The 12-step program aims to help people attain abstinence from substance use disorders or make a behavioral change through peer support. This intervention provides a supportive social network and fosters bonding among group members, which adds to the benefits. Members often run the groups without the involvement of healthcare professionals.
Although studies indicate that the programs are effective for people with alcohol use disorder, the research on their effectiveness for those with substance misuse is still preliminary.
This article discusses the 12-step program in more detail, including its history, how it works, its effectiveness, and the possible risks. It also lists similar organizations and provides resources for getting help.
The 12-step program is a strategy that aims to help people recover from alcohol use disorder, substance use disorder, and other forms of addiction. Members of the programs run them, and they involve low or no costs. They are available in many communities.
Each program follows 12 standard steps. Below are the 12 steps of AA, which all the other programs adopt, making only minor variations to address their specific purpose:
- We admit that we are powerless over alcohol and that our lives have become unmanageable.
- We believe that a power greater than ourselves can help us.
- We decide to turn our wills and lives over to the care of a higher power, whatever that may be.
- We make a searching moral inventory of ourselves.
- We admit to a higher power, ourselves, and another person the exact nature of our wrongs.
- We are ready to have a higher power remove these defects in character.
- We humbly ask the higher power to remove our shortcomings.
- We make a list of people we have harmed, with whom we are willing to make amends.
- Whenever possible, we make amends to these individuals.
- We continue to take a personal inventory and promptly admit when we are wrong.
- We ask for the knowledge of a higher power’s will for us and the strength to carry it out.
- We try to carry this message to other people with alcohol use disorder and practice these principles in all our affairs.
- refraining from drinking or misusing drugs
- going to meetings
- asking for help
- getting a sponsor
- joining a group
- becoming active
People typically use the programs as an add-on to treatment or as a form of continuing support following treatment.
AA now has almost 2 million members around the world, with groups in 180 countries. More than 1.2 million members are in the United States.
Later in the 20th century, other programs followed, and the founders modeled them after AA.
NA emerged in the 1950s. As of 2010, it had almost 200,000 members in the U.S., along with groups in 130 countries.
Today, a broad array of 12-step programs addresses mental health conditions and potentially dysfunctional behaviors. Examples of these include:
- Debtors Anonymous
- Eating Disorders Anonymous
- Gamblers Anonymous
- Workaholics Anonymous
Membership in one of the groups changes a person’s social network. It reduces the number of people in their life who engage in substance misuse while increasing those who abstain from it. This social shift results in decreased exposure to activities and behaviors relating to substance use and increased opportunities to take part in unrelated activities.
The bonding among group members is another factor that underlies the program’s effectiveness. Bonding leads to the provision of role models for attaining abstinence and fosters goal directedness.
- regular, early, and frequent attendance of meetings, such as attending three per week
- beginning the programs while in treatment
- engaging in other program activities, such as calling other group members or performing a service at a meeting
In other words, a link exists between the degree of involvement in the program and positive outcomes. Despite this association, it is not a cause-and-effect relationship.
One is that some people might not feel comfortable with religion or spirituality. Rather than accepting the concept of powerlessness and surrendering to a higher power, they might prefer the idea of taking action and responsibility themselves. Another possible downside is the lack of trained professionals leading the groups.
An alternative to a 12-step program is a support group. A small, older
- SMART Recovery, a worldwide community of support groups for people with substance or alcohol use disorder
- LOOSID, a website that offers chat groups and other resources for those with alcohol use disorder
- LifeRing Secular Recovery, a website that provides online meetings for people with a history of drug misuse
The Substance Abuse and Mental Health Services Administration (SAMHSA) offers a free 24-7 helpline on 800-662-HELP (4367). People with substance use disorders or mental health conditions can contact SAMHSA for information or a referral.
Other organizations that aim to help people attain abstinence from unhealthy behaviors include:
- Alcoholics Anonymous
- Narcotics Anonymous
- Cocaine Anonymous
- Overeaters Anonymous
- Sex and Love Addicts Anonymous
- Gamblers Anonymous
The following programs seek to help family members or friends of people with substance use disorders or other problematic patterns of behavior:
- Adult Children of Alcoholics & Dysfunctional Families, a program that seeks to help those who grew up in households where they experienced neglect, abuse, and trauma
- Nar-Anon, a program for family members of individuals with substance use disorders
- Gam-Anon, a program for family members and friends of people with a compulsive gambling problem
Seeking help for addiction may seem daunting or even scary, but several organizations can provide support. If you believe that you or someone close to you is struggling with addiction, you can contact the following organizations for immediate help and advice:
- Substance Abuse and Mental Health Services Administration (SAMHSA): 800-662-4357 (TTY: 800-487-4889)
- National Suicide Prevention Lifeline: 800-273-8255
Alcoholics Anonymous developed the first 12-step program, but such programs now exist in many different forms.
The 12-step program is a strategy for overcoming alcohol use disorder and other substance use disorders. It uses 12 distinct steps to guide people toward recovery.
There is limited research into its effectiveness, but one drawback is that it relies on people effectively surrendering themselves to a higher power. People who are not religious or spiritual may struggle with this concept.
That said, there are an estimated 2 million AA members worldwide, with even more people belonging to similar organizations. Many individuals have found success in treating their substance use disorders with the 12-step program.
People interested in partaking should speak with a relevant organization or healthcare professional about ways in which to treat and manage their substance and alcohol use disorders.