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Updated: Aug 8, 2026

The Motivation for Alcohol Reward: Predictors of Progressive-Ratio Intravenous Alcohol Self-Administration in Humans
Published on: April 28, 2022
Is alcoholism typology a predictor of both Alcoholics Anonymous affiliation and disaffiliation after treatment?
J Scott Tonigan1, Michael P Bogenschutz, William R Miller
1Department of Psychology, Center on Alcoholism, Substance Abuse, and Addictions (CASAA), University of New Mexico, 2650 Yale Southeast, Albuquerque, NM 87106, USA. jtonigan@unm.edu
Abstract:
Twelve Steps (TS) has demonstrated effectiveness; induction into Alcoholics Anonymous (AA) is a primary objective of TS and is a pivotal mechanism explaining its effectiveness. However, evidence suggests that, after treatment, dropout from AA is high. This study investigated whether alcohol problem severity predicted both AA affiliation and disaffiliation among clients receiving TS. This study of a Project MATCH sample included 453 alcohol-dependent clients randomly assigned to TS who reported AA attendance during treatment. Greater alcohol problem severity predicted AA attendance; opposite to prediction, less alcohol-impaired clients were more than twice as likely to discontinue AA attendance after treatment. When sustained AA attendance is desired, the evaluation of client pretreatment alcohol involvement may be useful for identifying potential AA dropout after TS treatment. Findings also indicate that, among treatment-seeking problem drinkers, AA dropout and disaffiliation are distinct, albeit correlated, constructs that require future investigation.
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