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Alcohol use disorder (AUD) is a chronic health problem in the United States, with social, economic, and personal consequences. The purpose of the current integrative review was to examine recovery from AUD in adult Alcoholics Anonymous® (AA) members working the 12 steps. Databases were searched using a combination of search terms with inclusion criteria of human adult studies published in English between 2010 to 2020. Searching the references of retained records also identified other relevant studies for inclusion. Through the process of two searches and examination of retained records' reference lists, 20 articles were retained. AA outcomes frequently cited are abstinence, improved self-efficacy, improved psychosocial well-being, and improved social networks. These positive outcomes are linked to attendance and participation in AA. There is a deficiency of research specific to how AA works to achieve the ascribed outcomes. This identified gap in the state of the science lays the foundation for future research. [ Journal of Psychosocial Nursing and Mental Health Services, 59 (12), 33–39.]

This study examined the lived experiences of 12 students in recovery from Substance Use Disorders (SUDs) who were members of Collegiate Recovery Programs (CRPs) at three academically-recognized uni...

Objective The authors developed and tested video clips depicting three paradigmatic substance use disorder (SUD) clinical scenarios, each portrayed by a different simulated patient interacting with the same clinician. Methods The authors embedded 21 short video clips (with a cumulative duration of 27 min) into a 2-h session on SUDs. The didactic was delivered online through synchronous videoconferencing with Zoom. The primary outcome compared learners’ scores on the Attitudes and Confidence in the Treatment of Patients with Substance Use Disorders (ACT-SUDS) before and after participating in the didactic. Results Fifty-eight second-year medical students participated and completed the survey prior to the didactic; 42 (72%) of them completed the survey immediately after. Compared to baseline, ACT-SUDS increased after the didactic: from 3.7 ± 0.5 to 4.0 ± 0.4 (mean difference = 0.4 [95% confidence interval = 0.2–0.5], paired-t = 5.75, p < 0.001), as did each of its four subscales: confidence, enjoyment, SUD as a medical disorder, and attitudes toward Alcoholics Anonymous (AA; t ≥ 3.0, p ≤ 0.005). Conclusions The video-based educational module proved easy to implement in the virtual classroom and led to measurable changes in perceptions and attitudes toward SUDs. The module is available to view or freely download and is amenable for adaptation by end-use instructors.

Although stigma can jeopardize the recovery efforts of people who formerly misused substances, potentially leading to relapse, how people in recovery for alcoholism manage stigma has not been comprehensively or systematically examined. Using stigma management communication theory (SMC) and in-depth interviews of 22 adults in recovery, this investigation uncovered the six main strategies participants used to negotiate the stigma of being an alcoholic. Consistent with the tenets of SMC, interviewees accepted, evaded responsibility for, reduced offensiveness of, avoided, denied, and/or ignored/displayed the stigma, depending on whether they accepted or challenged that the stigma of being an alcoholic applied to themselves and/or the public's perception. Findings inform practical strategies to help individuals in recovery effectively manage stigma while sustaining their sobriety. The study also suggests ways programs such as Alcoholics Anonymous and treatment centers can use communication to break down recovery barriers.

Participation in Alcoholics Anonymous (AA) appears to have numerous benefits beyond sobriety. Previous research has highlighted the role of gratitude and helping others in the AA philosophy, as well as their importance in creating social ties. Helping others, social relationships, and gratitude may contribute not only to sobriety but also physical health and psychological well-being; however, little is known about the relationship between these variables and how they contribute to well-being for people in recovery. In this study, we examined how gratitude (state and trait level), social contact, and helping predicted self-rated physical health and psychological distress in adult AA members maintaining sobriety. Participants (N = 113) completed baseline measures (trait gratitude, physical health) as well as daily reports of their participation in AA, helping behaviors, social contact, and psychological distress for 7 days. Analyses revealed different predictors for physical health and psychological distress. The implications for theory and practice are discussed.

