Millions of Americans are affected by substance abuse and addiction each year. Whether it’s alcohol, drugs, or behavioral compulsions, some 20 million people in the U.S. struggle with addiction in some form, while these rates are high, there are ample forms of treatment available.
One of the oldest and most well-known models for addiction recovery is the 12-Step program, which has its origins in Alcoholics Anonymous (AA). These programs are still in use today, either on their own as support groups or as part of integrated treatment plans. While they are not usually encouraged as a sole method for treating addiction, they provide valuable support to people struggling with addiction and can be an effective part of ongoing therapy.
This article provides information about the 12-Step models, what to expect, and how effective they are.
What Are 12-Step Models?
The 12-Step model was first established by Alcoholics Anonymous (AA) which came up with a program for helping people overcome their addictions to alcohol. Based on a self-help group dynamic, the 12-Step model is based on the idea that members can support each other through recovery and that healing occurs once a person surrenders to a higher power.
Since the establishment of AA, there have been many spin-off groups to support all kinds of addictions. The methods used in these programs differ across groups; however, the purpose of the 12-Step group is generally the same. While this model provides many benefits to people battling with addiction, some individuals struggle with what they interpret as religious elements of the program.
12-Step Traditions
The 12 traditions are laid out in what’s known as the Big Book, which forms the primary literature for Alcoholics Anonymous. These traditions have been adapted to different groups for their own recovery plans, but the meanings are generally the same.
- We admitted we were powerless over our addiction — that our lives had become unmanageable.
- Came to believe that a Power greater than ourselves could restore us to sanity.
- We made a decision to turn our will and our lives over to the care of God as we understood Him.
- We made a searching and fearless moral inventory of ourselves.
- Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- Were entirely ready to have God remove all these defects of character.
- Humbly asked Him to remove our shortcomings.
- Made a list of all persons we had harmed and became willing to make amends to them all.
- Made direct amends to such people wherever possible, except when to do so would injure them or others.
- Continued to take personal inventory and, when we were wrong, promptly admitted it.
- Sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
- Having had a spiritual awakening as the result of these Steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.
Types of 12-Step Programs
Since the origins of AA back in 1938, many 12-Step programs have been established based on similar principles of recovery. Below is a list of the active ones in the U.S. today.
Alcohol, Drugs, or Substances
- Alcoholics Anonymous (AA)
- Cocaine Anonymous (CA)
- Crystal Meth Anonymous (CMA)
- Heroin Anonymous (HA)
- Marijuana Anonymous
- Narcotics Anonymous (NA)
- Nicotine Anonymous (NicA)
- Pills Anonymous (for recovery from prescription pill addiction)
- Women for Sobriety
Behavioral Addictions
- Clutterers Anonymous (CLA)
- DA –Debtors Anonymous (DA)
- Food Addicts in Recovery Anonymous
- Food Addicts Anonymous (FAA)
- Gamblers Anonymous (GA)
- Overeaters Anonymous (OA)
- Online Gamers Anonymous (OLGA)
- Sexaholics Anonymous (SA)
- Sex Addicts Anonymous (SAA)
- Sexual Compulsives Anonymous (SCA)
- COSA (an auxiliary group of Sex Addicts Anonymous)
- Sex and Love Addicts Anonymous (SLAA)
- Sexual Recovery Anonymous (SRA)
- Underearners Anonymous (UA)
- Workaholics Anonymous (WA)
Emotional and Mental Health Recovery
- EA –Emotions Anonymous (EA) for recovery from mental and emotional illness
- Survivors of Incest Anonymous (SIA)
- Depressed Anonymous (DA)
- Social Anxiety Anonymous/Social Phobics Anonymous (SAA/SPA)
For Families and Dependents
- Adult Children of Alcoholics (ACA)
- Al-Anon/Alateen (for friends and families of alcoholics)
- Co-Anon (for friends and family of addicts)
- Co-Dependents Anonymous (CoDA) – for people working to end patterns of dysfunctional relationships and develop functional and healthy relationships
- COSLAA –CoSex and Love Addicts Anonymous
- Families Anonymous (for relatives and friends of addicts)
- am-Anon/Gam-A-Teen (for friends and family members of problem gamblers)
- Nar-Anon (for friends and family members of addicts)
- Recovering Couples Anonymous (RCA): A 12-step group for couples who want to restore and maintain their relationship in recovery.
What to Expect
12-Step groups are available in nearly every city across the U.S. These meetings are usually free and often take place multiple times per week. In terms of what to expect, 12-Step groups are usually open to anyone at any time (although some chapters operate groups that are only open to people struggling directly with addiction). Attendance at each meeting is not mandatory, and people are free to come and go as they please.
Unlike group therapy sessions, 12-Step meetings are often run by group members or people in recovery, rather than addiction counselors or mental health professionals. Therefore, what differentiates 12-Step meetings from group therapy is that AA or NA sessions are more about sharing and support rather than achieving therapeutic aims.
