The first female member, Florence Rankin, joined AA in March 1937,[6][7] and the first non-Protestant member, a Roman Catholic, joined in 1939.[8] The first Black AA group was established in 1945 in Washington DC by Jim S., an African-American physician from Virginia.[9][10] AA membership has since spread internationally "across diverse cultures holding different beliefs and values", including geopolitical areas resistant to grassroots movements.[11] Close to 2 million people worldwide are members of AA as of 2016.[12]
This final step is the service aspect, and it asks individuals to give back to others who are also struggling with addiction. After coming to God or a higher power, individuals are then taught to share this spirituality with others and support them in recovery. During Step 12, individuals are often asked to share their stories, testimonies, and struggles with others in order to provide hope and encouragement.
There are no dues or fees for members of AA. Prohibitive cost can be a major hurdle when it comes to sticking with a treatment program. Even if it’s working, someone might drop out if it becomes too expensive for them to stay with it. While a group might do a collection to cover expenses like rent or refreshments, there is no mandatory cost required to join AA.

NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used. To access online sources, copy and paste the URL into your browser.
Like many chronic diseases, alcoholism cannot be cured; however, effective treatment is available to help individuals who suffer from alcoholism remain sober. Treatment usually consists primarily of group therapy, one or more types of counseling, and alcohol education. Participants must acknowledge that they have a drinking problem and have a strong desire to stop drinking. Once the decision has been made, they may check into a treatment center for a brief period of time to rehabilitate as they stop drinking. The treatment center (and/or doctor) counsels patients, gives them support, and helps them get through their initial symptoms and safely withdraw from the alcohol. In some cases, short-term medications such as benzodiazepines (Valium or similar drugs) are used to help alleviate some of the symptoms of alcohol dependence.
Each person will have their own idea of who or what the higher power is to them, and in Step 3, individuals are asked to turn their lives over to this power for healing purposes. Steps 1 and 2 are all about reflection, learning that alcohol (or drugs) is a driving force in life and that a higher power is needed to recover and remain sober. With Step 3, individuals are called to action and to a willingness to change moving forward.
Alcoholism is appropriately considered a disease rather than a weakness of character or chosen pattern of bad behavior. It is the third most common mental illness, affecting more than 14 million people in the United States. Other facts and statistics about alcohol dependence include its pattern of afflicting about 4% of women and 10% of men. It costs more than $200 billion per year in lower productivity, early death, and costs for treatment. Worldwide, alcohol is thought to contribute to more than 200 illnesses and injuries, like liver disease, heart disease, and neurological problems. Alcohol-related deaths number more than 3 million per year, nearly 6% of all deaths worldwide. For adults between 20-40 years of age, that percentage rises to about 25% of deaths due to alcohol.
The term is also used by outlets like Salon and New York Magazine, which suggest that the time has come for Alcoholics Anonymous to be decoupled from mainstream alcoholism recovery. The point is made by Mia Szalavitz, a recovering addict and now an addiction researcher and author, who wrote a book about how developments in neuroscience and psychology might render AA obsolete. Szalavitz takes issue with the AA concept of “hitting rock bottom,” the moment when a person experiences a personal loss (e.g., a DUI, eviction, divorce, firing, etc.) as a sign that the addiction has become too damaging to ignore. This expectation, writes Szalavitz, is “harsh and humiliating,” in the sense that help is withheld until the person crosses a tragic Rubicon. But so deeply does it run in the DNA of Alcoholics Anonymous that it has influenced how any 12-Step methodology treats addiction therapy. This, says Szalavitz, has made the treatment community on the whole “embrace a totally false, harmful view of what addiction is.”
When alcoholism affects a spouse or partner, it’s possible to become too wrapped up in their well-being. This is called codependency. You may get to the point where you feel compelled to help your person get well. However, family members and friends often have deep emotional ties that prevent them from having the objective viewpoint necessary for treatment.
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Alcoholism, also known as alcohol use disorder (AUD), is a broad term for any drinking of alcohol that results in mental or physical health problems.[12] The disorder was previously divided into two types: alcohol abuse and alcohol dependence.[1][13] In a medical context, alcoholism is said to exist when two or more of the following conditions are present: a person drinks large amounts over a long time period, has difficulty cutting down, acquiring and drinking alcohol takes up a great deal of time, alcohol is strongly desired, usage results in not fulfilling responsibilities, usage results in social problems, usage results in health problems, usage results in risky situations, withdrawal occurs when stopping, and alcohol tolerance has occurred with use.[1] Risky situations include drinking and driving or having unsafe sex, among other things.[1] Alcohol use can affect all parts of the body, but it particularly affects the brain, heart, liver, pancreas and immune system.[3][4] This can result in mental illness, Wernicke–Korsakoff syndrome, irregular heartbeat, liver cirrhosis and increased cancer risk, among other diseases.[3][4] Drinking during pregnancy can cause damage to the baby resulting in fetal alcohol spectrum disorders.[2] Women are generally more sensitive than men to the harmful physical and mental effects of alcohol.[9]

