Teetotalitarianism: The Benevolent Stagnation of Alcoholics Anonymous

In examining the global expansion of Alcoholics Anonymous over the past 100 years, the author will pinpoint elements of the world's largest peer support program that have 1. helped untold millions recover from alcoholism/addiction and 2. impacted understanding of addiction in social and professional circles. The thesis will address the program's underlying practices, which remained largely unchanged after the 1930s. First, how does the canonical literature and tradition of Alcoholics Anonymous help and harm people in recovery? An examination is conducted of clinical best practices for substance use disorder, the effect of group cohesion and identity formation in recovery, and populations that may not benefit from the 12 Step disease model of addiction treatment. The second question: what harmful aspects of AA's program could change in the 21st century to help as the maximum number of people struggling with addictions? The author outlines several areas where the program has fallen short, including its silence toward underserved or abused members, its isolation from other support groups, and deadlock/attrition within its governmental structure. Research into both questions drew on empirical studies/reviews as well as AA publications/archives. Sociological theories from the likes of Émile Durkheim and Dorothy Smith are also featured. A trustee of AA's service board provided the author with her expert opinion on the organization's unchanging nature. Ultimately, the dominance of Alcoholics Anonymous in recovery peer support—in all of addiction treatment—is found to be self-perpetuating by virtue of its wide availability and its hierarchy's traditionalist leanings. The program's successes mask its shortcomings. It's recommended that AA, rather than rest on its laurels, should instead earn status by incorporating modern research, reforming its governmental structure, and stewarding newer non-12-step peer support groups in their own growth.