Self-Help Organizations for Substance Use Disorders

Self-help groups for substance use disorders have been active for decades, and notions of self-help have been prevalent for centuries. After presenting universal features of self-help organizations, the authors focus on Alcoholics Anonymous (AA) and Moderation Management (MM), discussing the origins, membership, and philosophy of AA and MM and highlighting important differences between these organizations. AA’s emphasis on spirituality, interpersonal conduct, and abstinence as the only goal contrasts sharply with MM’s emphasis on personal autonomy, rational cognitions, and setting drinking limits. The chapter discusses scientific evidence of the effectiveness of AA and MM on substance use outcomes and potential social and psychological mechanisms of change. More research is needed in the area of self-help organizations. In the meantime, AA is proven effective for alcohol-dependent individuals who embrace its philosophy, and MM may fill an important niche for nondependent drinkers or those in the precontemplation stages of change.