Using interpretative phenomenological analysis (IPA) and theoretically framed within Frankl’s logotherapy, the current paper explored how members of Alcoholics Anonymous (AA) with long-term recover...

People recovering from substance use disorders have a variety of options from which to choose to help them achieve their goal of sobriety. Often, they seek the assistance of peer- run 12-step progr...

This review examines a novel application of Jungian therapy and theory to the Twelve Step program of Alcoholics Anonymous (AA). The author, David E. Schoen, reprints an exchange of short letters be...

Harmful alcohol use is a public health problem worldwide, contributing to an estimated 5.1% of the global burden of illness. Screening and addressing at-risk drinking in primary care settings is an empirically supported health care intervention strategy to help reduce the burden of alcohol-use problems. In preparation for introducing screening and treatment for at-risk drinking in primary care clinics in Colombia, we conducted interviews with clinicians, clinic administrators, patients, and participants in Alcoholics Anonymous. Interviews were conducted within the framework of the Deteccion y Atencion Integral de Depresion y Abuso de Alcohol en Atencion Primaria (DIADA, [Detection and Integrated Care for Depression and Alcohol Use in Primary Care] www.project-diada.org ) research project, and its qualitative phase that consisted of the collection of data from 15 focus groups, 6 interviews and field observations in 5 regional settings. All participants provided informed consent to participate in this research. Findings revealed the association of harmful alcohol use with a culture of consumption, within which it is learned and socially accepted practice. Recognition of harmful alcohol consumption includes a social context that influences its screening, diagnosis and prevention. The discussion highlights how, despite the existence of institutional strategies in healthcare settings and the awareness of the importance of at-risk drinking among health personnel, the recognition of the harmful use of alcohol as a pathology should be embedded in an understanding of historical, social and cultural dimensions that may affect different identification and care scenarios.

Self-support groups have an important role in different dimensions in the treatment of alcohol dependence. The best known of these groups is the Alcoholics Anonymous (AA). In this study, the historical development, philosophy and important concepts of anonymous alcoholics are explained and their relationship with psychiatry is mentioned. However, it is thought that it is important to make a short introduction to the history of Alcohol and Alcohol Addiction in terms of determining the place and importance of the AA group in the historical process. The literature on alcohol, alcohol addiction and AA has been reviewed from a medical history perspective. Historical findings on alcohol addiction date back to antiquity. The relationship between the modern concept of alcohol addiction and medicine is parallel with the development of modern psychiatry. At the beginning of the 20th century, it is seen that religious groups are active in alcohol addiction. While AA took a different approach in this process, it gained a privileged place. Since the middle of the 20th century, it has been in interaction with modern medicine and psychiatry and has made important contributions to addiction. The development of AA in Turkey is relatively new and has encouraged the establishment of other groups. In conclusion, AA has a historically important place in the development of alcohol addiction treatment. The group's philosophical orientation and its relationships with addiction psychiatry have been important in this context.

The aim of the article is to compare the features of Theory of Mind between people dependent on psychoactive substances, at different stages of recovery and the group of conditional norm. 98 individuals participated in the research. In the study, the following groups were compared by different parameters: 1) persons dependent on psychoactive substances. This group includes patients of the rehabilitation center, i. e. people in the early stages of recovery who are dependent on alcohol and / or other psychoactive substances; 2) persons dependent on alcohol which are part of the previous group; 3) persons addicted to alcohol, at later stages of recovery. This group includes members of the Alcoholics Anonymous community; 4) persons belonging to the group of conditional norm. Methods. There were used such instruments as Theory of Mind assessment scale (Th.o.m.a.s, Bosco, Gabbatore, Tirassa & Testa, 2016); Toronto Alexithymia Scale TAS26, adapted by Bekhterev Psychoneurological Research Institute (Eresko, Isurina, Koidanovskaia, Karvasarskyi, Karpova, Korepanova & Shifrin, 2005); 5PFQ personality questionnaire, adapted by Hromov (Hromov, 2000). For further analysis, descriptive statistics as well as several non-parametric criteria (U-Mann-Whitney test; Kolmogorov-Smirnov criterion) has been used. The results. A number of statistically significant differences were found between the 4 groups. In particular, differences were found in ToM structure, in the severity of alexithymia, as well as in the strength of the manifestation of various factors and subfactors by the personal questionnaire 5PFQ. The complexity of the allocative perspective has been established in both groups of dependent persons, in patients of the rehabilitation center and within the group of Alcoholic Anonymous. It was found that these two groups are not statistically different in the Toronto alexithymic scale, although in both groups there are high median indicators, which are moderately higher the upper limit of normal scores, and there is a statistically significant difference between these groups and the conditional norm group. Conclusions. ToM of persons dependent on psychoactive substances is characterized by a reduced understanding of their own emotions, if usage of psychoactive substances continues or has stopped recently, but it is resumed over the term of sobriety; while a high rate of alexithymia is remained. Also, persons dependent on psychoactive substances have a complication of the allocative perspective of ToM, even during the long-term sobriety.

