Alcohol Problems and the Cochrane Review: What Every Prosecutor Needs to Know

Contributing Author: Susan Broderick, Senior Attorney, NDAA

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Photo credit: D-Keine/iStock

The stress and uncertainty associated with the current COVID-19 crisis is having ramifications far beyond the virus itself. Because of the increased fear and the sense of isolation that now exists, there are reports that the use of alcohol is skyrocketing. Given the correlation between substance use and offending, this is an issue of concern for prosecutors as well.

While the headlines paint a grim picture of the problem, a recent groundbreaking study has provided hope and some much needed positive news:

In the Cochrane Database of Systematic Reviews’ study, “Alcoholics Anonymous and other 12-step programs for alcohol use disorder”, researchers compared AA and clinical Twelve-Step Facilitation Programs with other forms of treatment, such as Cognitive Behavioral Therapy (CBT). The results? Those who participated in A.A. and Twelve-Step Facilitated programs achieved and maintained higher rates of recovery than those receiving other treatments including CBT.

From a public health perspective, these findings are striking. As noted by the review’s lead author, Dr. John Kelly, a professor of psychiatry at Harvard Medical School and director of the Recovery Research Institute at Massachusetts General Hospital, “These results demonstrate A.A.’s effectiveness in helping people not only initiate but sustain abstinence and remission over the long term. The fact that A.A. is free and so widely available is also good of the researchers, A.A. is the closest thing to free lunch that the public health system has.”

From a public safety perspective, the findings are just as important. Across the entire justice continuum, numerous offenses are related to alcohol use problems. From driving under the influence, sexual offenses, and other crimes of violence, very often an underlying issue exists around alcohol. Research has shown that a referral to the criminal justice system can provide the motivational fulcrum to initiate recovery. But if we want to sustain recovery, we must widen the lens beyond the courtroom and a treatment facility. A referral to A.A. or another 12-step program can provide the necessary long-term recovery support that this chronic condition needs.

This referral can be made from any interception point in the justice system. While treatment courts may be the most common referral, diversion and probation programs can also include conditions that include 12-step attendance. As prosecutors, we can share these findings with stakeholders we are collaborating with to ensure that these findings are disseminated throughout the system.

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These findings are also important beyond the professional realm. As noted in the ABA/Hazelden Study of 2016, attorneys experience problems with drinking at a higher rate than other professional populations. According to the survey, 1 in 3 respondents scored at a level consistent with problematic drinking and only 7% indicated that they would seek help. Very often, the cost of treatment or taking time away from work create obstacles to seeking help. Given the efficacy of A.A., those obstacles are eliminated.

From a personal standpoint, I was thrilled yet not surprised with these findings as they confirmed what I have been so fortunate to experience. I began my road to recovery in a church basement on a muggy evening in July of 2001. While initially frightened to walk through the front door, once inside I heard laughter and met people who had drank like me yet were now living a sober and happy life. The joy and hope I experienced that evening (and still experience to this day) is available for anyone, free of charge. For a meeting near you, check out If you have questions, please feel free to reach out to me at

For more information about this study including an interview with Dr. John Kelly, go to

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The National District Attorneys Association (NDAA) is the oldest and largest national organization representing state and local prosecutors in the country.

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