Many members of 12-step recovery programs have found that these steps were not merely a way to overcome addiction, but they became a guide toward a new way of life. Some of the best-known 12-step programs include Alcoholic Anonymous (AA), Narcotics Anonymous (NA), and Cocaine Anonymous (CA).
How the Twelve Steps Work
As explained in Chapter 5, “How It Works,” in the book Alcoholics Anonymous, the Twelve Steps provide a suggested program of recovery that worked for the early members of AA and continued to work through the years for many others, regardless of the type of substance they used. Twelve-Step meetings are considered the “fellowship” part of the AA mutual support groups, where people come together and share their experiences. For many people, these groups may serve as their primary resource for changing their behavior, but they also often augment formal treatment. Such programs can also be helpful for long-term support and care. One survey found that there were approximately 64,000 groups in the U.S. and Canada, with more than 1.4 million members. Worldwide, there are approximately 115,000 groups supporting more than 2.1 million members.
The 12 Steps
Though the original Twelve Steps of AA have been adapted over time, the premise of each step remains the same for all recovery programs that use a 12-step model. By exploring the steps in depth and seeing how others have applied the principles in their lives, you can use them to gain insight into your own experiences, and to gain strength and hope for your own recovery. The steps and their principles are:
The Twelve Traditions
Just as the 12 steps outline the path to recovery for individuals struggling with addiction, there are also 12 Traditions that are the spiritual principles behind the 12 steps. These traditions help guide how 12 step recovery programs operate. The traditions focus on the importance of unity, effective leadership, and independence. They also address questions related to financing the group and managing public relations. The purpose of the 12 traditions is to help provide guidelines about the relationships between the group and the community as well as between individual members of the group.
History of the 12 Steps of Recovery.
The 12 steps of recovery introduced by the founders of Alcoholic Anonymous are: While the 12 steps in use today are based on the same ideas written by the founders of AA in the 1930s, the understanding of the term “God” has since broadened to refer to any “higher power” that a person believes in. Believing in this higher power may help someone find meaning in their life outside of addiction. For instance, they may find a greater sense of community by joining a spiritual or religious group. Or, they may engage in prayer and meditation. These can be healthy coping mechanisms someone turns to as they progress through recovery.
Effectiveness of 12-Step Recovery Programs
There are many different paths to substance use recovery, and 12-step programs are just one resource that people may find helpful. Research suggests that 12-step interventions and mutual support groups can be essential in recovery. Self-report information collected by AA, NA, and CA suggests that the median length of abstinence among currently-attending members is five years. Around a third of members report remaining abstinent between one and five years. More formal research also supports the findings of support group surveys. For example:
Attending 12-step recovery programs in addition to specialized substance use treatment is associated with better overall outcomes. Greater involvement, particularly when a person first connects with a 12-step program, is also linked to better outcomes. Participating in activities and attending meetings may help reduce the likelihood of a relapse.
Pros and Cons of 12-Step Recovery Programs
While participating in the 12 steps of recovery can be beneficial for many people, consider the advantages and disadvantages of these programs before you decide if this approach is right for you.
Benefits
These programs offer a number of benefits, including:
A free resource for communities to address substance use problems Readily available Community-based Encourages members to take an active part in recovery Offers online and in-person options
Disadvantages
However, 12-step mutual support groups may not be for everyone. Some challenges or possible disadvantages include:
Co-occurring mental health or chronic health conditions may make participating in 12-step groups more challenging.This approach places full accountability for addiction and recovery on the individual12-step groups may be less effective for certain groups, including women, BIPOC, and sexual minoritiesThe emphasis on powerlessness can feel disempowering to some peopleEmphasis on a higher power can alienate some peopleDoes not address the physical aspects of recovery, such as drug detox and withdrawal
Alternatives to 12-Step Recovery Programs
The 12 steps of recovery are not the only type of mutual support options that are available for people who are trying to overcome drug and alcohol use. A few alternatives to 12-step programs include:
SMART Recovery
SMART Recovery is a secular alternative to 12-step programs like AA. Rather than emphasizing powerlessness and embracing a higher power, the SMART Recovery approach emphasizes viewing substance use as a habit that people can learn to control. It draws on aspects of cognitive-behavioral therapy (CBT) and helps members to build motivation, cope with cravings, change addictive thoughts, and adopt healthy habits.
Secular Organizations for Sobriety (S.O.S.)
This program is focused on helping people overcome addictions by focusing on their values and integrity rather than embracing a higher power. It encourages members to make sobriety the top priority in their life and take whatever steps they need to stay on the path to recovery.
Professional Treatment
In addition to mutual support groups, whether they are 12-step programs or an alternative approach, getting professional treatment can significantly improve a person’s chances of recovery. Depending on an individual’s needs, such treatments may involve therapy, medications, or inpatient/outpatient rehab. Talk to your doctor about which options might be suitable for your needs. For more mental health resources, see our National Helpline Database.
