Alcoholics Anonymous (AA) is a recovery program that is arguably more popular than all other treatment programs combined. AA is based on the foundation principle that alcoholism is a disease and that alcoholics must acknowledge their powerlessness over alcohol and surrender their lives to a Higher Power to help them overcome their shortcomings. Since its origin in 1935, AA has steadily grown to include almost 100,000 groups in more than 100 countries. Research by Emrick et al. (1993) found that people who regularly participate in AA activities and follow its guidelines are more likely to have a successful outcome in their recovery. The relative success of AA seems to be due to the fact that an alcoholic who no longer drinks has an exceptional ability to reach and help an uncontrolled drinker. In simplest form, the AA program operates when one recovering alcoholic passes along the story of his or her own problem drinking, describes the sobriety he or she has found in AA, and invites the newcomer to join the informal Fellowship. In their comprehensive psychopathology textbook, Barlow and Durand (2005, p. 409) describe AA as "without question, the most popular model for the treatment of substance abuse."

Biological treatments include medications such as acamprosate (which affects the glutamate and GABA neurotransmitter systems) and selective serotonin reuptake inhibitors (SSRIs) such as Zoloft and Prozac, which have been tested for their potential therapeutic properties in the treatment of alcohol dependence (Gordis, 2000). Acamprosate has been shown to be an effective aid in treating alcohol-dependent patients and in maintaining periods of abstinence of patients (Gage, Chabac, & Goodman, 2005; Sass, Soyka, Mann, & Zieglgänsberger, 1996). Medications may be beneficial when used in conjunction with other treatment modalities, such as abstinence, counseling, and support groups.

Controlled drinking (Miller & Muñz, 2005; Sobell & Sobell, 1978, 1998) has been considered a somewhat controversial approach to treatment that may be a viable alternative to abstinence for some alcohol abusers. Research has shown that some problem drinkers (particularly those with shorter drinking histories and no signs of dependence) may benefit from controlled drinking, whereas alcohol dependent people (particularly those with longer drinking histories, signs of dependence, and failed attempts at controlled drinking) may be more appropriate candidates for abstinence-based treatment. In any event, most experts agree that controlled drinking is clearly not a cure for alcoholism. Research by Marlatt et al. (1993) seems to indicate that controlled drinking is at least as effective as abstinence, but that neither approach is successful for 70% to 80% of patients over the long term.

Cognitive-behavioral models typically focus on relapse prevention, which addresses high-risk situations, feelings, thoughts, and behaviors. Relapse prevention (Marlatt & Gordon, 1985) focuses on learned aspects of dependence and views relapse as a failure of cognitive and behavioral coping skills. Recovering alcoholics learn to examine their positive cognitive expectancies and the negative consequences of substance use. Cognitive-behavioral models may be used in conjunction with both controlled drinking treatment and abstinence-based approaches to recovery.

Component treatment involves a number of treatment procedures that are combined in order to increase the effectiveness of the total "treatment package." Most comprehensive treatment programs incorporate component treatment in some way, such as including biological treatments, group therapy, twelve-step groups, and community support. One important question concerns the effectiveness of inpatient treatment compared to outpatient therapy that can cost 90% less (Barlow & Durand, 2005). Some studies suggest that there may be no difference between intensive residential programs compared to quality outpatient programs in treatment outcome for alcoholic patients (W. R. Miller & Hester, 1986). In other words, although some alcohol dependent individuals improve as inpatients, they may not necessarily require such an expensive level of care.

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