We have never called alcoholism a disease because, technically speaking, it is not a disease entity. For example, there is no such thing as heart disease. Instead there are many separate heart ailments, or combinations of them. It is something like that with alcoholism. We did not wish to get in wrong with the medical profession by pronouncing alcoholism a disease entity. We always called it an illness, or a malady—a far safer term for us to use.[96]


Over time, the regular consumption of alcohol will alter brain chemicals, making the drinker crave alcohol not for a good time, but to avoid feeling poorly. Brain function becomes more and more impaired as your blood alcohol content increases. Each time you drink alcohol, several chemicals in the brain become imbalanced. Over time, the brain becomes used to this imbalance, and considers it the new balance, so to speak. This is a disease of the brain called alcoholism.
FAS is the leading cause of mental retardation in the United States. One to two of every 1,000 infants born in the United States are afflicted with FAS. The incidence of FAS in children whose mothers drink heavily is 4% much higher than the rate in the general population. Research studies that have followed infants with FAS and FAEs across time have found that many of these children continue to have cognitive difficulties (e.g., lower IQ scores, more learning problems, poorer short-term memory functioning) and behavioral problems (e.g., high impulsivity, high activity level) into childhood and adolescence.
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According to Vaillant's research, inner-city men began problem drinking approximately 10 years earlier than college graduates (age 25–30 y vs age 40–45 y). Inner-city men were more likely to be abstinent from alcohol consumption than college graduates (30% vs 10%) but more likely to die from drinking (30% vs 15%). A large percentage of college graduates alternated between controlled drinking and alcohol abuse for many years. Returning to controlled drinking from alcohol abuse is uncommon, no more than 10%; however, this figure is likely to be high because it was obtained from self-reported data. Mortality in both groups was related strongly to smoking. Abstinence for less than 5–6 years did not predict continued abstinence (41% of men abstinent for 2 y relapsed).
Among older patients with alcoholism, from one third to one half develop alcoholism after age 60 years. This group is harder to recognize. A population-based study found that problem drinking (>3 drinks/d) was observed in 9% of older men and in 2% of older women. Alcohol levels are higher in elderly patients for a given amount of alcohol consumed than in younger patients.

Moderate alcohol consumption (1–2 drinks/d) reduces the risk of cardiovascular disease in men and women by approximately 30%. [13, 14, 15] The effect of heavy alcohol consumption on the risk of cardiovascular disease varies in different studies. The person's drinking pattern appears to have an effect on cardiovascular disease. Drinking with meals may reduce the risk, while binge drinking increases risk (even in otherwise moderate drinkers).


