Founded by two professionals who were also alcoholics, Alcoholics Anonymous began as a nonsectarian program based on mutual reinforcement and adherence to a set of twelve specified steps that led toward a healthy, alcohol-free lifestyle. The organization grew to more than three million recovering alcoholics worldwide and spawned a number of other addiction treatment groups based on the same principles.
On November 11, 1934, William G. Wilson, a failed stockbroker caught in the throes of alcoholism, checked himself into Towns Hospital in Manhattan. His few remaining associates, his wife, and even Dr. William Silkworth, the attending physician, regarded the veteran of three “cures” at this drying-out facility as a hopeless case. However, a few days before, a former colleague and fellow alcoholic had paid Wilson a visit. Rejoicing in his newfound sobriety, the friend persuaded Wilson to attend an Oxford Group meeting. Oxford Groups were an early twentieth century revival movement dedicated to moral reformation. Although nonsectarian, they were explicitly Christian, and they considered alcoholism to be a moral failing. Wilson, an agnostic with little interest in tackling any problem other than his addiction to alcohol, was a poor candidate for salvation by the Manhattan Oxford Group. What he heard there, however, persuaded him to attempt another visit to Towns Hospital. While undergoing detoxification, Wilson experienced a moment of total surrender to a vague power: He felt bathed in white light and completely lost the compulsion to drink.
Bill Wilson left Towns Hospital a changed man, and he immediately set about spreading the “gospel of sobriety” to alcoholic members of the Oxford Group, inhabitants of a homeless shelter, and anyone else who would listen. With the acquiescence of his patient wife, Lois Burnham Wilson,
His work in Ohio went poorly, however, and by the beginning of June of 1935, Wilson found himself in the Mayflower Hotel, his expense account depleted. For the first time since emerging from Towns Hospital, he was strongly tempted to drink. Recognizing that talking with other alcoholics kept him sober, he called a local clergyman, who put him in touch with Robert Holbrook Smith, a physician who was also an alcoholic. Dr. Smith listened to Wilson and was inspired, although he never had a “white light” experience and never entirely lost the compulsion to drink. His more gradual recovery helped temper Wilson’s enthusiasm and make the fledgling organization more receptive to tentative newcomers.
For the next several months, Wilson stayed in Smith’s house, and the two men attempted to bring the message of sobriety to other alcoholics. Together, Bill Wilson and “Dr. Bob” discussed every point of strategy, ideas that were later tested among a small group of people in the early stages of recovery from active alcoholism. When Wilson returned to New York in the fall, he left behind a group of half a dozen men who were attempting to stay sober by taking one day at a time and by holding frequent meetings at which they shared their concerns.
The fact that Smith was a physician helped smooth relations between the fledgling organization and the medical community. Furthermore, the Akron Oxford Group already had a strong emphasis on recovery from alcoholism, and it was more welcoming than the New York group, which expelled Wilson in 1938. Wilson’s first New York recruits came from Towns Hospital, where Dr. Silkworth had become convinced of the merits of Wilson’s approach. Silkworth was willing to let Wilson work with patients and even offered Wilson a job as a lay alcoholism therapist in 1938. The offer was extremely tempting, as the Wilsons’ finances were precarious, but the other members of the now-solid New York group persuaded Wilson that selling his services would undermine the organization.
At first, Alcoholics Anonymous grew slowly. When the first edition of Alcoholics Anonymous, the AA bible, appeared in April of 1939, membership numbered about a hundred, including a few women. By 1955, membership had increased to one hundred fifty thousand, and chapters had begun in a number of foreign countries. Membership stood at around a million in 1976, when the third edition of Alcoholics Anonymous appeared, and had risen to two million by 2001.
Wilson entertained grandiose plans for spreading the message of recovery. He envisioned massive publicity campaigns, a large paid staff, and special treatment centers run according to AA principles. He approached John D. Rockefeller, Jr., who agreed that the cause was worthy and its approach was successful but believed that it could and should be self-supporting. The modest support Rockefeller provided did, however, fill a critical need from 1938 to 1945. Living within its means was a critical ingredient in AA’s success. Indeed, the organization was supported by member contributions and the sale of publications, received no government grants or subsidies from religious or other charitable foundations, and refused large individual bequests. Instead, AA operated mainly with volunteer labor, and as a result it could open its doors to any suffering alcoholic with no strings attached.
