Quarterly Journal of Studies on Alcohol, Vol. 26( No.2 ) 279-284, June, 1965

The Growth and Effectiveness of Alcoholics Anonymous in a Southwestern City, 1945 – 1962 Bill C.*

This paper reports the results of a study of the membership of Alcoholics Anonymous living in the metropolitan area of a Southwestern city who are sober (abstinent) and have stayed sober for at least 1 year by the beginning of the year 1963, and of the AA members who have died or moved away from the city since joining AA. In addition, the growth and effectiveness of the largest AA group in the city (the Suburban Group) is described. Most of the data were obtained through direct interviews with the subjects. The initial list of subjects was compiled from the writer’s personal knowledge and records and from the records kept by the secretaries of the two largest and oldest AA groups in the city. Some information about those who had died and moved away from the area was obtained from other AA members still resident in the city. Such information is usually quite reliable due to the closeknit nature of AA which results in continuing contacts with persons who have not lived in the city for several years. The city’s metropolitan area is well suited for a study of this kind; good records have been kept since the city’s first AA group was formed in December 1945 and the area is generally considered to be one in which AA has been reasonably successful. The present AA population is large enough and diverse enough to make possible a reasonably valid statistical study and is at the same time small enough to permit the collection of the necessary data without excessive effort. The population of the metropolitan area was about 220,000 in 1963. The city has a sizable Negro and Latin American (Mexican) population. Many of the city’s working population are employed in the state government offices or connected either directly or indirectly with the large state university located here. At the present time there are eight AA groups in the area; five of these are predominantly white, one is a Negro group, one a Latin American, and one a mixed group which is the outgrowth of a court probationary program.

*The author is a member of Alcoholics Anonymous in the city under study. Received for publication: 11 May 1963.

Total A . A . Membership of the Area

In the following report, only the 182 white A.A. members who had stayed sober for at least a year as of 1 Jan. 1963 are considered. The 5 Negro and 1 Latin-American members were excluded to eliminate racial and cultural factors. Of the 48 women members, almost all 1957 and a11 but a very few of these are members have c o m e in s i ~ c e of the largest of the white groups – the Suburban Group. No Negro or Latin-American women in the city are AA members. – AA was started in the city in Dec. 1945 and the growth rate during the first few years was quite high. From about 1950 to 1957 the membership remained fairly static, but since 1957 another fairly sharp growth rate is evident. The average age of members at which continuing sobriety began was about 42.5 years; this seems to be true of both the early members and the more recent ones. About 50% of the 182 have never had a “slip” (resumed drinking). The median educational level of the 182 white AA members was about 12.5 years, which is very near the average of 12.4 years reported for the city’s adult white population by the 1960 U.S. Census; 74 members have had at least 2 years of college and of these, 41 have college degrees. The 182 members seem to be fairly representative of the city’s adult white population in both education and socioeconomic level. The religious preference distribution seems to follow the local pattern fairly well except for the unusually large number of Episcopalians – 38. A number of the city’s AA members have changed from other churches to Episcopal either before or after coming to AA. Usually the change has been from a church which takes a more fundamentalist view of alcohol than does the Episcopal Church, Episcopal groups being well known in this area for their sympathetic attitude toward those who have a drinking problem. Of the 182, 57 had never been hospitalized because of alcoholism, 61 had been hospitalized only in private hospitals, and 41 in state hospitals. Of those never hospitalized, 50% had two or more years of college, compared to 51% and 27%, respectively, of those treated in private and state hospitals. Those never hospitalized seemed to be the most successful in staying sober: Of those who had never been hospitalized, 72% had never had a slip, compared to 46% and 32% of those who had been in private and state hospitals. This finding seems to contradict the traditional belief of AA members that “hitting bottom” is a necessary prerequisite for successful affiliation with AA. It is suggested, however, based on personal acquaintance with many of those in all the groups, that to many alcoholics the threat of further trouble may constitute “hitting bottom” and may be more effective itself in encouraging recovery. THE SUBURBAN GROUP

