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Alcoholics Anonymous and other 12-step programmes for alcohol dependence

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Ferri, Marica, Amato, Laura, Davoli, Marina·2006·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd005032.pub2PMC PMC12167657
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Abstract

BACKGROUND: Alcoholics Anonymous (AA) is an international organization of recovering alcoholics that offers emotional support through self-help groups and a model of abstinence for people recovering from alcohol dependence, using a 12-step approach. Although it is the most common, AA is not the only 12-step intervention available there are other 12-step approaches (labelled Twelve Step Facilitation (TSF)). OBJECTIVES: To assess the effectiveness of AA or TSF programmes compared to other psychosocial interventions in reducing alcohol intake, achieving abstinence, maintaining abstinence, improving the quality of life of affected people and their families, and reducing alcohol associated accidents and health problems. SEARCH STRATEGY: We searched the Specialized Register of Trials of the Cochrane Group on Drugs and Alcohol, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE from 1966, EMBASE from 1980, CINAHL from 1982, PsychINFO from 1967. Searches were updated in February 2005. We also inspected lists of references for relevant studies. SELECTION CRITERIA: Studies involving adults (<18) of both genders with alcohol dependence attending on a voluntary or coerced basis AA or TSF programmes comparing no treatment, other psychological interventions, 12-step variants. DATA COLLECTION AND ANALYSIS: One reviewer (MF) assessed studies for inclusion and extracted data using a pre-defined data extraction form. Studies were evaluated for methodological quality and discussed by all reviewers. MAIN RESULTS: Eight trials involving 3417 people were included. AA may help patients to accept treatment and keep patients in treatment more than alternative treatments, though the evidence for this is from one small study that combined AA with other interventions and should not be regarded as conclusive. Other studies reported similar retention rates regardless of treatment group. Three studies compared AA combined with other interventions against other treatments and found few differences in the amount of drinks and percentage of drinking days. Severity of addiction and drinking consequence did not seem to be differentially influenced by TSF versus comparison treatment interventions, and no conclusive differences in treatment drop out rates were reported. Included studies did not allow a conclusive assessment of the effect of TSF in promoting complete abstinence. AUTHORS' CONCLUSIONS: No experimental studies unequivocally demonstrated the effectiveness of AA or TSF approaches for reducing alcohol dependence or problems. One large study focused on the prognostic factors associated with interventions that were assumed to be successful rather than on the effectiveness of interventions themselves, so more efficacy studies are needed.

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  • The protective function of 12-Step attendance has been well documented.

    “The protective function of 12-Step attendance has been well documented”

    From Development and initial evaluation of the Brief Addiction Monitor (BAM) (2013) · cites this paper as Ferri, Amato, & Davoli, 2006

    The authors’ conclusions (Background; page unavailable) state that no experimental studies unequivocally demonstrated the effectiveness of AA or other 12-step approaches in reducing alcohol problems. The Discussion adds that evidence for an abstinence benefit was inconclusive. This contradicts the claim that a protective function of attendance was well documented; it does not establish that attendance is ineffective. (LLM, conf=0.89)

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Authors
Ferri, M., Amato, L., & Davoli, M.
Affiliations
  • Agency of Public Health; Project Unit: EBM and Models of Health Assistance; Via di Santa Costanza 53 Rome Italy 00198
  • Azienda Sanitaria Locale Roma 3 (IT)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2006-07-19
Volume
2010
Issue
1
Pages
CD005032-CD005032
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd005032.pub2
PMC
PMC12167657
OpenAlex
W1541598409
Cited by
347
References
0
Citations by year
2026: 3 · 2025: 4 · 2024: 9 · 2023: 4 · 2022: 9 · 2021: 7 · 2020: 63 · 2019: 27 · 2018: 18 · 2017: 24 · 2016: 21 · 2015: 32 · 2014: 21 · 2013: 18 · 2012: 26
FWCI
1.28
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
Keywords
Alcoholics Anonymous, twelve-step facilitation, 12-step programs, alcoholism, self-help groups, abstinence, treatment retention, treatment discontinuation, alcohol consumption, psychosocial interventions, family quality of life, alcohol-related accidents
MeSH terms
Adult, Alcoholics Anonymous, Alcoholism, Humans, Self-Help Groups, Program Evaluation, Randomized Controlled Trials as Topic

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