for many individuals with alcohol use disorder (AUD).
A 2020 study by Kelly et al.—a distillation of a Cochrane review analyzing 27 peer-reviewed studies with over 10,000 participants—found that:
- AA is as effective as first-line clinical treatments in maintaining sobriety.
- AA participants had lower relapse rates compared to those who did not engage in 12-Step programs.
- Long-term AA involvement increased abstinence rates, especially for those who remained active in the program for multiple years.
Additionally, AA is cost-effective. The study found that for individuals with severe AUD, AA reduced alcohol-related healthcare costs by 45%, saving an average of $2,856 per participant over three years
Does AA work for everyone?
AA has helped millions achieve sobriety, but it is not the only path to recovery. Some individuals may find secular recovery programs, therapy-based treatments, or medication-assisted treatment (MAT) more effective.
AA can be a powerful tool for those who thrive in peer support communities and benefit from structured steps. But for those who need medical care, therapy, or a non-spiritual approach, alternative options exist.
Recovery is not one-size-fits-all; the most essential step is finding a program that works for the individual.
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Sources
1. Kelly JF, Abry A, Ferri M, Humphreys K. Alcoholics Anonymous and 12-Step Facilitation Treatments for Alcohol Use Disorder: A Distillation of a 2020 Cochrane Review for Clinicians and Policy Makers. Alcohol Alcohol. 2020 Nov;55(6):641–651. doi:10.1093/alcalc/agaa050. Available from: https://doi.org/10.1093/alcalc/agaa050
2. Kaskutas LA, Subbaraman M, Witbrodt J, Zemore SE. Effectiveness of Making Alcoholics Anonymous Easier (MAAEZ), a group format 12-step facilitation approach. J Subst Abuse Treat. 2009 Oct;37(3):228–239. doi:10.1016/j.jsat.2009.01.004. Available from: https://doi.org/10.1016/j.jsat.2009.01.004
3. Humphreys K. Circles of Recovery: Self-Help Organizations for Addictions. New York: Free Press; 2004.
4. Alcoholics Anonymous. Alcoholics Anonymous (4th ed.). New York: Alcoholics Anonymous World Services; 2001.