I.

Introduction

Alcoholics Anonymous (A.A.), international organization that helps people with alcoholism remain sober by following a “twelve step program,” a system that A.A. pioneered. A.A. is the world’s largest self-help organization, with over 2 million members worldwide. Of these, more than 1 million live in the United States. The organization has its headquarters in New York City.

A.A. members meet in groups, which range in size from fewer than 10 persons to more than 100. Each group is self-organized and self-supporting. About two-thirds of the members are men. Members refer to each other by their first name only to preserve anonymity. The only requirement for membership is a desire to stop drinking.

A board of trustees, of whom 7 are nonalcoholics and 14 are A.A. members, administers the organization’s activities in the United States and Canada. Regional delegates vote on matters of general significance at annual conferences; an international convention takes place every five years.

II.

The A.A. Approach

The A.A. program prescribes total abstinence, encouraging members to stay away from alcohol “one day at a time.” The first task for a new member is to admit that he or she has a drinking problem. To do this, the person stands up during a meeting, states his or her name, and proclaims, “I am an alcoholic.” Members are encouraged to share their experiences and learn to rely on each other to develop the strength to break their addiction to alcohol. Many new members attend meetings daily for three months or more. Experienced members often “sponsor” newcomers to A.A. by providing close personal support. Sponsors help newcomers work through the 12 steps of the A.A. program and keep in touch with them between meetings.

The 12-step system serves as the cornerstone of A.A.’s approach to achieving sobriety (see Twelve-Step Program). Each step specifies an action or behavior designed to help alcoholics live their lives differently. Among the Twelve Steps, members are encouraged to admit they are “powerless over alcohol,” to surrender their lives to “the care of God,” to identify things they have done wrong and make amends with people they may have harmed, and to share the message of sobriety with other alcoholics. (See the table accompanying this article titled “Twelve Steps of Alcoholics Anonymous.”)

The A.A. method has been criticized because it appears to be religious—5 of the 12 steps include references to God. However, A.A. does not require belief in a formal religion or in God. The success of A.A. has inspired many other international 12-step programs, including groups for family members of alcoholics (Al-Anon Family Groups) and for people suffering from other addictive behaviors, such as gambling (Gamblers Anonymous), overeating (Overeaters Anonymous), and drug abuse (Narcotics Anonymous).

III.

History

A.A.’s roots date to a 1935 meeting in Akron, Ohio, of two men who had serious drinking problems—New York City stockbroker Bill Wilson and Akron surgeon Robert Holbrook Smith. Both men had been members of the Oxford Group, a fellowship that emphasized spiritual values and discouraged alcohol consumption. Through the Oxford Group and with the help of a friend, Wilson had achieved sobriety, which had eluded Smith. Wilson explained to Smith that alcoholism was a disease, and with this new perspective, Smith was able to stop drinking. The two men began working with alcoholics at Akron’s City Hospital, referring to themselves as Bill W. and Dr. Bob, thus establishing the A.A. tradition of anonymity. Their approach—that alcoholics must recognize drinking as a sickness that they need help to overcome—helped dozens of Akron alcoholics to quit drinking.

Inspired by these successes, alcoholics in New York City and Cleveland, Ohio, began similar ventures. In 1939 Bill W. wrote a textbook called Alcoholics Anonymous, outlining A.A.’s philosophy and methods. Later that year a series of favorable articles and editorials in the Cleveland Plain Dealer gained the attention of problem drinkers throughout the Midwest.

Around the same time, industrialist John D. Rockefeller, Jr., began to take an interest in the budding movement. In 1940 he hosted a dinner in New York City to help promote A.A.’s mission. However, the event did not raise money for the group because Rockefeller believed that the organization should be self-supporting. A.A. later established a policy that prohibited the group from accepting donations from nonmembers. The dinner did help increase public awareness about the new organization, and by the end of 1940 more than 2,000 people had turned to A.A. for help. An article in the Saturday Evening Post the following year helped boost membership to 6,000 by the end of 1941. Around this time, chapters of A.A. began to appear in Canada.

By 1950 more than 100,000 people had attended A.A. meetings throughout the United States and in other countries. Smith died that year. Wilson died in 1971, several months after speaking at A.A.’s 35^th-anniversary convention.