He now has one year clean and sober in Alcoholics Anonymous. I'm very happy that he was able to let go of outdated ideas like the idea that science shows AA is ineffective (it doesn't), and instead use the program to become clean and sober.
What is AA's real success rate?
The question is this: What is AA's real success rate? We can never know the true number for two key reasons:
- AA does not keep track of members.
- "AA success" is a poorly defined term, which can have several actual meanings
While AA itself did not keep track of members, Moos and Moos 2006 did. It found the following: Of the people who were serious about AA, 67% of them were sober 16 years later.
But what about the dropouts? Not everyone who did the study did the 16-year followup, so we can't know the true success rate number, but looking at only the people who did follow up gives us a reasonable number (Dodes 2014 claims that Moos/Moos 2006 has completely invalid numbers because of these dropouts, but Dodes appears to have had no interest in an honest assessment of AA's success). Overall, 46% of the people in the Moos and Moos 2006 survey (again, only those who did the 16-year followup) were sober, regardless of their level of AA attendance.
Now we are getting in to the realm of philosophical questions: Do we count someone who was not serious about AA but still stayed sober as a success or failure for AA? Should we count people who weren't serious about meetings when calculating AA's success rate? Polemics like Dodes's The Sober Truth consider every single person who was not serious about AA a failure when making artificially low numbers for AA's success, even if the person got sober after all.
There are a lot of ways we can come up with a "success rate" number based on Moos and Moos 2006:
- There were 461 people in the survey who did a 16-year followup
- Of those, 25% (115) took the AA program seriously. Of those 115, 77 (67% of serious AA members, 17% overall) were sober, and 38 (33% of serious AA members, 8.2% overall) were not sober. We could use these numbers to argue that AA has "only" a 17% success rate, but that argument is dishonest because it discounts the 16% of people (72) who had some level of exposure to AA and still stayed sober.
- Overall, 214 (46%) got sober. Since pretty much any alcoholic out there at least knows of AA's existence, we could make a case this is a 46% success rate.
- If we look at just people who had a least a little bit of AA treatment, this is 58% (269 of 461 total) of the people in the survey; of those 55% (149) were sober 16 years later. Contrast this with the 42% (192) who didn't try AA at all, 34% or 14% overall (65) were sober 16 years later.
Alcoholics Anonymous's own success claims
Alcoholics Anonymous has, since 1939, made the following claim about AA's success "Rarely have we seen a person fail who has thoroughly followed our path." This claim was expanded in the mid-1950s: "Of alcoholics who came to A.A. and really tried, 50% got sober at once and remained that way; 25% sobered up after some relapses, and among the remainder, those who stayed on with A.A. showed improvement."
Alcoholics Anonymous has never claimed it would help people who did not take the program seriously. Any claim about AA's success should only look at the people who take AA seriously; once we discount the people who did not take AA seriously, the numbers we get are in line with the numbers AA gave us in the mid-1950s (75% success rate among those whose who "really tried" AA).
It is true that AA has a high drop out rate, so I contend this: Have we found a treatment which is effective for alcoholics who, for whatever reason, refuse to work the AA program? Zemore 2019 makes a strong case that people in other programs can also stay clean and sober, as long as the goal is abstinence from alcohol. So, yes, I think people who will not work the AA program can still be clean and sober, but I also think it's dishonest to label all such people "failures" when measuring AA success.
