Background:

The percentage of alcohol dependents who attend self-help groups increased from 33.4% in 2008 to 43.7% in 2011 according to the National Surveys of Addictions. Alcoholics Anonymous (AA) and their Twelve Steps program represent the main model for self-help in Mexico. The 12th Step or carrying the message is a common strategy to attract new members into AA groups and it is done frequently at hospital wards.

Objective:

To describe the activity of carrying the message in a hospital context in order to identify the meanings involved and how AA members relate to the patients.

Method:

An ethnographic approach was used to observe the activity of nine AA's members in a third level hospital in Mexico City over a ten-month period. The activity system model was used for data organization and interpretation.

Results:

The carrying the message activity consists of six core moments: 1. Self-introduction of the recovering alcoholic; 2. Defining alcoholism as an incurable disease; 3. AA's Twelve Steps as an alternative; 4. Self-diagnosis; 5. Ask about consumption; 6. Invitation to hospital AA's group meetings. The AA's member uses personal experience's stories to convey AA vision about alcoholism and recovering.

Discussion and conclusion:

The carrying the message activity is mainly oriented by the meaning of alcoholism-denial. The AA's actions are designed to avoid denial and to promote disease acceptance. Furthermore, the hospital setting itself legitimizes the AA presence and their Twelve Steps. Carrying the message presents a strategy to diminish stigma related to alcohol dependency which is one of the main obstacles for seeking help.