Book excerpt: Author Shane Butler tells the story of how Alcoholics Anonymous (AA) was established in Ireland - the first European country to start an AA group - in 1946, and how it gradually came to establish itself as a mainstream Irish institution, the need for which has become clearer as alcohol consumption levels increase. AA is described as a hybrid institution, straddling healthcare and religion, and the book looks in detail at how early Irish members negotiated working relationships with the mental health system and the dominant Catholic Church. The book also focuses on AA's commitment to the avoidance of conventional, organizational management systems, involving clearly-identified leaders and top-down instructions for front-line members. The survival of AA in Ireland, as elsewhere, is attributed primarily to the fact that it has remained firmly outside of alcohol politics, seeing itself as a 'fellowship' which exists only to help individuals who seek its help in relation to their own powerlessness over alcohol. It is recognized, paradoxically, that AA in Ireland could not have negotiated such a smooth entry to this country without the energies and skills of its early leaders, and this book documents the activities of these leaders who - with the assistance of AA in the United States - strategically managed the fellowship's establishment in a potentially hostile environment.