Recovery in Alcoholics Anonymous (A.A.) is framed within a broad notion of spirituality, in which members are encouraged to nurture personal concepts of spirituality. An interpretative phenomenolog...

In the United States, Alcoholics Anonymous (AA) is the best known and the longest running mutual aid group for persons who want to address their problems with drinking. Begun in 1935, it is a major...

This article discusses the role of identification in the treatment of alcoholism proposed by the Brotherhood of Alcoholics Anonymous (AA). As a methodological procedure, we performed a bibliographic study of AA literature and interviews with ten AA members in the city of Juazeiro do Norte-CE. For the analysis of the results, we made an articulation between psychoanalytic theory and discourse analysis, also considering the Foucaultian contributions on discourse and power. In psychoanalysis, identification is defined as the most remote affective bond that the subject establishes with the object. Freud uses this concept in his study of group and mass formations, highlighting three modes of identification: with the father, the symptomatic and the hysterical. We found that for the AA member, the practice of the twelve-step spiritual therapeutic program requires symptomatic identification with "alcoholic disease" and with the other "alcoholic" member. The Brotherhood's group cohesion occurs based on the self ideal of “sobriety”. The founders' experience recorded in the official Brotherhood literature serves as identifying features for members to this day. In the speeches of the participants, the need for group bonding, compared to the family bond, and the exercise of leadership in the groups was highlighted, although the Brotherhood did not officially establish leaders. We conclude that for AA, the treatment of alcoholism is equivalent to the gradual process of identity construction of the “anonymous alcoholic”, whose subjective effects are of massification at the expense of singularity.

An increasing body of evidence shows that informal mutual aid groups benefit those in addiction recovery. However, attention for mutual aid groups in practice and policy varies internationally and is only recently emerging in continental Europe. Existing evidence is mostly limited to studies of Alcoholics Anonymous groups in the United States. The aim of this cross-sectional study is to examine the relationship between membership of a variety of mutual aid groups and recovery capital, participation in social networks, and commitment to sobriety for individuals in drug addiction recovery (N = 367), living in the UK, the Netherlands, and Belgium. A convenience sample of participants completed an extensive assessment about their recovery experiences. Sixty-nine percent of participants reported lifetime (ever) membership of different mutual aid groups. Analyses reveal that membership of mutual aid groups is strongly associated with more participation and (self-reported) changes in social networks, greater levels of recovery capital, and a stronger commitment to sobriety. The findings suggest that participation in mutual aid groups may support addiction recovery through multiple mechanisms of change in favor of recovery. These findings highlight how mutual aid support may complement formal addiction treatment.

