Some Criticisms and Positives of AA/12 Step Programs (updated version)
I want to begin by saying and making it clear that for people who like AA/12 Step programs and find them effective, I have no problems with that and am sincerely happy for them. Also, in case readers may wonder, I am not espousing an atheistic viewpoint (although for people who are atheist, I respect their right to have their views). Personally, I would describe myself as spiritual, but not religious. Anyway, my main concerns here are a bit different.
Alcoholics Anonymous/12 Step based programs have been well known in the United States for a long time now. I believe that they are very popular and that many people feel that they are very effective for them. I have heard of and encountered many people like this. However, I have also heard of and encountered people who do did not find that the program was a good fit for them or saw some problems with the program. This is one of the things that I want to address in this blog post. I also have some criticisms of my own. In addition, I do feel that there are some very positive aspects to these programs that can be powerful tools, if used in the right way.
In my view, I think that AA/12 Step is at least a quasi-religious type program, based on it’s roots in the Oxford Group, which in my understanding was a Christian evangelical movement (Chat GPT, 2025). In addition, to my knowledge, in 12 Step/AA programs, meetings often end with prayers like the Serenity Prayer or the Lord’s Prayer (though practices vary by group and location) (Chat GPT, 2025). If a person is looking for such a program, I think that a 12 Step/AA Program could be a great fit for them. However, there are probably a fair number of people who may not find such a program to be a good fit for them. While it does appear that there are alternatives to AA/12 Step programs, I feel like, for whatever reason they are overshadowed by AA/12 Step programs.
Also, a significant issue comes up when we talk about mandating people to AA/12 Step. First of all, the government or any other organizations should not be able to mandate anyone to anything (with exceptions of course). The main exceptions should be situations where a person is infringing upon the rights of others, causing harm to others, etc.. Those are the only kinds of situations where I feel it is acceptable for the government etc. to mandate someone. It’s ok to offer help to someone who is struggling with alcohol addiction, drug addiction, etc., but it should not the government’s right or any other agency’s right to mandate someone to a program, if they are not causing other people harm.
In the case of mandated AA/12 Step programs, not only is the government or agency etc. mandating someone to a program, where that person has potentially not caused any other person harm, but they are mandating them to what I argue is at least a quasi-religious type program. I view this as being against the Establishment Clause of the First Amendment of the Constitution of the United States. According to Lee v. Weisman, 505 U.S. 577, 587 (1992), “The fundamental rule of the Establishment Clause is this: “It is beyond dispute that, at a minimum, the Constitution guarantees that government may not coerce anyone to support or participate in religion or its exercise, or otherwise act in a way which ‘establishes a [state] religion or religious faith, or tends to do so.’”.
While some people may argue that AA/12 Step programs are not religious in nature, from the research I have done, I feel there is enough there to say that it is at least a quasi-religious type program, due to the reasons I mentioned before (Having it’s roots in the Oxford Group etc.). The arguments that I just mentioned were corroborated in some reading that I did, which showed that indeed there have been a number of court cases where the mandating of AA/Step treatment was found to be a violation of the Establishment Clause of the First Amendment. However, I believe that this is still an ongoing issue that comes up in courts now and again.
In addition, another criticism I have of the program is that I argue that in certain ways, it may disempower some people instead of empowering them. One example of this would be the first step, where people say that they were powerless over alcohol and that their lives had become unmanageable. To me, this already seems to potentially not be the best approach because it starts with an assumption that these people are powerless and cannot help themselves. Perhaps for some people, they really won’t be able to overcome their addiction on their own (which is totally fine), and that in some situations it may indeed be useful to admit that your life has become unmanageable and that you need some help from other people or from a higher power. However, I think that there are probably also a fair number of people who go to the meetings who are capable of helping themselves through their own effort, even if it does also involve some kind of outside help as well.
In addition, to my knowledge, the AA/12 Step programs eliminate the possibility of overcoming an addiction on one’s own, which if true, I strongly disagree with. Although it is probably quite difficult, there are people who are able to successfully overcome their addictions on their own. One example would be Jean-Claude Van Damme, who at one point had a strong cocaine addiction and for whom attempts at drug rehabilitation didn’t go well (Godfrey, 2012). He ended up resorting to cold turkey and exercise to resolve his addiction (Godfrey, 2012). Of course he is just one example and this approach may not work for everyone, but there are probably many others just like him, who were able to overcome their addictions on their own.
Additionally, another criticism I have is that, to my knowledge, generally when people attend AA/12 step meetings, they introduce themselves and say that they are an alcoholic. At least this was the case when I attended an online AA meeting for educational purposes. From what I remember, everyone introduced themselves by name and then said that that they are an alcoholic. I believe one person referred to themselves as a drunkard. I don’t think it is necessary, useful, or healthy for a person to place this label out loud on themselves over and over again. I view this as disempowering and demeaning. I think it is one thing to admit that you have a problem (if in fact you do), but quite another to constantly place this label on yourself out loud over and over again in front of other people. To me it seems in certain ways almost like limiting yourself to that identity (Alcoholic), and not seeing yourself as something more than that. I don’t think that is very helpful for one’s self esteem, emotional well-being etc..
