Alcoholics Anonymous

Alcoholics Anonymous (AA) is a global mutual aid fellowship dedicated to abstinence-based recovery from alcoholism through its spiritually inclined Twelve Steps. AA's Twelve Traditions stress anonymity and a primary focus on recovery, as well as aiming to keep AA free to all with no governing hierarchy while abstaining from public controversies and unallied with other institutions, organizations or causes. In 2021 AA estimated it was active in 180 countries with nearly two million members, with 73% in the United States and Canada.

AA’s origin dates to a 1935 Ohio meeting between Bill Wilson, or Bill W, and Bob Smith, or Dr. Bob (for anonymity, members often go by first name and last name initial). They met through the Christian revivalistOxford Group, and under its aegis they fellowshipped with other alcoholics until forming what became AA. In 1939 the fellowship introduced its Twelve Steps with the publication of Alcoholics Anonymous: The Story of How More than One Hundred Men Have Recovered from Alcoholism. Known as "the Big Book", later editions amended the subtitle with "Thousands of Men and Women".

The Twelve Steps are a suggested, but not required, ongoing self-improvement program to abstain from alcohol with the aid of a personally chosen higher power. After admitting to no control of drinking, chaotic lives, and the need for divine assistance, transgressions and personal failings of morals and character are listed and addressed through better actions and atonement. To maintain these gains, appeal is made to an unprescribed “God as we understood Him”, and the carrying of AA’s message to other alcoholics, which is often done through meetings and sponsoring other alcoholics.

AA meeting formats vary with some being studies of AA literature and others have speakers and attendees sharing what AA calls their “experience, strength and hope” from speakers and/or from attendees. Open meetings restrict no one, while others are for distinct demographics such as LGBTQIA+, and men or women only meetings are common. Agnostic and atheist meetings are also not uncommon.

In regards to AA’s effectiveness, a 2020 Cochrane review found that AA involvement via Twelve-Step Facilitation (TSF) therapy demonstrated higher rates of continuous abstinence, and compared to other treatments, including cognitive behavioral therapy, AA attendance over time resulted in better healthcare cost savings.