Support groups in the 12-step tradition are an integral part of America’s conversation about addiction. Such groups give people the chance to talk about their addictions and seek advice from others, all in a setting that condemns harshly judging and shaming others.
Twelve-step programs operate on a nonprofessional basis and the quality of one group may vary significantly from the quality of another group. While these groups are helpful for many people, effective addiction treatment must meet the needs of an individual. Not every person benefits from these groups, which emphasize powerlessness and spirituality.
History of 12-Step Programs
Alcoholics Anonymous (AA) was the first 12-step organization, a grassroots group dedicated to helping its members get free and stay free from alcohol. Though it is not a rehabilitation program, its principles often are part of drug treatment programs with a comprehensive, psychological approach to recovery.
Because 12-step meetings are available around the world, taking part in the program after addiction treatment makes it easier for many to transition into sober life at home. Meetings offer familiarity and the 12 steps assist many people with their goals of staying sober.
The 12 Steps
The 12 Steps provide structure to those who participate in programs like AA and Narcotics Anonymous. Participants are encouraged to work the steps with the assistance of a sponsor and then help others as they apply the steps to their recovery. The following steps have been part of AA since at least the 1950s:
Step 1: Admitted we were powerless over our addiction – that our lives had become unmanageable
Step 2: Came to believe that a Power greater than ourselves could restore us to sanity
Step 3: Made a decision to turn our will and our lives over to the care of God as we understood God
Step 4: Made a searching and fearless moral inventory of ourselves
Step 5: Admitted to God, to ourselves and to another human being the exact nature of our wrongs
Step 6: Were entirely ready to have God remove all these defects of character
Step 7: Humbly asked God to remove our shortcomings
Step 8: Made a list of all persons we had harmed, and became willing to make amends to them all
Step 9: Made direct amends to such people wherever possible, except when to do so would injure them or others
Step 10: Continued to take personal inventory and when we were wrong promptly admitted it
Step 11: Sought through prayer and meditation to improve our conscious contact with God as we understood God, praying only for knowledge of God’s will for us and the power to carry that out
Step 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
While many people appreciate the 12-steps and a spiritual approach to recovery, the steps are controversial for many reasons. They do not have the same meaning for every person. Some people don’t find success with AA or similar programs and they may feel like failures. Since the program is so widely known, they sometimes don’t know there are other ways to treat and manage addiction.
How 12-step Programs Fit Into Treatment?
Some addiction programs incorporate 12-step principles into their treatment plans, while others recommend patients attend support group meetings after leaving the facility. Research shows people need some type of long-term support to be successful in recovery. Regular contact with people who understand addiction, such as the members of a 12-step group, gives many people the support they need to manage cravings.5
A number of characteristics define the person who successfully incorporates the 12-step process into their overall recovery. Some of these include:
Independence. Because 12-step programsare made up of addicts with no assistance beyond what’s offered in the literature or personal experiences shared in meetings, it is important for attendees to define their success in recovery without being overwhelmed by the judgment or pressure of others.
Ability to maintain boundaries. Addicts often relapse, especially when they have no other support in recovery than the 12-step program. Patients may bond with one or more 12-step participants who give in to temptation to drink or get high.It is therefore important attendees protect against relapse by setting boundaries and sticking to them.
Dedication to recovery. Some addiction treatment facilities encourage patients to attend 12-step meetings to build positive peer relationships and enjoy the spiritual benefits of the program. However, they also must participate in other aspects of recovery to make true progress. Outside of the 12-step group, participants should meet regularly with a personal therapist, take part in healthy hobbies and holistic therapies and address any obstacles to recovery.
Persistence. Different 12-step groups have varying characteristics based on where they are held, their subject matter focus, their structure and the people who attend. It takes time to find meetings that truly work for an individual. Additionally, even when the meetings become boring or tedious, they do serve a purpose and participants who persevere through these times report a high benefit from taking part.
When someone understands the purpose of 12-step groups and the importance of making sure the group meets her individual needs, they are beneficial. Not every group adequately addresses a person’s unique characteristics, such as a co-occurring mental health condition, cultural need or physical disability.