I remember at some point a while ago someone telling me that people are not actually required to say that they are an alcoholic etc.. However, I also spoke at one point with a (now former) client of mine who had mixed feelings about the program, and he described that at least in his experience, he encountered a social pressure of sorts, to say that you are an alcoholic. I think that at least some other people have probably had a similar experience. In either case, again, I don’t see how it is healthy and useful to constantly label yourself as an alcoholic out loud. To me, it’s like somebody struggling with severe depression constantly saying “Hi, my name is so and so, and I’m severely depressed”. It is one thing perhaps to admit that you have a problem, but quite another to constantly label yourself as an alcoholic out loud in front of others. I argue that there are better and healthier ways to approach these situations.
It is also important to acknowledge that this program does not work for everyone, some people do not like the program, and a “one size fits all” approach does not work here. I have heard a good number of accounts now of people who did not like the approach, did not find it helpful, etc.. For these people, I think it would be doing them a great disservice to just assume that AA is a one size fits all model and that if it doesn’t work for them, that they failed the program, not that the program didn’t work them, wasn’t a good fit for them etc.. In addition, to my knowledge, the scientific evidence for the effectiveness of AA/12 Step programs still contains significant caveats (Chat GPT, 2025). I think it is probably effective to at least some extent, and maybe even to a great extent, but a program that is this widely used and recommended etc., should be thoroughly scientifically studied to understand whether it is truly effective or not. I feel that a program like this should should ideally have very strong scientific evidence behind it. I believe though that there are some challenges that come with doing scientific studies of AA/12 Step unfortunately. If at some point though there was very strong scientific evidence that AA/12 Step is not very effective, then it should be modified or replaced completely with something else.
In addition, my understanding is that AA/12 Step does not view moderation as a possibility, instead of total abstinence. I think it would not be right to assume that none of the people who come to AA/12 Step can develop the ability to drink in moderation. I do think that there are indeed people who may never be able to have control over their drinking and perhaps total abstinence is the only way for them, but I don’t think this is the majority of people who have a problem with alcohol. Having said that, in a general sense, all of the various recreational substances, such as alcohol, marijuana, tobacco, cocaine etc. are bad for you anyway and not conducive to a healthy lifestyle, so I can completely understand someone just preferring to be completely abstinent from alcohol (for example), instead of trying to learn to drink in moderation. I don’t think alcohol is giving them anything useful anyway (even in moderation). I basically view alcohol as a poison of sorts. As an additional note though, I think it may be important to be open to the idea of potential medicinal uses of various substances, if they can be used safely and effectively to help people.
I also want to address the things I do like about AA/12 Step. One thing that I like is that if the approach fits well with a person, they can have access to a supportive (hopefully that is at least usually the case) community of people who have gone through something similar to themselves, and I think this can have a lot of value.
In addition, I believe the faith aspect of it can also be very powerful for people. In general, I think that resorting to a higher power to help with alcohol addiction and other addictions and challenges in life can be a great and powerful tool (while also doing what you can on your own or with the help of others, to try to improve the situation etc.). My understanding of AA/12 Step though is that it has its roots in at least a quasi-religious and kind of moralistic/dogmatic/condescending approach, due to its roots in the Oxford Group. I think that at least some of those elements may still continue to color the program in present day, even if it’s maybe not to the level it was originally. If that is the case and some people are ok with it and find it effective for them, that is fine, but personally, I would not be a fan of such an approach. I believe that if the approach was perhaps tweaked to something more truly spiritual and less quasi-religious and moralistic etc., (which, I think it probably is, at least to some extent, for reasons previously mentioned), and it had more of an empowering approach, it could be greatly improved and would maybe not turn certain people away.
I want to wrap up by saying again that I want to make it clear that for people who like AA/12 Step programs and find them effective, I have no problems with that and I really am happy for them. However, one of my main concerns is regarding mandating someone (to what I view as at least a quasi-religious themed program), who does not want to take part in it (or mandating them to any program for that matter, if they have not harmed anyone else). This needs to change. In addition, I have pointed out some other criticisms of AA/12 step and some positives that I see as well. I believe that much more research needs to be done to provide stronger evidence regarding the effectiveness of AA/12 Step. In addition, I believe it is important that more research is done regarding other potential treatments for alcohol use disorder and other substance use disorders. Finally, I feel it is very important that AA/12 Step should ideally be just one of a number of popular and widely available options for people, and to not take the approach that AA/12 Step is an automatically superior “one size fits all” program, which I think sometimes happens.
References
- Godfrey, Alex (10 August 2012). “Jean-Claude Van Damme: ‘I tried to play the system; I was blacklisted'”. The Guardian.
- Lee v. Weisman, 505 U.S. 577, 587 (1992)
- Chat GPT (2025)