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A.A. Works Best, Study Says

Experts Unsure Why Alcoholics Anonymous Is More Effective

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Updated July 16, 2006

Individuals who were encouraged to cut down on their drinking by fellow Alcoholics Anonymous members were three times more likely to be abstinent a year after their first treatment for alcoholism, compared to individuals who received no support, a new study reports.

Individuals who received similar support from non-AA members, however, had nearly the same chance of being abstinent as if they had received no support at all, according to Lee Ann Kaskutas, P.D., of the Alcohol Research Group in Berkeley, Calif., and colleagues.

"This suggests that AA members offer types of social support that differ from those typically offered by nonmembers," Kaskutas says.

The study by Kaskutas and colleagues examined the relationship between AA involvement, social support and alcohol use in 722 adults a year after their first treatment for alcohol or drug abuse.

Although AA involvement did help many of these individuals cut down on their drinking, the program's influence was reduced by a third when the individuals also had relationships with people who were heavy or problem drinkers or who encouraged drinking, say the researchers.

The study was published as part of a special collection of research on the ways AA involvement may influence behavior in the March 2003 issue of Alcoholism: Clinical and Experimental Research.

"We still have a poor understanding of what AA-exposed individuals actually do and how prescribed AA-related practices may mobilize and sustain behavior change," says J. Scott Tonigan, Ph.D., of the University of New Mexico.

Among the other findings reported in the issue:

There is no direct connection between the increased "spiritual awakening" reported by some AA participants and abstinence, but spiritual changes may lead to behavior changes that promote abstinence, according to a study by Tonigan. "In essence, spiritual beliefs may promote a code for living that is concordant with abstinence and discordant with alcohol," he says.

Many of the patients in his study who participated in therapy programs other than AA still attended AA meetings and read AA literature up to three years after their initial treatment for alcohol abuse.

"Clearly, clients voted with their feet regarding the desirability of AA three years after treatment," Tonigan says.

A study of 112 AA members found that all aspects of AA, including meetings, meditation and prayer and sponsorship, were related to the likelihood of abstinence a year after treatment for alcohol abuse. The study suggests that AA may influence lifestyle changes, such as avoiding places where drinking is common, that lead to abstinence.

But AA's influence on how individuals respond to life events like divorce or a family death is not related to the likelihood of abstinence, say Patricia L. Owen, Ph.D., of the Butler Center for Research at the Hazelden Foundation and colleagues.

Source: The study was published in the March 2003 issue of Alcoholism: Clinical and Experimental Research.

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