For many people with a drinking problem, yes. A 2020 Cochrane review of 27 studies found that structured programs that help people get involved in Alcoholics Anonymous (AA) led to more continuous abstinence than other proven therapies, and did about as well on other drinking outcomes (Kelly et al., 2020). It isn't the only path.
If you or someone you love is in danger right now, call 911, call or text 988, or call the SAMHSA National Helpline at 1-800-662-4357 (SAMHSA).
People type "does AA work" for different reasons. Some have been to a meeting and aren't sure they belong. Some are tired of hearing that AA is the only way. Some are parents or spouses who want to know if the free meeting down the street is worth pushing. Each of them deserves a straight answer from the research, not a slogan from either side. Here it is, in plain words.
What is AA, and what is twelve-step facilitation?
Alcoholics Anonymous (AA) is a free, peer-led fellowship. Members meet in groups, share their experience, work the Twelve Steps, and often have a sponsor, a more experienced member who walks with them. Nobody is paid, and nobody is a clinician in that role.
Twelve-step facilitation (TSF) is something different. It is a professional treatment, usually run by a counselor, that teaches the ideas behind the Twelve Steps and actively helps a person start going to meetings. Some TSF programs follow a written manual session by session. Others are less structured.
That difference matters. Much of the strongest evidence is about TSF, which is treatment that connects people to AA, not about walking into a meeting alone. The Cochrane review studied both, and its authors grouped them together as "AA/TSF" (Kelly et al., 2020).
What did the 2020 Cochrane review actually find?
Cochrane reviews are among the most careful summaries in medicine. They gather every qualifying study on a question and rate how sure we can be of the results. The 2020 review on AA, led by John Kelly, Keith Humphreys, and Marica Ferri, included 27 studies with 10,565 participants. All were adults with alcohol use disorder who were not forced into treatment (Kelly et al., 2020).
Here is what it reported:
- Staying fully sober. In randomized trials, manualized AA/TSF raised rates of continuous abstinence at 12 months compared with other established treatments like cognitive behavioral therapy (CBT). The risk ratio was 1.21, based on 2 studies with 1,936 participants, and the reviewers rated this high-certainty evidence. The effect held at 24 and 36 months.
- Days without drinking. AA/TSF did about as well as other treatments at 12 months, and better at 24 and 36 months, though that evidence was low or very low certainty.
- How much people drank, and the harm it caused. AA/TSF performed about as well as other treatments.
- Cost. In three studies, AA/TSF had higher health care cost savings than outpatient treatment, CBT, or no AA/TSF. The reviewers concluded it "probably produces substantial healthcare cost savings."
In plain words: on the outcome that matters most to many families, staying sober over time, structured 12-step help came out ahead. On most other measures, it did as well as the therapies it was compared with. That's a strong showing for a fellowship that is free.
What the review did not show
Be honest about the limits, too. The review covered alcohol only. Several of its studies had a high risk of bias in how people were selected or in how many dropped out. And the review compared AA/TSF to other good treatments. It did not find that AA beats everything for everyone.
Isn't it just that motivated people go to AA?
That's the fair objection. People who choose AA might already be more ready to quit, which would make AA look better than it is.
Researchers tested this. Keith Humphreys and colleagues re-analyzed data from randomized trials where people were assigned by chance to programs that encouraged AA attendance. In five of the six data sets, the extra AA attendance caused by that random assignment led to more days of abstinence at 3 months and at 15 months. In the one data set where people were already going to AA a lot, pushing them to go even more didn't change their drinking (Humphreys et al., 2014).
So, for most people seeking help with alcohol, AA's benefit doesn't appear to be explained by self-selection alone.
How does AA help people stay sober?
This is where the research gets interesting. In a study of 1,726 adults from Project MATCH, the main reasons AA attendance led to better drinking outcomes were changes in a person's social network and stronger confidence to stay sober around other people. For more impaired patients coming out of inpatient care, growth in spirituality and less negative emotion also played a part (Kelly et al., 2012).
A later review of 25 years of this research came to a similar view. AA's benefits seem to be carried mostly by social, thinking, and emotional changes. Spiritual awakening, the path described in AA's original Big Book, may be the main route for a minority of people with high addiction severity (Kelly, 2017).
That lines up with what many people already sense. Recovery grows best among people. You trade drinking friends for sober ones. You find out you aren't the only one. You learn, by watching others, that a hard day doesn't have to end in a drink.
How does AA compare with other options?
