12 Step Programs: 12 Steps to Recovery for Addiction
12-step programs are powerful peer support groups that help people recover from substance use disorders, behavioral addictions, and sometimes other co-occurring mental health conditions. 12-step programs also help people achieve and maintain abstinence from substances. Though 12-step programs aren’t the right tool for everyone, they do tend to help those struggling with substance abuse issues acquire new coping skills, feel the support and acceptance of a loving community, transition into sobriety, and foster long-term recovery from addiction.
What is the 12-Step Program?
The 12-Step program, first developed and used by Alcoholics Anonymous, is a 12-step plan in order to overcome addictions and compulsions. The basic premise of this model is that people can help one another achieve and maintain abstinence from substances of abuse, but that healing cannot come about unless people with addictions surrender to a higher power. This higher power doesn’t need to be a traditional Christian version of God – it can be as simple as the community of the 12-step meetings, the universe, or a different version of a higher power fit for your type of spirituality.
The 12-Step movement can be a powerful and helpful force for many people, but some people struggle with what they interpret as a strong religious element of the program. Many addiction treatment programs offer alternatives to 12-Step methodology for those who prefer a more secular foundation for treatment.
Twelve-Step programs remain a commonly recommended and used treatment modality for various types of addiction. According to the Substance Abuse and Mental Health Services Administration (SAMSHA) in its National Survey of Substance Abuse Treatment Services from 2013, 12-Step models are used, at least occasionally, by approximately 74 percent of treatment centers.1
AAC is in-network with many insurance companies, and your addiction treatment can be free depending on your policy.
What are The 12 Steps?
The 12 Steps, as outlined in the original Big Book and presented by AA are:2
- Admitting powerlessness over the addiction
- Believing that a higher power (in whatever form) can help
- Deciding to turn control over to the higher power
- Taking a personal inventory
- Admitting to the higher power, oneself, and another person the wrongs done
- Being ready to have the higher power correct any shortcomings in one’s character
- Asking the higher power to remove those shortcomings
- Making a list of wrongs done to others and being willing to make amends for those wrongs
- Contacting those who have been hurt, unless doing so would harm the person
- Continuing to take personal inventory and admitting when one is wrong
- Seeking enlightenment and connection with the higher power via prayer and meditation
- Carrying the message of the 12 Steps to others in need
The History of the 12-Step Program
Alcoholics Anonymous (AA) originated the idea for the 12-Step model in 1938, when founder Bill Wilson wrote out the ideas that had been developing through his experience with and vision of alcoholism. He wrote about the positive effects experienced when people struggling with alcoholism shared their stories with one another.
Wilson wrote his program in what has become known as the Big Book. As explained in historical information from the AA site itself, the steps were developed through synthesizing concepts from a few other teachings he had encountered, including a six-step program espoused by an organization called the Oxford Group.3
In their original form, the 12 Steps came from a spiritual, Christian inspiration that sought help from a greater power as well as from peers suffering from the same addiction struggles.3
The Big Book was originally written as a guide for people who couldn’t attend AA fellowship meetings, but it soon became a model for the program in general. It has since been adopted as a model for a wide range of addiction peer-support and self-help programs designed to help drive behavioral change. In addition to the original Alcoholics Anonymous (AA) group, various offshoots now exist, such as Narcotics Anonymous (NA), Heroin Anonymous (HA), and Gamblers Anonymous (GA).3
Given the current isolation in the country due to COVID-19, AAC has launched Virtual Support Meetings to help you stay connected. We also offer a private Facebook Group for those who need more virtual peer support; please join to be kept up to date on future meetings and to connect with those in recovery.
The 12-Step Practice
How Long Do 12-Step Programs Take?
The average length of time it takes for someone to work through the 12 steps once can vary. Many 12-step sponsors encourage sponsees and newcomers in AA and other 12-step programs to attend 90 meetings in 90 days, or at least one meeting a day for three months. Overall, the focus of working through the 12 steps in any 12-step program shouldn’t be on the amount of time it takes to get through the steps once, but on how thoroughly you are doing your step work and how you are using the steps to positively impact your everyday life.
