March 11 (UPI) -- Twelve-step programs still work for people trying to recover from alcohol problems, a new analysis has found.
A study published Wednesday by the Cochrane Library shows Alcoholics Anonymous, or AA, and clinically-related 12-Step Facilitation programs are more effective than other treatments, including cognitive behavioral therapy.
Researchers say that participants in AA and 12-step programs have higher rates of abstinence over longer periods of time than those opting for alternative approaches.
"One important finding from this review was that it does matter what type of 12-step facilitation intervention people receive -- better organized and well-articulated clinical treatments have the best result," study co-author John Kelly, a professor of psychiatry at Harvard Medical School and director of the Massachusetts General Hospital Recovery Research Institute, said in a press release. "In other words, it is important for clinical programs and clinicians to use one of the proven manualized programs to maximize the benefits from AA participation."
The National Institutes of Health estimates that as many as 15 million Americans meet the criteria for alcohol use disorder, which is a chronic, relapsing brain disease in which sufferers experience "compulsive alcohol use, loss of control over alcohol intake and a negative emotional state when not using."
The vast majority of those with AUD undergo behavioral health therapy or participate in "12-step" programs like AA, which feature peer-led mutual-help groups.
Conversely, 12-step facilitation programs adopt some of the principles and techniques of AA and are delivered by clinicians, although many people with AUD engage in both.
The new Cochrane review looked at the effects of these programs on reducing alcohol consumption and the effects of heavy drinking -- such as physical health, family or employment problems -- as well as their effectiveness in enhancing long-term abstinence. The authors of the review also examined whether AA and 12-step programs reduce healthcare costs compared to other treatments.
A previous Cochrane study published in 2006 was based on eight available studies including a few thousand participants, and the quantity and quality of the research has increased substantially since then, the authors noted. In all, 27 studies were included in the updated review, and collectively they enrolled 10,565 people.
The authors found high certainty evidence that clinically delivered and 12-step programs designed to increase AA participation can lead to higher rates of continuous abstinence over months and years, when compared to other active treatment approaches such as cognitive behavioral therapy.
In fact, the evidence suggests that 42 percent of all study participants engaged in AA remained completely abstinent one year after starting treatment, compared to 35 percent of those receiving other interventions, including cognitive behavioral therapy. This effect is achieved by fostering increased AA participation beyond the end of the 12-step program, the authors said.
When compared to the treatment approaches, AA-based programs perform just as well at reducing drinking intensity, negative alcohol-related consequences and addiction severity, they added.
In addition, four of the five economics studies identified by researchers showed considerable cost-saving benefits for AA and related 12-step clinical programs designed to increase AA participation, indicating that these programs may reduce healthcare costs substantially.
"Alcohol use disorder can be devastating for individuals and their families and it presents a significant, worldwide, costly public health problem," Kelly said. "Alcoholics Anonymous is a well-known, free, mutual-help fellowship that helps people recover and improve their quality of life."