The Suburban Group of AA, the largest of the city’s groups, was formed in August 1955 by approximately 30 former members of the

first AA group in the area. Since its beginning, the Suburban Group has grown to a nominal membership of about 130. Method Fairly good records have been kept since the beginning of the Suburban Group. It is the custom here that all persons in attendance at any meeting sign a roll book. These have been preserved along with other records. Every roll book was searched, the names of all area residents were recorded and a list was made of all those who had attended 10 or more meetings. For persons not well-known to the writer, a meeting attendance record was made to determine whether the person had attended as many as 10 meetings. In addition to the written records, much information was obtained from the original members of the group. A total of 393 members was found, all of whom were residents of the area during the period of time in which they attended 10 or more meetings. Since the beginning of their attendance, some persons in the sample had become members of other AA groups, while others had moved away from the city. Little is known as to present condition or place of residence of many of those who had moved away. Results On the basis of the information obtained, the outcomes can be categorized as follows: of the total of 393, (a) 122 (31%) have stayed sober for at least one year and are still sober; (b) 46 (12%) have stayed sober for at least 1 year but have slipped; of these 14 (3.5%) are known to be still attending AA, 4 (1%) have died while having a slip, and 2 (0.5%) have died sober; (c) 36 (9%) have never stayed sober for as long as 1 year but are known to be still attending AA; (d) 21 (5.3%) never stayed sober for as long as 1 year and have died, with excessive use of alcohol or drugs, or both, as strongly contributing factors; (e) 14 (3,5%) have never stayed sober for as long as 1 year and are either in prison or have been in prison since their first contact with the Suburban Group; (f) 5 (1.3%) have been placed in mental institutions on indefinite commitment since first contacting the Suburban Group; (g) 149 (38%) are not known to have stayed sober for at least 1 year and their present condition and whereabouts is unknown. Some of these may have found sobriety in AA in other cities, and some may have found relief from active alcoholism through their own efforts together with resources of help other than AA. If we assume that 10% of those in (g) have stayed sober for at least 1 year and add to this the number of persons in (a) and (b) we arrive at a total of 183 persons. This number represents 47% of the total sample who have stayed sober for at least 1 year while attending AA. Rate at Which Members Join the Suburban Group The rate at which new members join the Suburban Group has remained fairly constant over the years of its existence,

averaging, per year, about 60 new members who attend 10 or more meetings. The group grew from about 30 members to about 130 in the 7 years 1955-1962, so that the efficiency of the group in attracting new members does not seem to have grown in proportion to its size, . J h part, this may be because many alcoholics are first referred to AA by nonmembers – for example, ministers, doctors and friends. History of Members Who Stay Sober for a t Least 1 Year About 70% of those who stay sober for 1 year continue on to 2 years, and about 90% of those who stay sober for 2 years continue on to 3 years, and about 90% of those who stay sober for 2 years continue on to 3 years. These percentages, by general observation, seem to be rather constant for any sizable group. Assuming that the probability of continuation at 3 years is 0.85 and that the ultimate probability of continuation never exceeds 0.90, of the 394 who have attended at least 10 meetings the probability of attaining 1 year is approximately 0.43. These values together with the continuation percentages given earlier suggest the curve in Figure 1. The curve is seen to rise fairly steeply until 2 years is attained, but then begins to flatten.*

– DURQTIONOF SOBRIETYYERUS FICCRE 1.-Probability of Continuation of Sobriety

* Others who have been concerned with the rehabilitation of alcoholics have stressed the importance of the 2-year period – notably, R.G. Bell, M.D., Director, Bell Clinic, Willowdale, Ont., Canada.

Summary Alcoholics Anonymous was started in a southwestern city in 1945. At the beginning of the year 1963, 182 white members of the city’s 8 AA groups had been sober (abstinent) for at least 1 year, with about half of these never having had a slip (resumed drinking). The 182 seem to be fairly representative of the city’s adult white population in socio-economic level and education: their average educational level was 12.5 years and 41 have college degrees. Their average age was 42.5 years. A relatively large number (38) were Episcopalians, many by conversion from other denominations. Those members who had never been hospitalized for their alcoholism seemed to be the most successful in staying sober: of the 57 never hospitalized, 72% had never had a slip, compared to 46% of the 61 who had been in private hospitals and 32% of the 41 who had been in state hospitals. A search of records revealed that 393 members have attended 10 or more meetings with the Suburban Group, the largest in the city, since it was started in 1955. It is estimated that of these, 47% have stayed sober for at least 1 year. About 70% of those who stay sober for 1 year continue on to 2 years and about 90% of those who stay sober for 2 years continue on to 3 years. A curve showing the probability of continuation of sobriety was constructed. The probability curve rises fairly steeply until 2 years of sobriety is attained, but then begins to flatten.