Alcoholics Anonymous

Alcoholics Anonymous (AA) is a global, peer-led mutual aid fellowship dedicated to abstinence-based recovery from alcoholism through its spiritually inclined Twelve Steps. AA's Twelve Traditions, besides emphasizing anonymity and recovery from alcoholism as its only purpose, aim to keep AA free to all, with no governing hierarchy while avoiding public controversy. In 2021 AA estimated it was active in 180 countries with nearly two million members, 73% located in the United States and Canada.

AA dates its origin to a 1935 Ohio meeting between Bill Wilson (Bill W) and Bob Smith (Dr. Bob). (Members often go by first name and last name initial to stay anonymous.) Having met through the Christian revivalist Oxford Group, they continued under its aegis to fellowship 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. Informally called "the Big Book", later editions amended the subtitle with "Thousands of Men and Women".

The Twelve Steps are a suggested, ongoing self-improvement program to abstain from alcohol through the aid of personally defined, but not required, "God as we understood Him". The steps begin with an acknowledgment of powerlessness over alcohol and the unmanageability of life due to alcoholism. Subsequent steps emphasize rigorous honesty, including the completion of a "searching and fearless moral inventory", acknowledgment of "character defects", sharing the inventory with a trusted person, making amends to individuals harmed, and engaging in regular prayer or meditation to seek "conscious contact with God" and guidance in following divine will. The final step, the 12th, focuses on maintaining the principles of recovery, sharing the message with other alcoholics, and participating in "12th Step work," such as peer sponsorship, organizing meetings, and outreach to institutions like hospitals and prisons.

AA meeting formats include personal storytelling, either from select speakers and/or from attendees, while book studies are usually have open discussions of AA literature. Open meetings welcome all, while others target distinct demographics, eg. AA’s LGBTQIA+, men or women members. Open meetings welcome all while closed meetings are for those who self-identify as AA members.

In regards to AA’s effectiveness, a 2020 Cochrane review found that manualized AA and 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.