10 Alternatives to AA and 12-Step Programs
Nov 06, 2023
In This Article
While Alcoholics Anonymous (AA) is arguably the most well-known treatment for alcohol use disorder (AUD), it is not for everyone. Many people who have AUD don't want to abstain from drinking entirely and instead seek treatments that reduce drinking. And others have the goal to quit drinking, but don't find other aspects of AA to align with their values.
There are many alternatives to AA listed in the table and described below.
AA has been around for over 80 years. The program is built on an approach of “one alcoholic sharing with another" which involves in-person meetings where members share their personal experiences with AUD and support each other. At the end of 2021, AA estimated that it had about 2 million members worldwide, and 1.5 million members in the United States (1).
The program is based around the Twelve Steps to help its members achieve complete abstinence from alcohol use. AA’s free and anonymous meetings are available in over 180 countries and more than 100 languages.
While millions of people have found success with AA, there are also many people with AUD who have tried or researched AA and concluded that some aspect of the program, such as its focus on abstinence, required admission of powerlessness or religiosity lead them to search for alternative alcohol recovery programs.
AA has been studied extensively. While its effectiveness and success is well documented, it is also clear that it does not work for everyone. A 2002 study with 279 people compared AA or similar 12-step programs with other forms of psychosocial treatment. Researchers found that 24% of AA or 12-step participants remained fully abstinent from alcohol after 12 months (2).
These are impressive numbers that speak to the tremendous good AA does. But, if this study is typical, AA doesn’t help more than 75% of people who try it. That’s likely millions of people — and might very well include you.
The good news is there are many other paths to help you moderate or manage your alcohol use, or to achieve full sobriety. Let’s explore some of the available alternatives to AA and 12-step programs.
|Alternatives to AA||How does it help?|
|1. SMART||Teaches skills to help you stay motivated in your sobriety and cope with cravings.|
|2. The Sinclair Method||Evidence-based treatment that uses naltrexone to reduce alcohol cravings and alcohol intake.|
|3. Oar||Online recovery program featuring naltrexone, community support, & science-backed treatment.|
|4. Community Support||Having people with whom to share your struggles & successes can help keep you motivated.|
|5. Moderation||This harm reduction method helps reduce health risks by drinking less & more mindfully.|
|6. Therapy||A trained therapist can help you achieve your goals and offer one-on-one support.|
|7. Cognitive Behavioral Therapy||Scientifically proven to effectively treat AUD & prevent relapse.|
|8. Coaching||One-on-one support, often using CBT techniques like motivational interviewing.|
|9. Mindfulness||Decreases stress & increases awareness; can reduce pain, anxiety, & alcohol cravings.|
|10. Any Combination of the Above||Combine different treatments for a customized program that works for you & your needs.|
SMART Recovery is a global community of mutual support groups promoting "science-based, self-empowered addiction recovery." Their 4-Point Program covers motivation, urges, managing feelings and behaviors, and life balance (3). SMART stands for "Self-Management and Recovery Training."
[SMART] focuses on self-empowerment and self-reliance. Their program teaches skills that can help you stay motivated in your sobriety and cope with cravings. Its foundation is based in science, rather than spirituality. Many people have found success with SMART's alternatives to AA meetings. AA If you like the accountability and community of regular meetings, SMART Recovery may be a good option for you.
Learn more at SmartRecovery.org.
Developed by Dr. John D. Sinclair, the Sinclair Method is an evidence-based treatment for AUD that involves taking naltrexone.
Naltrexone is a prescription medication that immediately reduces the “buzz” of alcohol and curbs cravings in the long term. Unlike other treatments that require immediate abstinence, the Sinclair Method allows you to keep drinking when you start naltrexone.
When you drink alcohol, your brain releases endorphins, which are the body’s natural “feel-good” chemicals. These endorphins are responsible for the pleasurable, buzzed feeling you get from alcohol.
Naltrexone blocks these endorphins, taking away the pleasurable feelings you get from alcohol. Over time, this can help you drink less or even stop drinking completely.
Visit our in-depth article on the Sinclair Method for more information.
Oar Health offers science-backed, effective treatment for people ready to change their relationship with alcohol. Our licensed clinicians can prescribe Food and Drug Administration-approved naltrexone for AUD. We provide an online assessment, medical review, and personalized treatment plan.
