HAMS: Harm Reduction for Alcohol

When AA Fails


When Alcoholics Anonymous fails you, harm reduction may be the solution

There is a very common myth in circulation which says that the only cure for a "true alcoholic" is to go to AA and that anyone who quits drinking without AA is not a "true alcoholic". This myth was created by AA but actually it has no basis in fact.

Whether a person is successful at quitting drinking on their own, via AA, or via another program such as SMART or RR or SOS or WFS or LifeRing or HAMS, has no correlation at all with the person's level of Alcohol Dependence. Both people with a high level of dependence on alcohol and people with little or no dependence on alcohol decide to join AA and quit drinking. Likewise, both people with a high level of dependence on alcohol and people with little or no dependence on alcohol mange to successfully quit drinking on their own or via another program. In fact, data from the NIAAA and from George Vaillant (1995) show us that the vast majority of people who quit drinking do so on their own. These data also show us that people are just as likely to solve an alcohol problem by cutting back as by quitting.

AA is most successful at recruiting and retaining males of low IQ and educational attainment who have dependent personality types--i.e. they like being told what to do. According to Alcoholics Anonymous 2001: Membership survey (Kosok, 2006) AA members on the average have an 11th grade education. According to the 2003 US Census only 15% of Americans are high school dropouts and the majority report "some college". Research from Poldrugo and Forti (1988) demonstrates that AA is effective for people with dependent personality type but not others. Jeannie Long gives detailed information on why AA tends to be a poor fit for women.

AA is a very good fit for people with dependent personality type because the 12 steps function by making people totally dependent on AA. AA works fine in helping these people to abstain from alcohol and we wish them well. AA generally seems to fail women as well as failing people with independent personality types, higher IQs and higher educational attainments--i.e., the majority of people.

It is unfortunate that bright and independent thinkers who question the AA program are told that there thinking is diseased and that they need to go out and drink more until they "hit bottom". They are told that only after they have suffered enough will they meekly accept AA theology as divinely revealed truth. It is unknown how many people have died from following this bit of advice. A far more humane and realistic approach would be to tell people who find that the AA program does not fit them that there are other options out there which may fit them better.

Many people feel crazy in AA. Attending AA meetings can make some people clinically depressed, can make some people drink more, and can lead some people to commit suicide. What is the greatest shame is that the people who suffer the most from AA are usually the brightest and most independent thinkers there. Moreover most women find AA is damaging rather than helpful because they are in need of personal empowerment whereas AA specializes in "breaking down big egos".

AA sets people up to self destruct with alcohol if they ever quit going to AA meetings or drink again. The good news is that you don't have to self destruct if you leave AA. There are other ways to abstain that work better for people with independent personalities than AA does. And if you do drink again--you can practice damage control--i. e. harm reduction. You do NOT have to die simply because you left AA.

If you have been or are currently being damaged by AA--take heart--there is another way! In point of fact there are many other ways. Leaving an organization which is harming you is not something to feel ashamed of--it is something to be proud of.

Do you think you're different? Then almost certainly you are--the scientific evidence is with us on this one. If AA is damaging you, then walk away today. The life you save may be your own.


Kosok, A. (2006). The Moderation Management programme in 2004: What type of drinker seeks controlled drinking? International Journal of Drug Policy. 17, 295-303
Free Full Text

Long, J. Women Can Quit Drinking Without AA.
Free Full Text

National Institute on Alcohol Abuse and Alcoholism. (2008). Alcohol Alert No. 76: Alcohol And Other Drugs

National Institute on Alcohol Abuse and Alcoholism. NIAAA Five Year Strategic Plan FY07-11

Poldrugo F, Forti B. (1988). Personality disorders and alcoholism treatment outcome. Drug Alcohol Depend. 21(3):171-6.
PubMed Info

US Census Bureau (2004). Educational Attainment in the United States: 2003.

Vaillant, G E. (1995). The natural history of alcoholism revisited. Cambridge, Mass. Harvard University Press.

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