Alcoholics Anonymous and Twelve-Step programs help people to recover from alcohol problems

March 11, 2020

Newly updated evidence published in the Cochrane Library today compares Alcoholics Anonymous (AA) and clinically-related Twelve-Step Facilitation (TSF) programs with other treatments, such as cognitive behavioural therapy, to see if they help people who suffer from alcohol use disorders achieve sobriety or reduce the amount of alcohol that they consume.

Alcohol use disorder (AUD) is a prevalent, world-wide problem, and in some countries it is accelerating. 'Alcoholics Anonymous' (or AA for short) has been a popular treatment for alcohol use disorder for decades, but much debate has persisted on whether AA - and related 12-step clinical treatments designed to increase AA participation are effective.

AA are peer-led mutual-help groups. Twelve-step facilitation programs adopt some of the principles and techniques of AA and are delivered by clinicians. They are aimed at engaging people within AA during and after treatment for alcohol use disorder. Some of these programs follow a manual, so that the same treatment can be delivered at different times and places.

This Cochrane review looks at the effects of these programs on reducing alcohol consumption and the effects of heavy drinking (such as physical health, family, or employment problems), and enhancing long-term abstinence. The authors of the review also examined whether AA and TSF programs reduce healthcare costs compared to other treatments.

The previous Cochrane review published in 2006 was based on the eight available studies including a few thousand participants. The quantity and quality of the research has increased substantially since then. Twenty-seven studies are now included in this updated Cochrane review, comprising 10,565 people. The studies included in this update examined a range of programs that differed in their approach and intensity, and these were compared against other programs and different treatments for alcohol use disorder.

The authors found high certainty evidence that clinically delivered and manualized TSF programs designed to increase AA participation can lead to higher rates of continuous abstinence over months and years, when compared to other active treatment approaches such as cognitive behavioural therapy. The evidence suggests that 42 % of participants participating in AA would remain completely abstinent one year later, compared to 35% of participants receiving other treatments including CBT. This effect is achieved largely by fostering increased AA participation beyond the end of the TSF program.

When compared to the other treatment approaches Alcoholics Anonymous (AA)-based programs may perform just as well at reducing drinking intensity, negative alcohol-related consequences and addiction severity.

Dr. John Kelly, Elizabeth R. Spallin Professor of Psychiatry at Harvard Medical School and Director of the Massachusetts General Hospital Recovery Research Institute said, "Alcohol use disorder can be devastating for individuals and their families and it presents a significant, worldwide, costly public health problem. Alcoholics Anonymous is a well-known, free, mutual-help fellowship that helps people recover and improve their quality of life. One important finding from this review was that it does matter what type of TSF intervention people receive - better organized and well-articulated clinical treatments have the best result. In other words, it is important for clinical programs and clinicians to use one of the proven manualized programs to maximize the benefits from AA participation."

"In terms of healthcare costs, policy makers will be interested that four of the five economics studies we identified showed considerable cost-saving benefits for AA and related 12-step clinical programs designed to increase AA participation, indicating these programs could reduce healthcare costs substantially."
-end-
Full Citation: Cochrane Database of Systematic Reviews: Kelly JF, Humphreys K, Ferri M. Alcoholics Anonymous and other 12-step programs for alcohol use disorder. Cochrane Database of Systematic Reviews 2020, Issue 3. Art. No.: CD012880. https://doi.org/10.1002/14651858.CD012880.pub2

For further information and interview requests please contact:

Katie Abbotts
External Communications and Media Officer, Cochrane
M +44(0) 7810 504380 E kabbotts@cochrane.org or pressoffice@cochrane.org

Dawn Peters
Sr Manager, Global Communications & Media, Wiley (US)
P +1 781-388-8408 E newsroom@wiley.com

Follow us on Twitter @WileyNews

About Cochrane

Cochrane is a global independent network of researchers, professionals, patients, carers and people interested in health. Cochrane produces reviews which study all of the best available evidence generated through research and make it easier to inform decisions about health. These are called systematic reviews. Cochrane is a not-for profit organization with collaborators from more than 130 countries working together to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest. Our work is recognized as representing an international gold standard for high quality, trusted information.

Find out more at cochrane.org

Follow us on Twitter @cochranecollab

A reminder that you can unsubscribe from emails sent from Cochrane press office at any time. Please reply to this email and request to be removed from our press lists.

About Wiley

Wiley drives the world forward with research and education. Through publishing, platforms and services, we help students, researchers, universities, and corporations to achieve their goals in an ever-changing world. For more than 200 years, we have delivered consistent performance to all of our stakeholders. The Company's website can be accessed at http://www.wiley.com.

Wiley

Related Alcohol Articles from Brightsurf:

Alcohol use changed right after COVID-19 lockdown
One in four adults reported a change in alcohol use almost immediately after stay-at-home orders were issued: 14% reported drinking more alcohol and reported higher levels of stress and anxiety than those who did not drink and those whose use stayed the same.

Changes in hospitalizations for alcohol use disorder in US
Changes over nearly two decades in the rate of hospitalizations and in-hospital deaths from alcohol use disorder in the US were examined in this study.

Associations of alcohol consumption, alcohol-induced passing out with risk of dementia
The risk of future dementia associated with overall alcohol consumption and alcohol-induced loss of consciousness in a population of current drinkers was examined in this observational study with more than 131,000 adults.

New alcohol genes uncovered
Do you have what is known as problematic alcohol use?

Does estrogen influence alcohol use disorder?
A new study from researchers at the University of Illinois at Chicago shows that high estrogen levels may make alcohol more rewarding to female mice.

Sobering new data on drinking and driving: 15% of US alcohol-related motor vehicle fatalities involve alcohol under the legal limit
A new study in the American Journal of Preventive Medicine, published by Elsevier, found that motor vehicle crashes involving drivers with blood alcohol concentrations (BACs) below the legal limit of 0.08 percent accounted for 15% of alcohol-involved crash deaths in the United States.

Alcohol-induced deaths in US
National vital statistics data from 2000 to 2016 were used to examine how rates of alcohol-induced deaths (defined as those deaths due to alcohol consumption that could be avoided if alcohol weren't involved) have changed in the US and to compare the results by demographic groups including sex, race/ethnicity, age, socioeconomic status and geographic location.

Cuts in alcohol duty linked to 2000 more alcohol-related deaths in England
Government cuts to alcohol taxes have had dramatic consequences for public health, including nearly 2000 more alcohol-related deaths in England since 2012, according to new research from the University of Sheffield's School of Health and Related Research (ScHARR).

Integrated stepped alcohol treatment for people in HIV care improves both HIV & alcohol outcomes
Increasing the intensity of treatment for alcohol use disorder (AUD) over time improves alcohol-related outcomes among people with HIV, according to new clinical research supported by the National Institutes of Health.

The Lancet:Targets to reduce harmful alcohol use are likely to be missed as global alcohol intake increases
Increasing rates of alcohol use suggest that the world is not on track to achieve targets against harmful alcohol use, according to a study of 189 countries' alcohol intake between 1990-2017 and estimated intake up to 2030, published in The Lancet.

Read More: Alcohol News and Alcohol Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.