Addiction recovery programs that rely on peer support and increasing self-understanding are helpful even for people who have psychiatric illness, according to an article in the August issue of Alcoholism: Clinical and Experimental Research.

Alcoholics enrolled in Alcoholics Anonymous and similar programs were more likely to abstain from alcohol completely than people who did not take part in support groups, and they drank less if they did resume drinking. Furthermore, people who attended the most meetings got the most benefit.

“If you don’t go to any, you have the worst outcomes,” said study lead author John Kelly, PhD, associate director of the Massachusetts General Hospital/Harvard Addiction Research Program. “If you go to a few, you have a little bit better outcome, and if you go to a lot, you have an even better outcome.”

The study is among the first to examine the effectiveness of alcoholics anonymous-type programs among different types of people.

In the new study, Kelly and a colleague followed 227 patients with alcoholism for up to three years after they left outpatient rehabilitation programs in Boston and Providence, R.I.

In groups such as Alcoholics Anonymous, participants are urged to believe in a “higher power.” Even so, nonreligious people benefited as much from Alcoholics Anonymous and similar programs as those who were religious, Kelly said. However, the nonreligious were less likely to join the support groups.

The design of the study didn’t allow the authors to say exactly how much the various types of people drank after taking part in the programs. However, it was clear that men and women benefited equally, as did people with coexisting psychiatric illnesses, Kelly said. And those with the most severe alcoholism were most likely to be participants.

However, a comprehensive new review of eight studies from the Cochrane Library found that Alcoholics Anonymous and other 12-step group programs are not more effective than other psychosocial interventions for alcohol dependence. Lead reviewer Marica Ferri suggested that the best choice of treatment depends on the individual participant.

AA and similar programs appear to work by providing “camaraderie and a support structure,” said Aaron White, MD, associate professor of psychiatry at Duke University and a specialist in addiction. “When you feel like drinking, you have a sponsor, someone in charge of keeping you from doing that. That’s pretty powerful socially.”

Still, success in overcoming alcoholism ultimately comes down to “how badly people want to do it,” White said.