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The Success Rate of AA Is 5–10% — Here’s Why

Depending on whom you ask, AA has a success rate of about 5–10%.

And when I say “whom,” I mean people who actually study this shit — you know, scientists — not the schmuck old-timer at AA who likes to quote page 58 about, “rarely have we seen a person fail blah blah blah.”

Let me back up a bit and say that I work the AA program and have done so since 2011 — and I’ve been sober since that time.

For me, it works exceedingly well.

That doesn’t mean I can’t be critical of it.

I think a lot of people in AA who have stayed sober because of it just believe it works 100% and that anyone it doesn’t work for is just someone who is “doing it wrong.”

I’m 99% sure that’s bullshit.

AA’s Success Rate Is Fraught With Bullshit

AA has a BIG problem with survivorship bias, which (and I love this), “can lead to overly optimistic beliefs because failures are ignored.”

In AA meetings, guess whom you mostly have speaking?

The people who have worked the program and stayed sober.

That’s because most of the people who don’t stay sober tend not to be in the rooms because they’re out drinking and getting high (surprise surprise).

So you get this weird situation in AA where it sounds like it works really, really well, but in reality, it doesn’t.

And you wouldn’t ever know that by walking in the rooms because people like to quote stuff from the Big Book that is frankly bullshit.

Stuff like, “rarely have we seen a person fail who has thoroughly followed our path — and oh, by the way, Bill W said that he would change that word to never…”

Or they like to quote shit in the preface that says, “of alcoholics who came to AA and really tried (whatever the fuck that means), 50% got sober at once and remained that way; 25% sobered up after some relapses, and among the remainder, those who stayed on with AA showed improvement. Other thousands came to a few AA meetings and at first decided they didn’t want the program. But great numbers of these—about 2 out of 3—began to return as time passed.”

So here’s my favorite part about this line. They somehow come up with this meaning that AA has a 91.7% success rate.

Amazing.

91.7% Success Rate? Give Me a Break

There’s a ridiculous assumption here. they assume that “remained that way” is true — but how the fuck would they know? It’s not like the people in AA were tracking them.

And where did they come up with 50% in the first place? Did they count these people? They like to say these numbers came from comparing how many newcomer chips were given out to how many 1-year, 5-year, 10-year, etc. chips were given out, but how many people got dozens of newcomer chips?

And further, how do they know that chips didn’t just, oh gee, I don’t know, get lost or something? It’s not like they had some sort of scientific method going on here. Same with the 25%. Who knows how accurate that is?

The second thing they do is blatantly fuck with the numbers. The 2 out of 3? All it says there is that they began to return as time passed. It sure as shit doesn’t say that they got sober, but the hardcore DAA and PPG people love to use that to come up with this crazy 91.7% success rate.

This is all trash. Let’s talk about real numbers from real researchers.

Let’s talk about why the success rate of AA is so low.

Problem #1 — The Success Rate of AA Is Low Because the Wrong People Are Forced to Go

This is the biggest problem affecting the success rate of AA — people are forced to go who shouldn’t be there.

Look, AA is for people who are bottom-of-the-barrel drunks and drug addicts. It’s not for people who just got their first DUI after drinking 4 drinks and blowing a .09 or people who got caught with weed in trash states where it’s illegal and got sent to IOP by a judge.

It is not at all out of the realm of possibility for people like this to be forced to go to AA. Frankly, if all you did was get caught with weed, you probably don’t belong there.

Possessing weed doesn’t make you a drug addict. Doing a little coke on the weekend doesn’t make you a cokehead. I know people who shot heroin for a few months and then never did it again — they’re not heroin addicts.

But I promise you that if you get caught with heroin — and were physically addicted, which you will be if you shoot heroin for a couple months — that people are going to tell you you’re an addict.

You might actually believe it.

There are other cases where people who were just using because they had severe mental health issues or fell in with the wrong crowd get forced to go to AA by friends or family members — even though all they really needed to do was hang out with people who weren’t drug addicts or take their mental health medication like they’re supposed to.

There are people who have a significant other who does drugs and they end up doing drugs too because they love the person and want to do anything they can to make them happy.

I know more than a few people who got sober through AA and eventually learned to drink and use like normal people because guess what, they weren’t addicts or alcoholics in the first place, and all they needed to do was get away from it for a while.

So you get all these people who for one reason or another are forced to go to AA. In the minds of many people — including many of the people who run rehabs and many judges — AA is the only solution — even though that’s not true.