Introduction: women have increased the consumption of alcohol, affecting their well-being, to this is added the situation of lag they face in receiving specialized treatment, treating their ailments in mutual-help groups, this scenario affects social and gender inequalities. The COVID-19 pandemic exacerbates these conditions, affecting specific life situations of women and their health. Objective: to understand the experience of women who receive support for their recovery due to problems due to alcohol consumption in groups of Alcoholics Anonymous in the context of COVID-19. Method: qualitative study. Sampling by opportunity defined the participation of four women from “AA”. During May 2020, telephone interviews were conducted under informed consent. A thematic analysis was developed and Atlas.ti was used. The perspective on collective health and gender guided the analysis. Results: when analyzing the information, three categories were identified. The first contextualizes the recovery experiences of women. The following categories reveal the situations experienced in the face of the COVID-19 pandemic and physical distancing. The findings were: gender roles and stereotypes are reaffirmed by expressing harassment and discrediting; family burdens and worries increase; participation in its recovery decreased. Discussion and conclusions: in the context of COVID-19, the participation of AA women in their recovery decreased, putting their well-being at risk, despite the fact that international organizations recommended continuing the care of people with mental health problems and incorporating community actions.

This qualitative analysis looks at women across a continuum of sobriety and affiliation with Alcoholics Anonymous (AA). The sample frame consists of 60 women’s stories as submitted to the Grapevine...

Background: The term God, included in 5 of the 12 Steps of Narcotics Anonymous (NA) and Alcoholics Anonymous (AA), self-designated spiritual fellowships, has not been studied empirically relative to members’ experiences. A greater understanding of this can be clinically useful and can shed light on the 12 Step process of recovery. Objectives: To determine how NA members understand the 12-step concept “God as we understood Him” and the relationship between their understanding of God and the intensity of their craving and depressive symptoms.” Methods: 450 (59% male) NA members completed a survey related to their experiences relative to their relationship with “God.” The relationship among these variables and comparisons to the general population was analyzed. Craving and depressive symptoms were assessed by self-report. Results: 98% of the NA participants believe in God explicitly or some other higher power (vs 89% of a probability sample of the US population), 67% believe that God determines what happens to them some or all of the time (vs 48%), 78% (vs 28%) report hearing God talking to them “in their mind”; and 37% report that God talks to them “out loud.” Acceptance of 12 Step God-related variables inversely predicted a significant portion of the variance of scores on craving (7.5%) and depression (13.5%). Conclusions: Respondents’ understanding of God in NA varied considerably and was predictive of their depressive symptoms and craving intensity. These findings can serve as a basis for research into mechanisms underlying NA/AA recovery experiences and can also aid clinicians in how to employ these programs.

Substance use disorders (SUDs) are stigmatized conditions in medicine, with negative attitudes toward patients with SUDs beginning to form in medical school. Only a few studies with small samples show that attending an Alcoholics Anonymous (AA) meeting may help decrease addiction stigma. This study examined whether attending an AA meeting impacts medical student attitudes toward patients with SUDs and any gender and age group differences within these attitudes. As part of their psychiatry clerkship, 138 third-year medical students attended an AA meeting and wrote reflection essays discussing expectations before the meeting, feelings while there, and thoughts on how these feelings might affect patient care. The authors performed a thematic analysis to identify themes and t tests to compare theme frequency by gender and age group. A primary theme in student responses was a reduction in stigmatizing attitudes, which was broken down into three subthemes: complexity of addiction (46%), diversity of people with addiction (37%), and practical applications (66%). Practical applications comprised compassionate care (53%) and intention to address SUDs clinically (35%). While no gender differences were found in theme frequency, younger students showed significantly higher frequency of all themes. Attending an AA meeting can challenge medical students’ stigmatizing attitudes about addiction and increase flexibility of thinking. Younger students’ biases may not be as solidified, stressing the importance of early exposure to patients in recovery during medical school. Attending an AA meeting and reflecting on the experience may be one way to decrease addiction stigma among medical students.

The idea that helping others and practicing gratitude are associated with lower selfishness among members of Alcoholics Anonymous (AA) is discussed in AA literature, in AA meetings, and among AA me...

This is a qualitative account of LGBTQ experiences seeking recovery in Alcoholics Anonymous. Tracing back over the past four decades, personal stories of recovery reflect the struggles with getting...