The large Project MATCH trial assigned 1,726 adults with alcohol dependence to 12 weeks of CBT, motivational enhancement therapy, or twelve-step facilitation. All three groups improved a great deal, and there was little difference in outcomes between them. Outpatients with low psychiatric severity had more abstinent days after TSF than after CBT (Project MATCH Research Group, 1997).
For people who don't connect with AA, there are other peer groups. A study that followed 647 adults with alcohol use disorder for a year found no clear difference in how well Women for Sobriety, LifeRing, SMART Recovery, and 12-step groups worked for people who got involved. People who committed to lifetime total abstinence did best across groups (Zemore et al., 2018). The authors called those results tentative.
| Option | What it is | What the research found |
|---|---|---|
| AA (peer-led) | Free meetings, Twelve Steps, sponsors | More attendance led to more sober days for most people seeking help (Humphreys et al., 2014) |
| Twelve-step facilitation | Counselor-led treatment that connects you to AA | More continuous abstinence at 12 months than CBT and similar treatments; high-certainty evidence (Kelly et al., 2020) |
| CBT or motivational therapy | Professional talk therapy | Similar results to TSF on most drinking outcomes in Project MATCH (1997) |
| SMART Recovery, LifeRing, Women for Sobriety | Secular peer groups | No clear difference from 12-step groups for people who got involved; tentative (Zemore et al., 2018) |
None of these rule out medical care. The NIH's alcohol treatment guide says many people benefit from mutual support groups in addition to professional treatment, and that because groups vary widely, it's important to try different ones to find a good fit (NIAAA). For a wider look at what works across treatment types, see Does rehab work? What actually works in addiction recovery.
Does AA work for drugs other than alcohol?
The Cochrane review studied alcohol only, so it can't answer this. The evidence for drugs is thinner.
One trial in the National Institute on Drug Abuse Clinical Trials Network tested a 12-step program called STAGE-12 with 471 people who used stimulants such as cocaine or methamphetamine. Participants attended more 12-step meetings and did more 12-step activities than people in usual treatment. But the results on drug use were mixed: they had better odds of reported abstinence during the 8-week program, yet those who didn't stop used on more days (Donovan et al., 2013).
That doesn't mean Narcotics Anonymous or Cocaine Anonymous can't help. It means the research is less settled, and a peer group should sit alongside treatment, not replace it.
Can you go to AA while taking medication like Suboxone or naltrexone?
Yes. Medication for addiction is real treatment, and many people use it alongside a support group. AA publishes a pamphlet for members who take prescribed medication, with suggestions for using it safely while staying sober (Alcoholics Anonymous). If anyone at a meeting tells you to quit a prescribed medicine, thank them and talk to your doctor instead. Never stop a prescribed medication on your own.
How do you get the most out of AA or any recovery group?
The research points to involvement and relationships, not just showing up. Here is a simple way to start:
- Try several meetings. Groups differ. Give three or four different ones a fair chance before you decide (NIAAA).
- Go often early on. For most people, more AA attendance led to less drinking (Humphreys et al., 2014).
- Get phone numbers. A sober network is one of the main ways AA helps (Kelly et al., 2012). Call someone before a hard evening, not after.
- Ask someone to walk with you. A sponsor or mentor gives you a person, not just a program.
- Do something. Set up chairs, make the coffee, greet the new person. Service turns you from a visitor into a member.
- Keep your care team. Stay with your doctor, counselor, or medication plan. Groups and treatment work well together.
- Write down your warning signs. Relapse usually starts well before the first drink. Our guide to relapse warning signs and the Gorski model can help you make a plan.
If you're weighing a short program, read Is 30 days of rehab enough? too. Recovery is long work, and ongoing community is one of the few things that lasts as long as you need it.
What does faith have to do with it?
AA has religious and spiritual roots (Kelly, 2017), and the steps still talk about God "as we understood Him." At Recovering Addict, we name Him plainly. We believe Jesus Christ is the One who saves, forgives, and gives a new start. We are a Christ-centered peer-support community, not an AA group, but we've learned the same thing the research keeps finding: people heal in company.
"Two are better than one, because they have a good reward for their labor. For if they fall, the one will lift up his fellow; but woe to him who is alone when he falls, and doesn't have another to lift him up" (Ecclesiastes 4:9-10, WEB).
Scripture also tells us to "confess your offenses to one another, and pray for one another, that you may be healed" (James 5:16, WEB). That is what a good meeting is. Honest people, telling the truth, praying for each other, and showing up again next week.
