Bankole Johnson, an alcohol researcher and consultant to pharmaceutical companies who is also the chairman of the Department of Psychiatry at the University of Maryland School of Medicine, puts it this way: “We are wedded to the abstinence model as the goal, despite evidence that there can be many successful outcomes.”

Because of the promise of anonymity, A.A. doesn’t track its members or conduct research. Some studies have found that many members find support for healthier habits from a like-minded group of nondrinkers. But a systematic review found “no conclusive evidence to show that A.A. can help patients to achieve abstinence.”

Research shows that many problem drinkers — those who repeatedly drink more than they intend, sometimes have physical or psychological consequences from overdrinking, and may have difficulty controlling themselves — could benefit from brief interventions and practical advice about how to set better limits and change their drinking by cutting back.