So these poor bastards who are not bottom of the barrel, real-deal alcoholics and drug addicts end up in a program that’s not for them.

And they fail.

Because they just don’t belong there.

They need other solutions.

And when they inevitably fail, we blame them instead of the program or the people who forced them into a program they didn’t belong in.

Speaking of blaming the victim…

Problem #2 — Victim Blaming

Another huge problem that I see in AA that contributes to the low success rate is that, when someone fails, everyone — even them — assumes that they are the problem — and not something else.

I have sponsored a lot of guys who did everything I told them to do — everything.

They relapsed anyway.

But in their minds, they fucked up somewhere, and I’ve heard lots of people in AA say that the person must have messed up the steps somehow — even though they did what they were supposed to do.

They say, “well, maybe they left something off their 5th step secretly, or maybe they didn’t carry the message enough, or maybe they just didn’t believe in god or a higher power, or maybe blah blah blah.”

And so, somehow, someone who did everything they were told to do ends up being blamed when they relapse.

So we blame the victim. The victim internalizes this. They decide that they’re not good enough. That they’re failures.

In reality, AA might not be for them. Maybe they’re not hopeless bottom-of-the-barrel drunks and just need some separation before they can learn to moderate.

Maybe they’ve got mental health issues that aren’t being addressed, leading them back to their drug of choice.

And they see AA as the only game in town, so they keep going back, even though AA is failing them, and not the other way around.

I will admit that there are people who are definitely alcoholics and/or drug addicts who don’t do the steps the way they’re supposed to, but these are few and far between. Most of the people who aren’t throwing themselves into this likely don’t have to.

But when they’re told they’re the ones messing up, it just makes it that much more likely that they’re not going to get sober. They’re not going to try something else, like SMART Recovery or therapy.

And they won’t make it.

In fact, they’ll engage in behavior that makes them look like they’re alcoholics/drug addicts, even when they’re not for one simple reason.

That’s what AA tells them they’re supposed to do. 

Problem #3 — The Success Rate of AA Is Affected by the All-or-Nothing Mentality of AA

AA is a program of complete abstinence. For the majority of people who go to AA, that’s not necessary. It’s the people who can’t stop no matter what and who can’t moderate no matter what who need complete abstinence.

As a result of this, there’s an all-or-nothing mentality in AA. A perfect example is what happens when you relapse — your day count starts over, and you feel like you’ve completely failed.

So you’ll see people who have been sober for 20 years drink for a few days in a row and then come back to AA feeling totally defeated even though all they did was drink for a few days.

How does that negate 20 years of sobriety?

The reality is that it doesn’t.

That person spent 20 years doing the right thing. They weren’t getting shitfaced all the time. They weren’t hurting people.

They should not only get credit for those 20 years, but they should continue to get credit after a so-called relapse.

They shouldn’t just say, “I now have 4 days.”

They should say they have 20 fucking years and just subtract the 4 days of the slip-up.

Do you know how researchers determine the effectiveness of methods of helping people who are abusing alcohol and drugs?

They look at how many days they have sober/moderating compared to how many days they have abused alcohol/drugs, and if the number of days of sobriety/moderation increase while the days abusing decrease, they see that as a success.

So someone who drinks for 3 days out of the month compared to when they were drinking 15 days out of the month is considered to be successful — but AA would say they’re failing and can’t stay sober.

How does this affect the success rate of AA? People who relapse get this mentality of, “fuck it — I might as well go crazy because I just threw away all my sobriety.

That all-or-nothing mentality tells them their might as well make the most out of the relapse and go crazy instead of just saying, “you know, this isn’t even a setback — I drank a little and moderated, and that’s okay, and I can go back to complete sobriety and not feel ashamed.”

But in AA, those people feel ashamed. They stop doing all the things that were helping because they feel like utter failures.

So they don’t come back.

For real alcoholics and drug addicts who need this program, that can be a death sentence.

Instead of cutting themselves some slack, they just give up completely because they’ve “lost” their sobriety.

If we just counted total days sober instead of starting over all the time, people might not feel so fucking ashamed and might come back to the program after drinking or using for a day or a week or whatever.

Problem #4 — Actively Telling People Not to Do Things Like Go to Therapy or Take Mental Health Medication or Take Meds With Addictive Potential That They Actually Need

Most people who come into AA have co-occurring disorders. They have mental health issues, eating disorders, or trauma.