If AA has been a lifeline for you, praise God, and keep going. If it hasn't fit, that doesn't mean you're beyond help. It may mean you need a different room. We offer peer support from a team certified in relapse prevention (Terence Gorski model).
Where can you find a Christ-centered group in Ogden?
Recovering Addict meets Monday, Wednesday, and Friday, 6:00 to 8:00 p.m., at Iron House Gym in Ogden. The workout starts at 6, then the group stays for Christ-centered teaching and practical recovery skills. It's free. You can read about the program or plan your first visit.
Want to ask a question first? Call or text 801-695-3085, or use our contact page. The phone isn't staffed around the clock, so if it's an emergency, call 911, call or text 988, or call SAMHSA at 1-800-662-4357.
Is there a Christ-centered 12-step workbook for the work between meetings?
Many people find it helps to have something in their hands between meetings. Our free meetings use the Recovering Addict 12-Step Workbook Series, written by Leonard Ted Weaver. It walks through the steps with Scripture and honest questions. It's optional, and it works alongside community and care, not in place of them.
- The full series: Recovering Addict 12-Step Workbook Series
- Drugs & Alcohol
- Sex & Porn
- Food Addiction
Whatever room you end up in, don't do this alone. Reach out today.
Recovery questions answered
Does AA actually work?
For alcohol use disorder, the best evidence says yes for many people. The 2020 Cochrane review found that structured programs that connect people to AA led to more continuous abstinence than other established treatments, and did about as well on other drinking outcomes.
What is the AA success rate?
There is no single trustworthy AA success rate, because members are anonymous and come and go freely. Controlled studies are a better guide, and the 2020 Cochrane review found 12-step help did as well as or better than other treatments, depending on the outcome.
Does AA work for drug addicts?
The Cochrane review studied alcohol only. A National Institute on Drug Abuse trial with people who used stimulants found that a 12-step program raised meeting attendance, but its effect on drug use was mixed. Narcotics Anonymous and other groups may still help, especially alongside treatment.
Does AA work for atheists or non-religious people?
Research on how AA helps found that its benefits come mostly from social support and confidence, with spiritual change mattering more for a smaller group with severe addiction. People who don't want a spiritual program can also try secular groups like SMART Recovery, LifeRing, or Women for Sobriety.
Is SMART Recovery better than AA?
One long-term study of 647 adults found no clear difference in how well SMART Recovery, LifeRing, Women for Sobriety, and 12-step groups worked for people who got involved. The best group is usually the one you will actually keep attending.
Can I go to AA if I take Suboxone or other medication?
Yes. AA publishes a pamphlet for members who take prescribed medication, with suggestions for taking it while staying sober. Never stop a prescribed medication without talking to your doctor.
How many AA meetings should I go to?
There's no proven magic number. Research found that for most people seeking help, more AA attendance led to more days without drinking, so going often and building real friendships matters more than counting meetings.
Sources
- Alcoholics Anonymous and other 12-step programs for alcohol use disorder (Kelly, Humphreys & Ferri, 2020). Cochrane Database of Systematic Reviews (via PubMed).
- Estimating the efficacy of Alcoholics Anonymous without self-selection bias: an instrumental variables re-analysis of randomized clinical trials (Humphreys, Blodgett & Wagner, 2014). Alcoholism: Clinical and Experimental Research (via PubMed).
- Determining the relative importance of the mechanisms of behavior change within Alcoholics Anonymous: a multiple mediator analysis (Kelly et al., 2012). Addiction (via PubMed).
- Is Alcoholics Anonymous religious, spiritual, neither? Findings from 25 years of mechanisms of behavior change research (Kelly, 2017). Addiction (via PubMed).
- Matching Alcoholism Treatments to Client Heterogeneity: Project MATCH posttreatment drinking outcomes (1997). Journal of Studies on Alcohol (via PubMed).
- A longitudinal study of the comparative efficacy of Women for Sobriety, LifeRing, SMART Recovery, and 12-step groups for those with AUD (Zemore et al., 2018). Journal of Substance Abuse Treatment (via PubMed).
- Stimulant abuser groups to engage in 12-step: a multisite trial in the NIDA Clinical Trials Network (Donovan et al., 2013). Journal of Substance Abuse Treatment (via PubMed).
- Types of Alcohol Treatment. NIAAA Alcohol Treatment Navigator (National Institutes of Health).
- The A.A. Member: Medications and Other Drugs (P-11). Alcoholics Anonymous World Services.
- SAMHSA's National Helpline, 1-800-662-HELP (4357). SAMHSA.