How Effective is the 12-Step Program?
Before discussing the efficacy of 12-step programs, it’s important to remember that efficacy is relative, meaning that how effective something is depends on your goals. If your goal is abstinence from substance abuse, 12-step programs are extremely promising modalities.7
12-step members may use the phrase “it works if you work it”, meaning that if you invest yourself fully in working a thorough program and completing the 12 steps with your sponsor, the program will be effective for you. However, studies and efficacy rates vary.7
In people who are non-comorbid, meaning that they suffer from a substance use disorder but do not suffer from any other additional mental health condition, 12-step programs prove highly effective in improving the likelihood of long-term abstinence. For those who suffer from substance use disorders and co-occurring mental health conditions, 12-step programs were also found to be extremely effective in one New York city study.7
Other studies mention that many people drop out of 12-step programs – 40% in the first year, to be exact.8
Overall, 12-step programs are still one of the most effective and best modalities for fostering long-term abstinence from substance abuse and facilitating the successful transition for people who struggled with SUD into sobriety. They prioritize and work to manifest values of faith, community, abstinence, acceptance, and ongoing self-improvement in their members.
When Do I Need a 12-Step Program?
You may need a 12-step program if you suffer from an SUD or qualify for having substance abuse issues of any kind. If you’re wondering whether a 12-step program is right for you, discuss this with your therapist, doctor, or other medical professional. They might have better insight as to whether a 12-step program could help you. At the very least, you can try to attend a free 12-step meeting on your own to see if it could be the right fit. Make sure not to make your decision off of one meeting, however, because every meeting is a bit different and some might fit your personality and goals better than others.
Does American Addiction Centers Offer 12 Step Programs?
Yes, most American Addiction Centers rehab locations integrate some 12-step ideology into their program model in the form of optional 12-step groups, because this does seem to be a helpful and effective supplemental modality for many clients. To learn more about our treatment centers that offer 12-step programs and meetings, call .
Find Rehabs Near Me With 12 Step Programs
American Addiction Centers has rehab facilities scattered across the United States. Many offer 12 step programs within the addiction curriculum. Explore our rehab centers below.
Variations of the 12 Steps
Since its origin with AA, the 12-Step model has been adopted and altered by many groups to fit other programs – for addiction treatment and otherwise. Many groups, like Narcotics Anonymous, use the steps exactly as they were conceived by AA. Others have modified the steps to fit their own needs and cultures. For example, a Native American group has combined the 12 Steps with the Native American concept of the Medicine Wheel to create a program designed specifically to help indigenous Americans who struggle with alcoholism and addiction, the Medicine Wheel and 12 Steps program. Others have come up with similar ideas to integrate the basic ideas of the 12 Steps into a cultural framework that makes sense for members of that culture.
Another variation comes from the fact that some people are uncomfortable with the specific, religious aspects of the 12-Step program. As stated above, and as evident by the steps themselves, the 12-Step model originated from a Christian point of view. Those who are not Christian have modified the steps to refer to their specific religious or spiritual practice as a way to connect more with the structure of the 12-Step program. In addition, a number of non-religious 12-Step groups have modified the steps to fit a secular model that can help those who are agnostic or atheist practice the program without feeling forced to adhere to a religion they don’t believe in.
The 12 Steps with Other Treatments
According to the National Institute on Drug Abuse’s Principles of Drug Addiction Treatment: A Research-Based Guide, short-term residential programs developed the idea of using a modified 12-Step approach to provide a shorter stay in treatment that included follow-up through a 12-Step fellowship.9 This is seen as a way to provide the important post-treatment structure that helps people maintain long-term recovery. Other programs have also incorporated the 12 Steps, both by encouraging clients to attend 12-Step fellowship meetings, and by incorporating 12-Step ideas into their practices.