They need to deal with those things if they’re going to stay sober. In many cases, that means years of therapy, taking mental health medication for life (or both).

It might mean they need to take drastic measures, like going to a Ketamine clinic once a month for their depression — something that people would tell them is “wrong” because Ketamine “changes the way they feel.”

They might have such severe anxiety and panic attacks that they need to take a benzo every now and then.

They might need to be on Suboxone for 6 months or 6 years to stay away from heroin

Remember that all-or-nothing mentality of AA? That applies here too.

A lot of people will tell you that you don’t get to count yourself as sober if you take Suboxone, or if you take a benzo for a panic attack, or if you get Ketamine treatment, or if you have to take hydrocodone for pain.

I’ve actually heard people say that you’re not sober if you take mental health medication — meds that aren’t even addictive.

This bullshit keeps people who need these meds from taking them — and they inevitably struggle with sobriety.

Or kill themselves.

Or die from a seizure because some dipshit told them they need to stop taking their Xanax.

And the people who survive? They struggle to stay sober. They’re not taking medication for depression, so they find sobriety depressing (surprise surprise) and decide that it’s not worth it to be miserable and sober and then wonder why they keep going back to meth.

Or they’re in such terrible pain that they don’t take pain meds because it doesn’t “count” as being sober, leading them to eventually give up on sobriety entirely — and abuse their meds again.

When they might have been able to just take the meds as prescribed in combination with AA and been able to stay away from abusing them.

The people giving out this advice are not doctors. They’re hurting people. They’re killing people. They’re keeping people from changing their lives because they’re so deadset on absolute abstinence (and forcing that on others).

And these people fail at AA, the success rate of AA goes down, and everyone is somehow surprised.

What’s Your Experience?

Do you think the success rate of AA I’ve included here is bullshit? Do you think it works better than what researchers have found?

Let me know in the comments.

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Larry Cashin
Larry Cashin
7 months ago

Interesting article. I agree with most of what you wrote and want to offer my own perspective and experience. First, I’ve been going to AA for 27 years and have been sober the entire time. That was my second go around. The first time I went for a week, hated it and stayed sober on my own for 18 months. Then I cured myself!!! hallelujah!!!!! When I cured my self, I drank 2 cans of beer a day and 3 on weekends, then 3/4, then 4/5. Then vodka. It ended spectacularly when I was kicked out of my house. I got sober with the aid of detox about 7 months after leaving home and moved back after a year.
I’ve also been a licensed addiction counselor in Massachusetts for 14-15 years. I run group therapy sessions and do case management (referrals, etc). The success rate of AA is all over the board and is hard to measure. As far as addiction, even if someone is sober for years (i.e. you and me) it’s the presence of the previous obsession/compulsion that indicates if you have the disorder (it’s called a disorder now more than a disease; easier to relate to). AA isn’t the only act in town. There’s SMART Recovery, Refuge Recovery, Secular Recovery to name a few. To me the camaraderie is one of the most valuable aspects of meetings; being with others like yourself who understand what you’ve been through. As far as medications, I’ve gone at it with some AA hardliners more than once who think any medication is bad. They can cause serious harm.

