12-step programs utilize peer support and shared experience to foster growth, connection, and the willingness to remain drug or alcohol-free.

12-Step Programs for Substance Abuse

Three crucial ideas prevail in 12-step programs: acceptance, surrender, and active involvement. A person must accept they suffer from addiction, surrender oneself to a higher a power, and become actively involved in meetings and support groups. Although there is little research to prove the effectiveness of 12-step programs, these programs have shown useful for remaining sober during recovery.

What Are 12-Step Programs?

12-step programs are self-help groups offering peer support during addiction recovery and treatment. These groups place emphasis on abstaining use of drugs or alcohol, and follow 12 “steps” or developments to recover from substance dependence. 12-step programs exist not only for people suffering from substance abuse, but for their family members as well.

Other important elements of 12-step programs include sharing personal narratives, incorporating the existence of a higher power into daily life, helping others, and taking responsibility for recovery. 12-step programs depend on a person’s willingness to face the problem of addiction, give themselves up to a higher power, and participate and engage in meetings and discussions.

Those participating in 12-step programs may be paired with a sponsor, or an experienced member of the group who has experienced long-term success in recovery. The sponsor acts as the person’s guide through recovery, offering assistance and support when they need it most.

12-step programs consist of meetings often held in public buildings like churches or community centers. Larger cities may offer a variety of programs with specialized meetings for particular groups. For example, there may be 12-step programs based on gender, sexual orientation, length in recovery, age, profession, etc.

Attending a 12-step program is typically free, and meetings tend to be open, meaning anyone can sit in and join. However, sometimes meetings will be “closed,” meaning they’re only open to those suffering from substance abuse and addiction. While many 12-step programs are likely to be different, the format is derived from the first 12-step program, Alcoholics Anonymous (AA). 

The 12 Steps of Alcoholics Anonymous (AA)

Alcoholics Anonymous (AA) is perhaps the most well-known 12-step program. Founded in 1935, AA defines the 12-step model for recovery is a 1953 book called Twelve Steps And Twelve Traditions. The book, written by co-founder Bill Wilson, is known today as “The Big Book” and highlights the essential principles of 12-step recovery.

The 12-steps of AA are:

  1. We admitted we were powerless over alcohol-that our lives had become unmanageable.
  2. Came to believe that a Power greater than ourselves could restore us to sanity.
  3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
  4. Made a searching and fearless moral inventory of ourselves.
  5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
  6. Were entirely ready to have God remove all these defects of character.
  7. Humbly asked Him to remove our shortcomings.
  8. Made a list of all persons we had harmed and became willing to make amends to them all.
  9. Made direct amends to such people whenever possible, except when to do so would injure them or others.
  10. Continued to take personal inventory, and when we were wrong promptly admitted it.
  11. Sought through prayer and meditation to improve our constant contact with God as we understood Him, praying only for knowledge of his will for us and the power to carry that.
  12. Having had a spiritual awakening as a result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

Along with the 12 steps, AA features 12 traditions that hold the good of the group above the individual, and many other 12-step programs were inspired by the 12 steps and traditions of AA.

Other 12-Step Programs for Substance Use Disorder

The AA model of 12-steps has been adapted to serve people dependent on drugs. Some 12-step programs, like Narcotics Anonymous (NA) and Chemically Dependent Anonymous, don’t focus on one particular substance of abuse but offer support for any substance use disorder (SUD). Other 12-step groups, like Crystal Meth Anonymous or Cocaine Anonymous, focus on a particular substance like AA.

There are also 12-step programs and groups to help people with co-occurring disorders (dual diagnosis), like Double Trouble in Recovery and Dual Recovery Anonymous. Other groups take a 12-step approach to help support family members of those struggling with abuse and addiction. Some of these groups include Al-Anon/Alateen, Co-Anon, Nar-Anon, and Families Anonymous.

All these programs follow the 12-step model of therapy that draws on social support. Through peer discussion and support, the hope is the meetings will inspire a person to live and sustain a healthy and drug-free lifestyle. While peer support can help a person foster recovery and growth, 12-step programs are not everyone.

Do 12-Step Programs Work?

Due to the nature of anonymity for many of these programs, there is little research available. While it’s difficult to determine the facts or data as to whether the 12-step model is effective, personal stories and testimonies speak for themselves. Many people claim AA or other 12-step programs have saved their lives.

At the very least, 12-step programs offer a safe and supportive environment for intimate discussion among people with shared experiences. Furthermore, attending 12-step meetings is an effective way to continue care and recovery after treatment. By attending meetings, a person is likely to reinforce what they’ve learned in therapy and share it with the group.

But, 12-step programs aren’t for everyone. Some people may be distracted or entirely put off by the spiritual element of the programs. If a person lacks spirituality, they may prefer a more secular (non-religious) approach to recovery.

Regardless of personal preference, 12-step programs are offered at nearly 75% of all treatment centers. While 12-step programs may not be enough for people with severe addiction to get clean, attending a 12-step program during and after treatment can be effective to sustain recovery.

12-Step Programs With Other Treatments

Utilizing 12-step programs with other treatment plans can offer an additional layer of peer support. Peer support is a very important part of the recovery process, and 12-step programs can offer support and advice from people with similar experiences with addiction. This can be very effective when it’s combined with other treatments, and some treatments may include what’s called 12-step facilitation therapy.

12-step facilitation therapy consists of therapists encouraging, promoting, or requiring a person attend and participate in a 12-step program during or after treatment. The point of the therapy is to increase the likelihood a person will participate and become actively involved in 12-steps programs to remain drug-free.

12-step facilitation therapy may be offered, as well as various 12-step programs and peer support groups, at inpatient treatment centers. Entering inpatient treatment is a good option because it likely provides the essential components of addiction treatment: detoxification and withdrawal support, medications, behavioral therapy, and peer support. 12-step programs may be implemented in treatment plans to facilitate growth and self-awareness to carry on with recovery.

Call now for more information on 12-step programs and treating addiction.


Alcoholic Anonymous—Twelve Steps and Twelve Traditions

National Institute on Drug Abuse—How do 12-step or similar recovery programs fit into drug addiction treatment?

National Institute on Drug Abuse—12-Step Facilitation Therapy

Substance Abuse and Mental Health Services Administration—An Introduction to Mutual Support Groups for Alcohol and Drug Abuse