Types of 12-step Programs
Various 12-step programs offer more specialized ways to discuss addiction. Patients leaving a treatment facility can choose from a range of programs, including the following:
Alcoholics Anonymous. The first 12-step program, AA remains the most common among 12-step programs around the world. It’s easy to find meetings, and the literature is extensive.
Narcotics Anonymous. Focused on helping individuals with a primary addiction to drugs besides alcohol, it supports people who struggle with intense cravings, extensive legal issues related to their past addiction and other issues specific to hard drugs of abuse.
Sex Addicts Anonymous. Sex and love addictions commonly occur along with substance abuse. Some people abuse substances for the purpose of enhancing sexual experiences. Others attempt to make love and romance their drug of choice after they enter sobriety. SAA supports these issues.
Gambler’s Anonymous. Drinking, drug use and gambling often go hand in hand. Many patients who struggle with both disorders find it difficult to avoid relapse from one if they slip in fighting the other. Incorporating 12-step treatment for gambling when it is a problem for a patient is helpful in overcoming addiction as well.
Overeaters Anonymous. It’s not unusual for patients to gain weight in early recovery. Many don’t eat well during active addiction. Some patients start abusing stimulant drugs solely for the weight loss effect. Getting support from others who struggle with binge eating is helpful, especially when food and weight are trigger issues for relapse.
Codependents Anonymous. Healthy relationships are complicated for people in recovery because for years they lived in exceedingly unhealthy relationships. CoDA meetings can help people learn to get needs met while maintaining boundaries.
Will 12-step Treatment Work?
Twelve-step meetings offered in the community provide a lower level of support than 12-step meetings incorporated into a residential treatment program. Even if a patient at an inpatient rehab takes part in 12-step meetings in the community, participants have the benefit of additional support from treatment specialists, who assist them with addiction-related issues, working the steps and getting the most out of meetings.
In most cases, however, 12-step meetings integrated into treatment programs occur on site, which means they are uniquely different, because a therapist often guides the meetings. This offers participants a higher level of support, guidance and accountability, all of which improves their progress in treatment.
No matter what the context, not everyone feels comfortable in 12-step meetings. Many types of personalities are present and on occasion, this leads to conflict or discomfort to varying degrees among participants. Fortunately, there are always other meetings to attend or styles of meetings to choose. Additionally, many addiction experts counsel newcomers to “take what they need and leave the rest,” giving them permission to enjoy the benefits while avoiding anything that would detract from their recovery. Treatment programs that incorporate 12-step meetings, almost always offer the option to replace them with other forms of therapy if they are not helpful.
The 12-step structure and philosophy can augment a well-rounded addiction treatment program and help patients to build a strong community made up of peers who understand the struggles that come with dedication to abstinence.
Call us at The Canyon now to speak with someone about the wide range of treatment services that we provide to our patients. We’re here to help your family begin the healing process today.
 Mendola, Annette & Gibson, Richard L. (2016). Addiction, 12-step Programs, and Evidentiary Standards for Ethically and Clinically Sound Treatment Recommendations: What Should Clinicians Do? American Medical Association Journal of Ethics. Retrieved Jan. 16, 2017 from http://journalofethics.ama-assn.org/2016/06/sect1-1606.html.
 Miller, Michael. (2015). The Relevance of Twelve-Step Recovery in 21st Century Addiction Medicine. American Society of Addiction Medicine. Retrieved Jan. 16, 2017 from http://www.asam.org/magazine/read/article/2015/02/13/the-relevance-of-twelve-step-recovery-in-21st-century-addiction-medicine.
 Alcoholics Anonymous Publishing. (2016). The Twelve Steps of Alcoholics Anonymous. Service Material from the General Service Office. Retrieved Jan. 16, 2017 from http://www.aa.org/assets/en_US/smf-121_en.pdf.
 NPR Staff. (2014). With Sobering Science, Doctor Debunks 12-step Recovery. “All Things Considered.” Retrieved Jan. 16, 2017 from http://www.npr.org/2014/03/23/291405829/with-sobering-science-doctor-debunks-12-step-recovery.
 Center for Substance Abuse Treatment. Comprehensive Case Management for Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 27. Retrieved Jan. 16, 2017 from http://store.samhsa.gov/shin/content//SMA15-4215/SMA15-4215.pdf.