Manualized Alcoholics Anonymous or other 12‐step programs are effective in terms of abstinence and may be at least as effective as other well‐established treatments for other outcomes.

High‐certainty evidence shows that, for people with alcohol use disorder, manualized Alcoholics Anonymous (AA) or other 12‐step facilitation (TSF) programs compared with alternative interventions (both for five hours/week, five days a week, for three to six months) lead to more people being completely abstinent at 12 months (on average, 367 vs 304 per 1000 people), and this benefit seems to persist for at least 36 months.

Very low‐certainty evidence suggests that the percentage of days abstinent may be higher with AA/TSF programs than with an alternative clinical intervention at 24 and 36 months (approx. 13% and 7%, respectively); it is unclear why similar benefit was not observed at 12 months. Low‐ to moderate‐certainty evidence suggests little to no difference in the period of abstinence at six months, in alcohol‐related consequences (physical, social, or psychological) at any time point, or in the number of drinks per drinking day at 12 and 24 months but probably favors AA/TSF at 36 months (by one drink). Results for the Addiction Severity Index may be better with AA/TSF programs than with an alternative clinical intervention at 6‐ and 12‐month follow‐up.