AA Membership and Alcoholism Treatment Work Best if Started Together

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Treatment of Alcoholism

People who join Alcoholics Anonymous at the same time they seek professional help for alcohol problems are more likely to be sober years later than those who initially seek only one or the other, according to a new report.

The study in the latest issue of Alcoholism: Clinical and Experimental Research suggests that the timing of a person's entry into Alcoholics Anonymous may be more important than previously thought.

Some studies have indicated that Alcoholics Anonymous participation can help alcohol abusers reduce their drinking, while noting that apparent benefits may be partly due to the fact that the group attracts people who are highly motivated to control their drinking.

In the new study, Rudolf Moos and Bernice Moos, researchers with the Department of Veterans Affairs and Stanford University, found that individuals who first sought help with Alcoholics Anonymous and later entered treatment were less likely to be sober years later than those who did not get professional help.

On the other hand, people who delayed joining Alcoholics Anonymous after starting professional treatment "did not appear to obtain any additional benefit from AA," said Rudolf Moos.

The findings "counter the concern that entry into treatment might reduce motivation to participate in AA," he added. "In fact, they suggest that participation in treatment may temporarily strengthen affiliation with AA."

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The researchers surveyed 362 people one year, three years, eight years and 16 years after they first sought help for alcohol abuse with professional treatment or Alcoholics Anonymous membership. The study participants were almost evenly divided between men and women, most were white and unmarried and 56 percent were unemployed at the start of the study.

Nearly half (180) of the people chose to start treatment and Alcoholics Anonymous membership at the same time, while 89 people joined AA only and 93 people sought professional help only at the start of the study.

Professional help included treatment by a physician, psychologist, psychiatrist or counselor on an outpatient basis or in a hospital program.

To determine the impact of the treatment or Alcoholics Anonymous membership, Moos and Moos asked individuals whether they had been abstinent or moderate drinkers and whether they had any alcohol-related problems at home or at work in the past six months. Those who had stopped or slowed their drinking with no recent alcohol-related problems were considered to be "in remission."

The amount of participation in Alcoholics Anonymous was also an important factor in remission, the researchers found. The more weeks people participated in AA during their first eight years of treatment, the more likely they were to be in remission at the one-, three- and eight-year marks.

Rudolf Moos says that more individuals might have joined Alcoholics Anonymous more quickly and increased their chances at remission "if some of the barriers to participation in AA could have been overcome, such as the perception that it encourages a sick role identity and dependence on the group."

According to alcohol abuse researcher J. Scott Tonigan of the University of New Mexico, "We still have a poor understanding of what AA-exposed individuals actually do and how AA-related practices may mobilize and sustain behavior change."

The study was supported by the National Institute on Alcohol Abuse and Alcoholism and the Department of Veterans Affairs Health Services Research and Development Service.

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