We believe there is no single path to sobriety. Our treatments are tailored to serve each person’s unique needs and you can read about both Oar members who want to quit drinking entirely as well as Oar members who want to moderate their drinking.
To get started, take a brief alcohol use assessment.
No matter what your sobriety journey looks like, a supportive community can be crucial to sticking with it. It can help to have a trusted confidant or two with whom you can share your struggles, successes, and revelations.
Not everyone has someone they can talk to about this. It’s understandable if you don’t want to share this part of your life with friends or family.
You can still find community online in places like Reddit. Reddit is full of subreddits, or communities, of like-minded people who connect over a specific topic. One subreddit, r/stopdrinking, is full of people who are sober or sober curious. Their motto is “IWNDWYT,” which stands for “I will not drink with you today.”
With a Reddit account, you can protect your privacy and stay anonymous. Because r/stopdrinking is public, you can read its discussions without commenting or even creating a Reddit account.
If you do wish to participate, you can create a free Reddit account to comment on others’ posts and make your own. Reddit does not require you to provide your name, photo, or even your email address.
Check out this unique sober community on Reddit.
Yes, moderation is possible, despite the prevailing notion that abstinence is the only way.
It’s important to note that moderation does not work for everyone, but it is a valid approach for some.
Moderation research is limited. A 2014 study showed that “baseline motivation and self-efficacy” are key predictors of moderation success (5). In other words, those who are motivated and believe they can successfully moderate their drinking tend to have the best results.
There is no tried-and-true way to determine whether moderation works for you. One common way is through experimentation. In other words, try moderation for a short time and see how it goes.
If you are able to maintain moderate drinking, it may work for you. But if you find yourself falling into previous unhealthy drinking habits, abstinence may be your better option.
One-on-one psychotherapy with a trained therapist is another way to address your drinking. There are therapists who specialize in AUD, and psychiatrists can prescribe medication for AUD or co-occurring mental health conditions.
When searching for a therapist, it’s a good idea to look for one who specializes in AUD or addiction.
According to a 20101 scientific review of available research, cognitive behavioral therapy (CBT) has been scientifically proven to effectively treat AUD using motivational interventions, contingency management, and relapse prevention (6).
Researchers found that CBT has different effectiveness rates for different substances. For example, it is more effective at treating cocaine and opioid addictions than it is for tobacco and polydrug use (use of multiple substances).
Sobriety coaches work with clients to reduce or stop their drinking, often using CBT techniques like motivational interviewing (MI). A 2018 study found that MI can have a positive effect on people with AUD, including increasing their self-esteem (7).
Mindfulness can decrease stress and increase awareness. It can even reduce pain, anxiety, and alcohol cravings, according to a 2018 review of mindfulness research as it relates to AUD (8).
Researchers stated that mindfulness techniques for addiction usually target addictive behaviors like cravings, and teach you how to apply these techniques in everyday life.
You and your needs are unique, and you know yourself best. Pick and choose what works for you. What works today might not work tomorrow (or next week or next year, etc.).
While AA has proven beneficial for many people, it is not the right choice for everyone. Some people are not comfortable "surrendering to a higher power", and prefer a nonreligious AA alternative. For others, the idea that you are “powerless over alcohol” doesn’t make sense: If you’re powerless over drinking, why even try to stop?
For other people, full abstinence—a key tenet of AA—doesn’t take into account other appropriate goals, such as managing or moderating their drinking, stopping binge drinking episodes, or becoming “mostly sober” (which might mean an occasional celebratory cocktail).
Though AA may be the most well-known solution for alcohol abuse, it is far from the only one. There are many alternatives to Alcoholics Anonymous, including The Sinclair Method, moderation, cognitive behavioral therapy, therapy, coaching, and Medication Assisted Treatment (MAT).
There are many alternatives to AA to stop drinking. The best one is the one that works for you. There are many paths to changing your relationship with alcohol, and it may take some experimentation to figure out what treatment—or combination of treatments—is most effective for your unique needs.
Yes. You may find that you enjoy certain aspects of AA, but also require additional recovery support from non-AA recovery treatments. There is no "one true path" to changing your relationship with drinking. Try a few different treatments and stick with what works for you.
Get Started With Medication To Drink LessQualify For Treatment
About The Author
Ash Fisher is Oar's Community and Content Manager. She is a writer and editor with a background in standup comedy. Read more of her writing at ashfisherhaha.com.