In recent years, the number of people who identify as “spiritual but not religious” has grown. At the same time, many addiction recovery programs such as Alcoholics Anonymous promote spiritual beliefs to help those suffering from alcohol use disorders. In this paper, we hypothesize and test to see whether individuals who have attended substance abuse groups such as Alcoholics Anonymous are more likely to identify as spiritual but not religious (SBNR). Using longitudinal data from the Midlife Development in the United States study (N = 1711), we find that those who have attended substance abuse groups are more likely to identify as SBNR. Further, frequency of attendance in these groups is positively and significantly associated with being SBNR when compared to being both religious and spiritual. Implications for understanding the connections among religion, spirituality, and substance abuse recovery programs are discussed.

Spirituality is a construct that is reflected in a diversity of strongly felt personal commitments in different cultural and national groups. For persons with substance use disorders (SUDs), it can serve as a component of the recovery capital available to them. This position statement reviews empirical research that can shed light on psychological, social, and biological aspects of this construct. On this basis, the Spirituality Interest Group of the International Society of Addiction Medicine (ISAM) makes recommendations for how this construct can be incorporated into research and clinical care.

The concept of recovery is not a new one in behavioral health, but it has experienced resurgence since the release of the President’s New Freedom Commission report in 2003 (Hogan 2003). The belief that persons with mental illness or substance use disorders can lead productive and satisfying lives has been part of the philosophic core of community psychiatry for many years and was practiced most notably in psychiatric rehabilitation paradigms through the latter part of the twentieth century. While variations on the theme of recovery have been noted since the nineteenth century and perhaps even earlier, they were established more formally in the 1930s with the establishment of the Alcoholics Anonymous and Recovery, Inc. (Sowers 2003).

Highlights • A large proportion of addiction treatment in the U.S. is at least somewhat religious in nature. • Some evidence suggests that attitudes toward addiction and addiction treatment are influenced by religious beliefs. • Relatively little prior research has examined how religion may shape attitudes toward addiction. • Some research suggests that religious beliefs are associated with negative attitudes toward addiction. • Future research is urgently needed to understand how religious beliefs may influence attitudes toward addiction treatment., Introduction Throughout history, ideas about addiction have been informed and influenced by religious belief and practice. Even continuing into the present, religion and spirituality are often thought to impact attitudes towards addiction and its treatment, particularly given the use of religion and spirituality in various well-known treatments such as Alcoholics Anonymous. Although research has flourished with regards to the role that addiction and spirituality might play in vulnerability to addiction or the treatment of addiction, there has been comparatively less research examining how religion might impact attitudes toward addiction more broadly. Method The present work sought to examine the current state of empirical literature evaluating the relationships between religion and attitudes toward addiction and addiction treatment. In service of the above aim, a scoping review was conducted. Results This summary of peer-reviewed, quantitative studies (n = 36) found that higher religiosity is related to more belief in the disease model of addiction in providers, negative attitudes towards addiction, and a stronger support for spiritually-based treatments. However, results varied based on the measures used and many relationships tested were not significant. There also appeared to be differences in the interaction between religion and spirituality and other variables, such as the respondent’s sex or whether the individual was a student or provider, in terms of attitudes. Conclusions Further research is needed to fully understand the nuances in the relationship between these variables, including more clear operationalization and standardized measurement. Until such research is conducted, no cohesive conclusions can be drawn, and clinical implications remain unclear.

A prevalent critique of Alcoholics Anonymous (AA) is that members must adopt an inflexible illness narrative, taking on an "alcoholic" identity and performing a set of practices to address this condition. Conversely, a small body of research suggests that, rather than comprising the uniform adoption of a rigid narrative, integration into AA is achieved by negotiating individual beliefs, values, and preferences with the AA model. To investigate such processes of negotiation, the current study aimed to explore the politics of belonging in AA. The study involved semi-structured interviews with 15 AA members recruited from meetings across Sydney, Australia, and data were analyzed thematically. Findings illustrated how participants navigated the politics of inclusion/exclusion within AA. While some aspects of AA were found to be negotiable by participants, a non-negotiable aspect of AA ideology that emerged was the axiom that "alcoholics" have no control over alcohol and therefore should maintain abstinence. Findings raise questions about how the politics of belonging in AA may shift over time following broader patterns of societal change.