The path to getting sober and drug-free is never exactly the same for any two people. However, anyone looking to find out more about rehab and recovery - either for themselves or their loved ones - will recognize some common steps, particularly when it comes to inpatient residential treatment programs. These steps are usually similar whether you’re looking for private alcoholism treatment or a drug addiction recovery center.
Alcohol abuse, now included in the diagnosis of alcohol use disorder, is a disease. While many have described this disorder as dipsomania, the latter term more accurately describes the intense craving that can be a symptom of alcohol use disorder. A maladaptive pattern of drinking alcohol that results in negative work, medical, legal, educational, and/or social effects on a person's life characterizes the disorder. The individual who abuses this substance tends to continue to use it despite such consequences. Effects of alcohol use disorder on families can include increased domestic abuse/domestic violence. The effects that parental alcoholism can have on children can be significantly detrimental in other ways as well. For example, the sons and daughters of alcoholics seem to be at higher risk for experiencing feelings that are more negative, stress, and alienation as well as aggression. There are a multitude of negative psychological effects of alcohol use disorder, including depression and antisocial behaviors.

When a service is offered (especially in a crisis), that service is expected to work.  In the case of the addict, simply providing 'treatment' cannot be viewed the same way as other services.  Substance abuse detox that transitions to the 12-step program requires a level of immersion on the end of the user.  I used to HATE hearing 'It works if you work it'.  But... it's true.


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The Sinclair method is another approach to using naltrexone or other opioid antagonists to treat alcoholism by having the person take the medication about an hour before they drink alcohol and only then.[137][138] The medication blocks the positive reinforcement effects of ethanol and hypothetically allows the person to stop drinking or drink less.[138]
Stereotypes of alcoholics are often found in fiction and popular culture. The "town drunk" is a stock character in Western popular culture. Stereotypes of drunkenness may be based on racism or xenophobia, as in the fictional depiction of the Irish as heavy drinkers.[171] Studies by social psychologists Stivers and Greeley attempt to document the perceived prevalence of high alcohol consumption amongst the Irish in America.[172] Alcohol consumption is relatively similar between many European cultures, the United States, and Australia. In Asian countries that have a high gross domestic product, there is heightened drinking compared to other Asian countries, but it is nowhere near as high as it is in other countries like the United States. It is also inversely seen, with countries that have very low gross domestic product showing high alcohol consumption.[173] In a study done on Korean immigrants in Canada, they reported alcohol was even an integral part of their meal, and is the only time solo drinking should occur. They also believe alcohol is necessary at any social event as it helps conversations start.[174]

More than a quarter (27%) of all 15- to 19-year-olds worldwide consume alcohol. Rates are highest in Europe (44%), followed by the Americas (38%) and the Western Pacific (38%). Total alcohol consumption per capita among those older than 15 years around the world rose from 5.5 liters of pure alcohol in 2005 to 6.4 liters in 2010 and remained at that level in 2016. [1, 2]