Claire
Claire
2 months ago

It was enlightening to read some criticism of AA coming from an actual AA member. WOW! That was my main problem with fellowship (CA and NA too). It’s what gives the fellowship its ‘cult’ status. The perception from old-timers that AA, or the 12-steps is the ONLY way and if you fail, you did something ‘wrong’ (for me it was I didn’t make 1 silly amends, so silly I’d forgotten about it and it wasn’t the reason that I drank, or that I didn’t believe in a Christian God). Where I do differ from you is that I consider myself to be the ‘real deal’ alcoholic. I was bottom-draw. I get terrible withdrawal if I’m on it for long enough, including hallucinations and severe shakes, I’ve passed out a few times in withdrawal and usually can’t come off it without the help of benzos or librium. I have lost jobs, my child, crashed cars, lost partners. The whole sorry mess. However, AA did not work for me for the reason you talk about in your final section of your blog – AA’s all or nothing mentality. I got multiple years in fellowship in my local town, then had a slip. I was treated like a child, a ‘know nothing newcomer’ and the shame and self-hatred that comes from being lectured at by some 12-step hardcore Big Book basher, telling me over and over again that I’m stupid and I know nothing and I did the programme wrong, I’m grandiose, I’m arrogant…. the list went on and on. It felt worse than the relapse. I allowed fellowship old-timers to speak to me in a way that even my worst enemies wouldn’t speak to me. There was no love, there was plenty of judgement and lecturing. I did earn another couple of years, but this sense of not being ‘part of’, of having ‘failed’ continued to haunt me. I gave up really. Also my first lapse made me see the fellowship in a very different light. I think it works if you never relapse, or perhaps if you are in and out constantly for years, without really taking it seriously (so you never experience the shame of having got multiple years really doing the ‘do’). A huge amount of ex-fellowship members have experienced the same journey as me in fellowship. They relapse and are ‘demoted’ to newcomer, know nothing status. Their long-term friends in fellowship start being more aloof. There are ‘newcomer’ sections in the rooms (usually the front row), you end up sitting apart from your previous close friends. The gap between you and your previous close friends in fellowship widens. You end up in a sub-culture of the sub-culture – the ‘serial relapser’ group. This happens both organically (if you have just come back from a relapse, you inevitably have more in common with others in the same situation) but also forcefully via the old-timers’ rules. Yes rules! The theory is that there are no rules in AA. Like Marxism, the theory is brilliant but rarely plays out in reality because humans are involved. I live in a big treatment centre town and moved here to do treatment back in 2006. So we all just know other fellowship members ( I was advised to move here to stay sober). This makes fellowship even more of a sub-culture than it might be in other towns. So when you relapse you are faced with either isolation, or mixing with others that have also relapsed (a recipe for disaster as everyone is at the bottom-rung of addiction and there’s no attempts at moderation). I know countless people who relapse after a petty but really mean fight between home-group members. The bitchiness of groups is astounding (I’m talking about both males and females here). Some ‘real’ alcoholics or addicts actually leave fellowship because of it’s narrow-minded views and DON’T drink or use again – not because they were never the real deal in the first place, but because there simply ARE other ways of staying sober and happy, if AA doesn’t work. You just have to hunt really hard for them. More tragically, many fall off the wagon and never go back because after a while, although fellowship old-timers insist that you are a newcomer, they don’t actually treat you like a newcomer (a real newcomer is fresh-faced and vulnerable and really does see the group 12-step hardliner as some divine, sober-giving God, rather than a tyranical and hypocritical Big Book thumper with as many, if not more, defects as your average person). Therefore, the old-timers flock to the ‘real’ newcomers as fresh faces they can ‘sponsor’ but they don’t want to help someone who has had multiple years previously, because that’s too much hardwork. And the person knows them too well. It all breeds more failure. I haven’t gone back to fellowship since relapsing at the end of the first lockdown, in June 2020. I drank on and off for a while, with the usual disastrous consequences coming. I have found This Naked Mind much more helpful, mainly because it uses a modern, scientific approach to addiction. They also don’t have the all or nothing mentality and recognise the clean time you have as a ratio, like the one you described above (if you drink 3 days out of month when you used to drink every day, this is a success). They don’t put any emphasis on a higher power, rather they ask you to be your own higher power. I think AA is getting old and tired. It fails far too many people for it to be seen as the ‘only’ way to get clean for much longer. I just hope treatment centres and judges etc recognise that it has failings and start to look at more modern methods of recovery. It’s ridiculous that we are using something that stated in the 1930s to help us now in the back-end of the 21st century.

Gib
Gib
20 days ago
Reply to  Claire

Thank you Claire. I’ve recently struggled with feeling that I have no choice except continued abstinence, not so much for the sake of keeping my life intact but because all of my closest friends are in the program and I am in fear of loosing status.

Teresa
Teresa
2 months ago

Teresa

My opinion really doesn’t matter but I’ll give you my 2 cents worth. Has there been a program for substance use disorder that has a better success rate than AA? I think the percentage is very low in this article. Does it make it true cuz you say so?? Where exactly did you get your information from?? If AA help one person like myself get better then it’s worth a standing ovation

rkirk2k
rkirk2k
1 month ago

LOVE this. I really want to remember to be humble, and to know that my ego is always looking for ways to “run the show”… But it is absolutely true. Personally, I believe attrition and inertia have corrupted the program the way they corrupt everything in humanity. The spirit begins to die, as time in sobriety distances us from the pain, and to maintain the surge we once enjoyed from meetings, our ego begins to develop ways to assert our flavor of sobriety on the group. The ONLY time I think about drinking is listening to “old timers”. Then I remember that they have nothing else, and this is their refuge too.
But the problem in my opinion, comes from the migration away from the spirit of the program, and gravitation toward the dogma of the group think that develops.
Think about it – the program did the MOST good and grew thoroughly and quickly long before the advent of all the saints and priests with decades of sobriety. I will keep going to try and offer hope to those coming in hopeless like I did – but I pray I NEVER become part of what the program has become on whole.

