This question raises some interesting issues, including the very definition of effectiveness. Consider the following hypothetical case: a person who drank to the point of intoxication daily before joining AA, now only drinks to the point of intoxication once a week after being a member of AA for 3 years. Contrast this person with another who drank heavily for 15 years, joined AA, abstained from alcohol for 12 months, and then died from cirrhosis of the liver as a result of his or her previous drinking history. The classification of either case as a success or failure is necessarily subjective.
Next, different AA groups are autonomous. If members of a certain AA group were to agree to allow a researcher to ask for volunteers at a meeting for a research study and fifty people were to volunteer to participate in the study, they may not be representative of all members of AA in other parts of the country. Likewise, members of Narcotics Anonymous (NA) in Oregon may not be the same as members of Narcotics Anonymous (NA) in Florida.
Remember that those alcohol-dependent persons who attend AA are not the same as those alcohol-dependent persons who choose not to attend meetings. A growing number of people who attend 12-Step meetings “on-line” because of their geographic isolation or wish to avoid recognition as having a SUD in their home community. Finally, the forced attendance of some group members might also change the nature of a 12-Step group.
1. Of the two cases presented in the first paragraph, which (if either) would you consider to be a success story for AA? How would you measure the effectiveness of AA?
2. Would a research study conducted on volunteers from an NA group in Florida be applicable to members of NA groups in Oregon? How many differences between members of these hypothetical groups might exist?
3. What differences exist between those who attend AA or NA voluntarily, and those who are forced to attend? Does having both types of members in one group necessarily make the group less effective? Could it make the group more effective?
4. What differences might exist between those who attend AA meetings online and those who physically attend traditional 12-Step groups?
5. Consider a hypothetical research study in which fifty members of a 12-Step group volunteered to be in the study. Would the fact that thirty of the volunteers were voluntary attendees while the remainder were court-mandated attendees change the results of the study?
6. What do you think—is AA effective? Can you defend your answer?
 Surprisingly, just the very fact that a person chooses to attend AA meetings means that they are different than the person who decides not to attend AA meetings.
 People who attend meetings at the invitation of the courts, employers, spouses, etc.