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Alcoholics Anonymous (AA) helps alcoholics to become sober, but the program may affect men and women differently.

Two researchers from Massachusetts General Hospital (MGH) report in the journal Drug and Alcohol Dependence that when it comes to beating alcohol addictions, coping mechanisms may be driven as much by gender as any other factor related to recovery. For instance, men benefit more from finding socially-based ways of weaning themselves from alcohol, such as avoiding friends and social situations that promote drinking, and gradually gaining confidence in their abilities to do so. Women, on their other hand, do better after learning to avoid drinking while feeling negative emotions like depression, anxiety and anger.

The authors suggest that these differences highlight specific areas that men and women can focus on to improve recovery.

In the study, John Kelly, associate director of the MGH Center for Addiction Medicine and his colleague Bettina Hoeppner followed more than 1,700 participants who were enrolled in Project MATCH, a federally-funded study comparing three different approaches to treating alcohol addiction. In addition to the recovery program to which they were assigned, the participants could attend AA meetings and reported reported on whether they were successful in achieving and maintaining sobriety. The researchers also assessed the recovering alcoholics’ confidence to remain sober in various situations and whether their friends and family supported their goal to abstain from alcohol.

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For men, participating in AA increased their confidence in building a network of supportive friends and staying sober in high-risk social situations like parties. Independent of AA, these same social factors were twice as influential for men in avoiding relapse than for women. In contrast, dealing with negative emotions that can be a trigger for bouts of drinking was a much higher factor in relapse risk for women than for men.

“This was a very stark contrast. Both men and women benefit the same from AA, but women’s exposure and involvement in AA resulted in better coping with anxiety and anger. In men, this was not the case. It was very surprising to me,” says Kelly.

The findings offer insights into how treatment works for different genders, and how strategies for recovery might be refined in the future to more effective. For men, focusing on the types of social risks they face will increase their recovery, for example, while helping women find alternative ways to handle feelings of depression without alcohol could be most effective.

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“It’s important to understand that men and women trying to recover from alcoholism use AA and other resources in different ways to cope with the kinds of risks of relapse which are pertinent to their particular social situation and life context,” says Kelly.