Despite the ubiquity of AA meetings, a worldwide membership base, and the widespread integration of 12-Step tenets into many forms of formal substance abuse treatment, whether or not AA works remains a debated question. Research is mixed when it comes to abstinence rates among those who attend AA meetings. For example, a review of AA research found strong evidence for the program’s effectiveness with rates of abstinence almost twice as high among those who attended AA. However, the associations were different across studies, making it difficult for researchers to determine an absolute cause-and-effect relationship between attending AA and abstinence . 3 While most studies state that AA is a positive component in a person’s sobriety, it is not the only tool recommended or used in recovery.
Although AA lacks an official, singular definition of alcoholism, Dr. William Silkworth contributed the chapter in the basic text of Alcoholics Anonymous entitled "The Doctor's Opinion." This chapter has become one of the more influential pieces in AA literature. In it, he wrote they "have one symptom in common: they cannot start drinking without developing the phenomenon of craving. This phenomenon, as we have suggested, may be the manifestation of an allergy which differentiates these people, and sets them apart as a distinct entity."  The allergy takes the form of a craving, which is explained earlier in the chapter, "the phenomenon of craving is limited to this class [alcoholics] and never occurs in the average temperate drinker. These allergic types can never safely use alcohol in any form at all; and once having formed the habit ... they cannot break it..."