Mutual-help Groups (MHGs) for alcohol use disorders

Despite developments in medications and behavioral therapies, MHGs remain the most commonly sought source of help for alcohol use disorders in the United States. MHGs are groups of two or more people who share a problem and come together to provide problem-specific help and support to one another. Although Alcoholics Anonymous has the largest following, groups catering to populations with different demographics and preferences (e.g., women and younger people) also can be found.

One reason for the popularity of MHGs may be their inherent flexibility and responsiveness. People can attend MHGs as frequently and for as long as they want without insurance and without divulging personal information. Often, people can attend MHGs at convenient times, like evenings and weekends, when they are at higher risk of a relapse to drinking. MHGs also are more cost effective than formal treatment. For example, patients can attend AA at no cost, which translates into about 45 percent lower overall treatment costs than costs for patients in outpatient care while achieving similar outcomes.

Although high-quality clinical trials assessing MHGs are difficult because of their voluntary and anonymous nature, studies that follow drinkers during and after treatment have shown that MHGs compare well with more formal treatment. AA participants in a 16-year study did as well in achieving abstinence at the 8-year mark as those in formal treatment (approaching 50 percent), and a group that participated in both AA and formal treatment performed better than formal treatment alone at years 1 and 3. Other studies show that people involved in MHGs had more friend support resources than those in outpatient programs. Indeed, some scientists believe the improvement in participants’ social network and the support they receive for abstinence may explain the success of MHGs. Also, people can have access to this support for as long as they need it.

Thus, MHGs remain a staple treatment tool and provide a good alternative for physicians to consider when counseling patients. One method doctors use to encourage patients to try MHGs, called twelve-step facilitation (TSF) therapy, dispels myths and encourages patients to attend meetings. Studies of TSF show that if physicians actively refer their patients to MHGs by making arrangements for them to attend meetings or setting up introductions to group members, patients do become more involved. Patients who receive TSF also have shown higher rates of continuous abstinence than those receiving some other behavioral therapies.