During a typical 12-Step meeting, people introduce themselves to the group using their first name only (to maintain anonymity). People are encouraged to share their stories, challenges, and successes while dealing with addiction or substance abuse. Meditation, reading 12-Step literature, and reciting prayers or affirmations can also be part of the meeting.
12-Step meetings are also semi-structured in that they don’t allow crosstalk. Members are not permitted to give advice, and nobody is typically allowed to interrupt someone while they are sharing their feelings or experiences. As part of the anonymity, members are also discouraged from talking about other members outside the group.
The Role of a Sponsor
Many 12-Step programs also use sponsors to guide a person towards sobriety through the 12 Steps. Sponsors are usually in recovery and are seasoned members of the group. Their role is to help a person become familiar with the 12 Steps and to provide support and share knowledge while they recover from their addiction.
Another key role of the sponsor is to provide accountability for the person in recovery. Not only do they encourage the person to attend 12-Step meetings, but they can serve as accountability buddies if the person has a relapse or is tempted to relapse. Sponsors provide an invaluable peer support system by helping individuals understand addiction and how they can live a life free of addiction.
How Do I Find a 12-Step Group?
Finding a 12-Step group or chapter is easy as they exist in most towns and cities across the U.S. One of the easiest ways to find a 12-Step meeting in your area is to visit the website of the particular group you’re looking for (e.g., Alcoholics Anonymous, Narcotics Anonymous). These sites usually provide a search function that allows you to find meetings in your area.
History of the 12-Step Model
The 12-Step model of Alcoholics Anonymous (AA) was founded in 1938 by Bill Wilson, who wrote about the positivity people experienced when they shared their stories of alcoholism with each other. His ideas on the 12-Step program were published in what is known as the Big Book, and these were also influenced by Christian traditions and a 6-step program called the Oxford Group.
These ideas are based on the idea that a person can seek help for their addiction by surrendering to a greater power. The Big Book was originally for people who couldn’t attend AA meetings, but it later became a guiding manual for the program.
Benefits of 12-Step Programs
Some of the purported benefits of the 12-Step program include the following:
- Fostering and improving self-awareness
- A deeper understanding of the root causes of addictions and compulsive behaviors
- The comfort of knowing you’re not alone or the only one going through it
- A sense of community and family through meetings
- A safe place to express difficult emotions or experiences
- Learning new skills and techniques for managing addiction and recovery
- Being able to give support to others and see outside your own issues
Effectiveness of 12-Steps for Recovery
The effectiveness of 12-Step groups is complicated to assess, especially as addiction recovery often requires multi-faceted approaches. Some studies indicate that long-term abstinence is achievable and sustainable when a person regularly attends 12-Step meetings.
However, some argue that evidence-based treatment programs that are individualized and customized to each client are the most effective. These programs can sometimes include 12-Step principles, but they do not rely on them as a sole method for recovery.
On their own, though, 12-Step groups can be highly beneficial for individuals who are unable to access proper treatment or who have been through treatment and wish to have continued support while they rebuild their lives. The AA Big Book states that there is a 50% success rate with a 12-Step program, with 25% remaining sober after one or more relapses.
A separate 2014 report from AA also states that 27% of their 6,000 members who participated in the study were sober for less than a year. Of those, 24% stayed sober for up to 5 years, while 13% lasted for up to a decade. On the other hand, the American Society of Addiction Medicine (ASAM) indicates that only 10% of people who join 12-Step programs have long-term recovery success.
Whatever the outcomes, 12-Step programs are a personal choice. However, well-rounded programs that tailor their treatment to individual needs while offering a range of therapies and structured environments are known to be highly effective when it comes to long-term recovery.
Resources
If you or a loved one are struggling with substance abuse, you are not alone. Treatment and support are readily available. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment.
You can also find a list of treatment centers near you on our website to help get you on the path to recovery.
Key Sources
Department of Mental Health and Addiction Services. (2016). 12-Step Facilitation. Ct.gov. http://www.ct.gov/dmhas/cwp/view.asp?a=2901&q=494054&pp=3.
Donovan, D., Ingalsbe, M., Benbow, J., and Daley, D. (2013). 12-Step Interventions and Mutual Support Programs for Substance Use Disorders: An Overview. Soc Work Public Health. 28(0), 313–332. doi: 10.1080/19371918.2013.774663.
Lesser, B. (2021). Support Groups for 12-Step Programs. dualdiagnosis.org. https://dualdiagnosis.org/support-groups/12-step.
Thomas, S. (2021). The 12 Steps of Alcoholics Anonymous (AA). https://www.alcohol.org/alcoholics-anonymous.
Medical Disclaimer
At RehabAid.com, we are dedicated to helping people recover from problematic substance use and associated mental health disorders. If you or a loved one are struggling with addiction to drugs or alcohol, you are not alone. Information on treatment and support options is readily available through the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357. To further assist you along the path to recovery, the treatment center locator on our website allows you to easily find rehabilitation programs and services in your local area.
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