AA based its program on a series of twelve steps to recovery that began with recognition of the problem and culminated in work with other alcoholics. These steps, adapted from principles employed by the Oxford Groups, included taking a moral inventory and making amends for past behavior. The Twelve Steps of AA first appeared in the 1939 edition of Alcoholics Anonymous, and they were soon copied by other recovery programs geared toward addressing addictions and compulsive behaviors.
The principle of anonymity was established early and served several purposes. Because of the stigma attached to alcoholism and potential legal complications, the professionals who dominated AA’s early membership were anxious to avoid public identification. Wilson also knew that relapses were common and calculated that a celebrity who slipped would destroy any positive effect created by an initial recovery. AA members, therefore, identified themselves by their first names only and avoided being photographed for national publications. Wilson himself is often referred to as simply “Bill W.”
From the outset, AA was an inclusive organization that welcomed alcoholics regardless of their race, gender, social class, sexual orientation, or prior criminal history. The only requirement for AA membership is a desire to stop drinking. Individual branches had considerable autonomy, and some were more restrictive than others. After some initial hostility, most medical doctors and mental health professionals came to support AA and referred patients to the organization (usually as an adjunct to treatment). Most religious groups in the United States also endorsed the program, although some found absence of sectarian dogmatism too unorthodox. On the other hand, dedicated secularists complained that mere reference to God by an organization with a prominent community role violated separation of church and state.
Alcoholism is a progressive, fatal, socially devastating disease to which roughly 10 percent of people are susceptible. The foundation of Alcoholics Anonymous followed close on the heels of Prohibition, a singularly ineffective attempt to eliminate alcoholism by a constitutional amendment prohibiting the sale of alcohol in the United States. Prohibition failed to curb alcoholism, and it spawned a culture of crime that continued to plague the nation for decades. Later attempts to solve the problem of drug addiction through the criminal justice system had similarly problematic results.
In contrast, Alcoholics Anonymous’s work saved the lives of many thousands of people at negligible cost. In the early years of the twenty-first century, the worldwide membership numbered somewhere between two and three million, and in the United States, the average member had been sober for four years. Although medical treatment programs became widely available, many people found AA to be the only organization that could help them achieve sobriety, and many more relied on continuing participation in AA to avoid relapse. Al-Anon, a group founded by Lois Burnham Wilson to help families of alcoholics cope with the disease’s effects, provided invaluable services and support for families in crisis.
Alcoholics Anonymous faced accusations that it brainwashed its members by insisting on admissions of powerlessness, by promoting religion, or by adhering to methods that had not been rigorously tested in a controlled clinical setting. Unfortunately, AA’s success rate, although probably equal to that of reputable medical programs, nonetheless remained discouragingly low. However, few people who personally experienced alcoholism or who worked in social service organizations doubted that the foundation of Alcoholics Anonymous was a major turning point in American social history.
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Alcoholics Anonymous World Services. Alcoholics Anonymous. 4th ed. New York: Author, 2001. Includes unrevised text of the 1939 edition, introductions to all four editions, and forty-two personal stories of recovery spanning seventy years of AA operation. The AA bible. -
_______. “Early AA’s Take Stock.” AA Grapevine 60, no. 6 (November, 2003). An introduction to the work of E. M. Jellinek and his collaboration with AA in refining the concept of alcoholism as a disease. -
_______, ed. Alcoholics Anonymous Comes of Age: A Brief History of AA. New York: Editor, 1985. Texts of talks given by Bill Wilson and other key figures at the AA General Service Conference in 1955; includes a detailed timeline. -
Hartigan, Francis. Bill W.: A Biography of Alcoholics Anonymous Cofounder Bill Wilson. New York: St. Martin’s Press, 2000. A well-researched, balanced account that presents a favorable picture of the man and organization and steers clear of the various myths surrounding AA.
U.S. Public Health Service Is Established
Rockefeller Foundation Is Founded