Any American who has any experience with addiction, including family or friends who have struggled with alcohol- or drug-related dependency, has heard of Alcoholics Anonymous (AA). It’s so ubiquitous that judges will sometimes require defendants to attend AA meetings. Some people have indeed found AA to be helpful, and credit the organization with saving their lives. I am in no way attempting to belittle their accomplishments in getting sober. Addiction is a terrible disease that has claimed or ruined many lives, and any program that successfully helps people deal with their additions should be lauded.

That said, there is scant evidence that the AA method actually works. The organization is founded on the idea of anonymity, partially to help attendees deal with the shame that often accompanies addiction. While there may be good reasons why AA protects its members’ anonymity, it also makes it difficult for researchers to assess the program’s success rate, beyond self-reported studies. Anecdotes are all well and good, but they aren’t evidence. There is some research demonstrating that the feeling of community is beneficial for people who are struggling, and in that way AA probably does help people who are struggling with addiction. However, AA also includes a religious component that not everyone may feel comfortable with. AA also holds that you have to wait until someone hits rock-bottom before you can help them. While it is true that someone needs to recognize they need help before interventions will be successful, there is no evidence to support the idea that you have to wait until someone hits their lowest possible point before offering help.

A self-reported study suggests that the AA approach works for about 1/3 of people, helps another 1/3 but not enough to cure their addiction, and does nothing for the remaining 1/3. Self-reported studies are not 100% reliable, but they’re better than nothing. (Self-reported studies are considered less reliable than other types of studies because the participants have, by definition, chosen to participate in them, which introduces a possible source of bias.) In the U.S., there are some secular alternatives to AA, and those may appeal more to people who struggle with AA’s religious components. Cognitive behavioral therapy and/or motivational enhancement therapy can also be effective treatments for addiction, as can medicine-based approaches. There are drugs designed specifically to reduce the effects of alcohol, or to reduce cravings for alcohol.

One approach might work better for one person, while a different treatment works better for someone else who is suffering with addiction. That’s okay. If you or someone you know is struggling with addiction, it can be a process finding which treatment works best. Failing at one approach doesn’t mean that you’ve failed at getting sober–it just means that you haven’t found the right treatment yet.