What to Know About Combining Alcoholics Anonymous with Naltrexone

At Oar Health, we know that there are multiple paths to recovery. We believe that every person has the right to assemble the recovery toolkit that works for them.

Some of our members want to drink less or quit privately and independently with help from safe, effective prescription medication. Others find that combining medication with a mutual peer support group fits them best.

The most well-known mutual support group for AUD, Alcoholics Anonymous (AA), was founded in 1935 and has been used globally by people who want to stop drinking. It’s entirely peer-led and free for attendees. 

So, it’s no surprise that many Oar Health members have combined medication from Oar with AA.

While substantial bodies of research examine the benefits of AA and naltrexone individually, what does the science say about using them together? A small 2019 study found the pairing may be a strong combination (1).

Twenty patients received naltrexone for 90 days and 10 AA behavior therapy sessions. Throughout treatment, and during the eight-week post-treatment follow-up, there was an overall increase in the percentage of days abstinent. 

Another 2023 study explains that combining medication with a psychosocial intervention, like AA or therapy, can increase the chances of recovery success (2). 

Because AA and naltrexone are distinct treatments, they work in different ways. AA works by following the 12 steps, the guiding framework, to help change behavior to overcome addiction. Naltrexone blocks the opioid receptors in the brain responsible for the feel-good effects of alcohol. 

Why People Combine AA and Naltrexone

Despite the efficacy of using naltrexone alone, or in combination with professional behavioral healthcare, sometimes people want more to help with AUD. 

While naltrexone works within the body and brain to reduce cravings for and reward from alcohol, AA can provide complementary benefits.

Community

Many people find attending AA meetings fulfilling. You can make friends, share experiences, and support others in recovery. 

Accountability

AA can help people stay honest and accountable about their recovery goals. Having a group with similar struggles can be helpful to point out when you have strayed from your goals.

Structure 

Recovery can feel destabilizing, even though it’s a path toward acquiring stability. New sobriety can feel a lot like a second adolescence—you’re now doing things without alcohol, which can be challenging and confusing. AA meetings, as often as every day, can be a source of stability.. Spirituality

There’s a spiritual component to most AA meetings that can be helpful for some. The concept of a “higher power” helps some people have faith that their life is worth living without alcohol. AA does encourage a belief in a higher power, though it does not claim to be affiliated with any religion. If this part is not for you, many other mutual support groups may be more of a fit. 

Is AA Supportive of Medication-Assisted Treatment?

AA does not have a policy on whether or not it supports the use of medication-assisted treatment for AUD. (3), AA does have a policy that “No A.A. member should play doctor’ (4). This means that AA members should not give each other medical advice on what medications are appropriate for them.

One common concern is that using medication to treat addiction is “replacing one drug with another.”. It’s important to remember that naltrexone is not = addictive. 

Some people get tripped up on the statement in AA’s Big Book that, “there is no such thing as making a normal drinker out of an alcoholic. Science may one day accomplish this, but it hasn’t done so yet.” 

It’s important to remember that The Big Book was written before the discovery of naltrexone and the other FDA-approved medications for the treatment of AUD.

One AA’s defining characteristics is that it is decentralized. Each member-led meeting has a slightly (or sometimes very) different feel and philosophy. 

Some AA members and meeting may be adamantly opposed to medication-assisted treatment. But other members and meetings are supportive. So, if you are interested in pursuing MAT + AA, it may pay to hunt around for an in-person or online meeting that fits you.

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