12-Step Addiction Treatment: Some Facts


Twelve-step programs are self-help meetings where participants admit past mistakes, Twelve-step programs are support groups for people battling a variety of destructive behaviours, including substance use disorders. These meetings are readily available, easily accessible and most often free to join. They consist of men and women who share experiences, strength and hope with one another.


Used by millions of people around the world, 12-Step programs encourage members to adopt a set of guiding principles called the 12 Steps. Following the steps in order has helped people achieve and maintain abstinence from behavioural problems such as substance use disorders, gambling addiction and eating disorders. The bonds formed and lessons learned during these meetings can last a lifetime.


The 12 Steps of Recovery


  1. We admitted we were powerless over our addiction, that our lives had become unmanageable.

  2. Came to believe 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 understand God.

  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 God 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 wherever 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 conscious contact with God as we understood God, praying only for the knowledge of God’s will for us and the power to carry that out.

  12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to other addicts, and to practice these principles in all our affairs.

Many rehab centres in the United States use 12-Step programs in combination with evidence-based treatment, which often includes medical detox. Individuals who complete rehab often continue participating in meetings because the 12 Steps help them focus on sobriety.


The most popular 12-Step support groups, Alcoholics Anonymous and Narcotics Anonymous, host meetings every day throughout the United States, and South Africa.


Examples of 12-Step programs include:


  • Adult Children of Alcoholics

  • Alcoholics Anonymous

  • Al-Anon or Alateen

  • Food Addicts Anonymous

  • Gamblers Anonymous

  • Nar-Anon

  • Narcotics Anonymous

  • Nicotine Anonymous

  • Overeaters Anonymous

  • Sex Addicts Anonymous

Through the 12 Steps, people learn how to cope with addiction, avoid triggers and live sober lives. Support group members admit their powerlessness over addiction, examine past mistakes and make amends with those they’ve wronged. Each meeting, they share support and learn ways to apply the 12-step principles to their lives.


The goal is to help members experience a spiritual awakening, a phrase used by Alcoholics Anonymous to describe the personality change required to overcome addiction.


Meetings often are held in public facilities such as schools, churches or community centres. They offer a forum for individuals to share their story, including past struggles and triumphs, with those in similar situations. Together, participants learn and work the 12 Steps of recovery.


For decades, countless individuals have used 12-Step meetings to recover from substance use problems. In many instances, participants overcome their problems and become healthy, productive community members.


Origin and History of 12-Step Programs


Bill Wilson had experienced success as a stockbroker on Wall Street in the early 20th century before alcohol addiction ended his career. He frequented medical treatment at Towns Hospital in New York City, but he continued to drink afterwards.


Edwin Thatcher was a friend of Wilson’s who was later known in Alcoholics Anonymous circles as Ebby T. He spoke with Wilson about the Oxford Group’s blueprint of self-improvement and how it helped him quit drinking.


The Oxford Group, a Christian organization founded in the early 20th century, based its core principles in spirituality and involved honesty and unselfishness. Although Wilson declined an invitation to join the group, he conceded the possible existence of a higher power.


After re-entering treatment at Towns Hospital in December 1934, Wilson experienced a spiritual awakening that caused him to stop drinking. Shortly after, in 1935, he co-founded AA with Dr. Bob Smith, a physician in Akron, Ohio, who struggled with alcoholism. In 1939, Wilson published The Big Book, which describes how to recover from alcohol addiction.


AA uses the 12-Step formula outlined in The Big Book to ask members to take responsibility for improving their behaviours and assisting others in their recovery. Since the development of AA, many other self-help groups have incorporated the 12 Steps into their program.


Today, support groups use these principles to address addictions to cocaine, crystal meth, heroin, marijuana and prescription painkillers.


Are 12-Step Programs Religious?


Twelve-step groups often reference a higher power, but these programs are not just for religious people. In fact, two large multi-site studies found that nonreligious participants who commit to 12-Step programs seem to benefit from these groups as much as religious individuals do.


Some support groups may interpret a higher power to be something other than a religious deity. For example, AA Agnostica, a secular self-help organization for agnostics and atheists with drinking problems, offers alternative steps that omit references to a higher power.


“There are references to God in 12-Step programs, but they are not religious programs,” members of AA say, , “A higher power can be anything. A higher power is something bigger than you.”


Although the 12-Step philosophy involves spirituality, many support groups are compatible with evidence-based treatment approaches such as psychotherapy. In fact, many mental health experts encourage people with a substance use disorder to join a 12-Step program.


What Are the Most Popular 12-Step Programs?


AA is the most popular 12-Step program in the world. The resource for alcoholics comprises nearly 1.3 million members in the United States, more than 85,000 members in Canada and more than 705,000 members in other countries.


Researchers estimate that as many as 10 percent of people in the United States have attended an AA meeting.


Narcotics Anonymous, also known as NA, helps members focus on recovering from various substances, including alcohol. As of April 2016, NA hosts more than 67,000 meetings every week in 139 countries. According to demographic surveys, the average age of an NA member is 48, and 74 percent of members are Caucasian.


A 2015 NA survey also found that 79 percent of U.S. members regularly used alcohol, the most widely used substance. The next most frequently used drugs were cannabis, cocaine, stimulants, opiates, opioids and crack.


Should I recommend 12-Step Programs as an addiction counsellor?


If your client lists abstinence from all mind-and-mood altering substances as a treatment goal, you should consider getting them in touch with a 12-Step fellowship in their area.

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