Chris D
Chris D
1 month ago

So refreshing to hear this. So often I feel as though I must tow the party line or face ostracization. I’ve been in AA for awhile a few relapses followed by shame and judgement regarding my lack of spiritual connection or not really being honest etc..
Some of the advise or feedback I hear AAers give people in the room just make me cringe.
Other parts of AA can be wonderful, you just must not say the The Big Book has no clothes in front of some AA folks.

Gib
Gib
20 days ago

Thank you for writing this. I struggled with addiction and depression in my mid 20’s, winding up in treatment in a new city at 28. After leaving treatment I decided to start a new life in that city, where I didn’t know a single person, and quickly became involved in AA as a way to put down roots, remain sober and build friendships. I’m sober about 8 years now and am starting to realize that my desire for connection and community has led me to identify in ways that I don’t really feel and aren’t accurate. I didn’t grow up around alcoholics. I have no experience with relapse. I have no experience with hard drugs. I’ve never gotten a DUI or in any trouble with the law, employers, etc. I don’t have any childhood trauma or anything like that, my relationship with my family is strong. I knew my drinking was a problem well before getting sober and never had any trouble rationalizing it, admitting defeat, or deciding it wasn’t really a problem and my drinking was okay. My life is very manageable and I rarely struggle with feelings of anger or resentment. My fourth steps have been short, easy, and I rarely need to work 10ths (like once a year I’ll talk to my sponsor about an issue) I often find that remembering I DO have personal power and agency is more helpful than reminding myself of how powerless I am. I’ve sponsored people but never found that part of the program particularly inspiring or helpful in keeping me sober. I have never felt a need to meditate or pray as a way to improve my life. I have never in 8 years felt any strong urge to drink, even when it’s right in front of me or when I’m in “dangerous” or depressing situations. It feels so wrong to think that I might not be an alcoholic of the type AA is helpful for.

People I have met in the program who struggle with these issues on a daily basis have a continual level of chaos and unmanageability in their lives I can’t comprehend. I have a friend in the program who nearly got into a fistfight the other day with a stranger on the street who he felt “disrespected his honor” by bumping into him on the sidewalk and not apologizing. He said this kind of thing happens to him frequently and I replied that I’ve never had that happen in my entire life. My sponsor is in a custody battle with his ex-girlfriend. I have another friend who just got 5 years who is often unable to pick up the phone or respond to text messages because she gets triggered and it’s “too hard for her.” For me, unmanagability looks like, I watched Netflix too late and was slightly tired at work the next day, or that I’ve been single for a long time and it’s a struggle to find dates. The first being a normal person problem and the second having nothing at all to do with the program.

I no longer feel safe, at home or comfortable in AA meetings and around other alcoholics. I have a few close friends who have been supportive of me and I am working on building a life outside AA, something I’d never considered until getting into traditional talk therapy recently. I feel that I’ve been gaslighting myself for the better part of 8 years into believing that I am the sole source of problems, I’m a terrible person and the only solution lies in the steps and doubling down on the program, something I’ve done a number of times. Now I feel guilty for thinking that thinking that “AA isn’t enough” for me to be happy in my life. I’ve been trained to think that any negative thoughts about the program are evidence of some deep-seated resentment that will destroy my sobriety. I’m not sure what my future looks like, but I’m slowly pivoting away from 12-step programs and enjoying finding new communities of normal, well-adjusted people.

Last edited 20 days ago by Gib
haef
haef
5 days ago

Problem #5 The ad lib composition of every AA group had, to me anyway, a significant impact on the vibe of the group. That really impacts how connected and supported members of the group feel. I’ve been to groups all over the spectrum. If a group isn’t a good fit, change.

The only problem is if there are new comers and they get exposed to control freaks and drama queens that inhabit some groups.

We’re looking for a healing learning environment, not community theatre.

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Adam Fout

I'm a speculative fiction and nonfiction writer. I have a B.A. in English and an M.A. in Professional and Technical Communication. I'm a graduate of the 2020 Odyssey Writing Workshop. I'm a regular contributor to Recovery Today Magazine, and I have been published in numerous literary magazines, including December, J Journal, and Flash Fiction Online, among others.

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