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.
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.
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.