Long-term recovery (LTR) from substance use disorders (SUDs) has been described as a complex process. It has been proposed that psychological mechanisms can influence the resolution of problematic substance using behaviors and may explain how and why a recovery process works. The aims of this narrative review were to (a) examine acceptance and change as an underlying mechanism in LTR from SUDs; (b) examine the practice of acceptance and change in the Narcotics Anonymous (NA) and Alcoholics Anonymous (AA) programs; and (c) present a conceptual model of self-acceptance and change in LTR from SUDs. Based on dialectical behavioral philosophy and mindfulness-based intervention, I posited that self-acceptance is an underlying mechanism that addresses the cyclical nature of shame, guilt, and SUDs; improves emotion dysregulation; psychological well-being; and activates a change process of recovery from SUDs. This article contributes to the field by presenting the opposing forces of acceptance versus change and their synthesis in promoting LTR from SUDs, and by discussing the practice of acceptance and change in the AA and NA programs.

Spirituality is a key element of Alcoholics Anonymous (AA) recovery. However, little is known about the potential religious and secular sources of spiritual experiences in AA fellowship. The aim of the study was to verify if in a sample of AA participants, meaning in life mediates the relationship between their religiousness and spiritual experiences, as well as between their involvement in AA and spiritual experiences. The study sample consisted of 70 Polish AA participants, and the following tools were used: the Alcoholics Anonymous Involvement Scale (AAIS), Santa Clara Strength of Religious Faith Questionnaire (SCSORFQ), Purpose in Life Test (PIL), two one-item measures regarding frequency of prayer and Mass attendance, and the Daily Spiritual Experiences Scale (DSES) duration of AA participation, which was positively related to involvement in addiction self-help groups and religiousness. Involvement in AA and religiousness were positively related to meaning in life, which in turn positively correlated with spiritual experiences. This research indicated that in a sample of AA participants, finding meaning in life partially mediates the relationship between religiousness and spiritual experiences, as well as fully mediating the relationship between involvement in AA and spiritual experiences. The theoretical and practical implications are discussed.

Members of Alcoholics Anonymous (AA) draw upon beliefs, practices, and experiences they deem spiritual in order to help them get and stay sober. This article traces how AA emerged from its evangelical parent to become a “spiritual rather than religious organization” by encouraging members to engage with “God as we understood Him.” Interviews with thirty-four current and former AA members in the greater Los Angeles area, as well as ethnographic observation at AA meetings and related events, reveal how a significant number of modern AAs have adopted a personal “spiritual but not religious” orientation, seeking a healing truth outside of traditional religious organizations. Emerging from the Twelve Steps and sometimes in imitation of one of AA’s founders, this perennialist orientation touts a loving and forgiving Higher Power and a notion of spirituality as a profound interconnection with other alcoholics, challenging scholarly assumptions about narcissism and social disengagement in contemporary spirituality.

Based on ethnographic research in Northern Mexico, this article describes the efforts of men within a therapeutic community closely tied to Alcoholics Anonymous (AA) to manage perceptions of AA recovery pathways, and to define for themselves and the larger public the nature of the spirituality that they acquired in recovery. Through an analysis informed by discourse studies and linguistic anthropology, the article shows that through discourse and symbolic actions in public display events, the men reinforced a belief in the effectiveness of AA recovery pathways by affirming their stigmatized identities as “addicts,” and by framing experiences such as rejection by family, an arrest or an encounter with death as possibilities for demonstrating honesty and authenticity, and for developing a sense of spirituality and the confidence needed to do the work of recovery. The men’s spirituality did not rely on any kind of consistent religious or spiritual practice; rather, it involved recognizing God as a force in their lives and remaining open to new discoveries and insights.