Wilson took this to heart, coming up with additional points to safeguard the integrity and future of his group. To that effect, he wrote that every individual AA group should decline outside contributions and ought to be able to fully support itself. Alcoholics Anonymous was never to be a professional organization; “the only requirement for AA membership,” he wrote, “is a desire to stop drinking.” Above all, groups had to prize anonymity; Wilson wrote that it is “the spiritual foundation of all our traditions,” and that the sacrifice of identity would help members “place principles before personalities.”
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In collaboration with University of Texas Southwestern (UTSW) psychiatrists, we provide truly integrated care for mental and behavioral health and substance abuse issues. Our expert team is led by Dr. David Atkinson, a full-time psychiatrist who is dually board certified in child adolescent psychiatry and addiction psychiatry. His addiction fellowship training at Mayo Clinic helped him understand the addiction treatment process and its connection to many teens’ mental health issues.
Genetic differences that exist between different racial groups affect the risk of developing alcohol dependence. For example, there are differences between African, East Asian and Indo-racial groups in how they metabolize alcohol. These genetic factors partially explain the differing rates of alcohol dependence among racial groups.[84][85] The alcohol dehydrogenase allele ADH1 B*3 causes a more rapid metabolism of alcohol. The allele ADH1 B*3 is only found in those of African descent and certain Native American tribes. African Americans and Native Americans with this allele have a reduced risk of developing alcoholism.[86] Native Americans, however, have a significantly higher rate of alcoholism than average; it is unclear why this is the case.[87] Other risk factors such as cultural environmental effects e.g. trauma have been proposed to explain the higher rates of alcoholism among Native Americans compared to alcoholism levels in caucasians.[88][89]
Various forms of group therapy or psychotherapy can be used to deal with underlying psychological issues that are related to alcohol addiction, as well as provide relapse prevention skills. The mutual-help group-counseling approach is one of the most common ways of helping alcoholics maintain sobriety.[6] Alcoholics Anonymous was one of the first organizations formed to provide mutual, nonprofessional counseling, and it is still the largest. Others include LifeRing Secular Recovery, SMART Recovery, Women For Sobriety, and Secular Organizations for Sobriety.[127] Rationing and moderation programs such as Moderation Management and DrinkWise do not mandate complete abstinence. While most alcoholics are unable to limit their drinking in this way, some return to moderate drinking. A 2002 US study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) showed that 17.7 percent of individuals diagnosed as alcohol dependent more than one year prior returned to low-risk drinking. This group, however, showed fewer initial symptoms of dependency.[128] A follow-up study, using the same subjects that were judged to be in remission in 2001–2002, examined the rates of return to problem drinking in 2004–2005. The study found abstinence from alcohol was the most stable form of remission for recovering alcoholics.[129] A long-term (60 year) follow-up of two groups of alcoholic men concluded that "return to controlled drinking rarely persisted for much more than a decade without relapse or evolution into abstinence."[130]
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Jump up ^ Littrell, Jill (2014). Understanding and Treating Alcoholism Volume I: An Empirically Based Clinician's Handbook for the Treatment of Alcoholism: Volume Ii: Biological, Psychological, and Social Aspects of Alcohol Consumption and Abuse. Hoboken: Taylor and Francis. p. 55. ISBN 9781317783145. Archived from the original on 20 July 2017. The World Health Organization defines alcoholism as any drinking which results in problems
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Meditation, prayer, and journaling make up Step 11 as individuals use these tools to form a spiritual connection with God or the higher power. Quiet time and solitude provide for self-reflection, and meditation can be helpful to increase the connection between the body, mind, and soul. When a person is in tune with themselves physically and emotionally, the spiritual aspect is also strengthened. Journaling during Step 11 can be a beneficial way to explore thoughts and emotions more fully as well.
Another variation comes from the fact that some people are uncomfortable with the specific, religious aspects of the 12-Step program. As stated above, and as evident by the steps themselves, the 12-Step model originated from a Christian point of view. Those who are not Christian have modified the steps to refer to their specific religious or spiritual practice as a way to connect more with the structure of the 12-Step program. In addition, a number of non-religious 12-Step groups have modified the steps to fit a secular model that can help those who are agnostic or atheist practice the program without feeling forced to adhere to a religion they don’t believe in.
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While admitting that the oft-cited success rate of 5 percent “isn’t great,” Dr. Drew Pinsky, a celebrity doctor and addiction medicine specialist argued that “the fact it, [Alcoholics Anonymous] does work when people do it,” saying the real success rate is as high as 12 percent. The American Society of Addiction Medicine speculated that approximately 10 percent of the people who become part of a 12-Step program enjoy long-term success in their recovery. In 2014, AA self-reported that 27 percent of the 6,000 members who participated in an internal study were sober for less than a year; 24 percent retained their sobriety for up to five years, and 13 percent lasted for as long as a decade. Fourteen percent of the study’s participants stayed sober between 10 and 20 years, and 22 percent reported remaining sober for more than two decades.
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