While 12-Step facilitation programs don’t necessarily follow the steps, they promote the use of a 12-Step methodology, in the hope that clients will move to a 12-Step program after rehab to help maintain sobriety. In addition, certain treatment centers base their model for service around some of the ideas promoted through the 12-Step program. These centers can offer research-based services and promote a more scientific understanding of addiction treatment, but they incorporate some of the spiritual, psychological, and practical practices that the 12-Step program promotes. This results in an encompassing model of care designed to support clients through rehab and to give tools that they can use after treatment to maintain their recovery for the long-term.
Alternatives to the 12-Step Model
Some people don’t like or are not interested in the 12-Step model, even with the variations above or through organizations that facilitate the 12-Step model. Some people don’t like basing their recovery on the idea that they cannot control their addiction, when there is evidence that there are ways of practicing internal control over the recovery process.
Some of the programs based on this active control model include groups like SMART Recovery and Moderation Management. These groups use a similar peer-sharing model, but they don’t rely on the idea of surrender. They instead promote the empowerment of the individual to exercise control over the treatment of and recovery from addiction
Other Alcohol Addiction Programs
There are many program alternatives to the 12-step treatment offered by peer support groups such as Alcoholics Anonymous.
Residential treatment programs provide the highest level of rehab services for individuals suffering from alcohol addiction. Residential programs are offered at professional rehab facilities, providing an alcohol-free environment that eliminates any potential triggers and temptations to drink. Programs usually start with medical detox and require individuals to remain on-site for the duration of the program, which is typically 30, 60, or 90 days, depending on the specific needs of the individual. Residential rehab may include medical care, mental health services, administration of medications, group and individual counseling, behavioral therapy, experiential workshops, wellness and fitness activities, and training on proper nutrition and health.
Outpatient alcohol treatment programs are typically held at a local treatment center during the night or in the early morning. This allows individuals to live at home and maintain a normal daily routine, thereby limiting any interference with daily responsibilities such as work, school, and family obligations. Programs can last for several months and may include medication-assisted detox, individual and family counseling, behavioral therapy, and support groups.
Faith-Based Rehabilitation Programs
Many faith-based organizations offer alcohol addiction programs that are often free of charge, and many do not require participants to subscribe to any particular religious belief. One of the larger organizations is the Salvation Army, which offers spirituality-based residential alcohol rehabilitation programs at any of their 119 Adult Rehabilitation Centers located throughout the United States.10 These free programs provide a clean and healthy living environment, food, holistic work therapy, leisure time activities, group and individual counseling, spiritual direction, and important life-skills development.
Medicare and Medicaid are federal and state-funded health insurance programs that offer alcohol treatment assistance to those in need. Each state typically determines their own eligibility criteria and the amount of money disbursed. It is important to note that some rehab facilities may not accept Medicaid or Medicare as a form of payment, so it is best to check with specific programs prior to starting any treatment.
State-funded alcohol addiction treatment programs are funded by tax dollars and vary from state to state, with some offering only short-term rehab (consisting primarily of detoxification) and others offering long-term treatment that includes residential care. Treatment waiting lists can take a couple of weeks up to several months, and enrollment in most state-funded treatment services will usually require proof of residence and income.
The Department of Veteran’s Affairs (VA) provides eligible veterans the opportunity to participate in alcohol dependence rehabilitation programs that are offered at VA medical centers and clinics. These programs are free of charge and include various forms of treatment such as detoxification, rehabilitation, and psychiatric care.11
The Path to Recovery
Most experts believe that a research-based, residential treatment program that is customized to an individual’s needs is the most effective method to achieve and maintain recovery. Whether this program includes 12-Step aspects, is based on the 12-Step concept, or is an alternative to this original model of addiction treatment, it’s important that care is customized to the individual. Working with an addiction treatment professional is a good way to find the treatment modality that is appropriate for each person, leading to the best path to recovery.
List of 12 Step Groups
The following are just some of the various 12-step groups:
- Alcoholics Anonymous (AA)
- Adult Children of Alcoholics (ACA)
- Cocaine Anonymous (CA)
- Crystal Meth Anonymous (CMA)
- Heroin Anonymous (HA)
- Marijuana Anonymous (MA)
- Narcotics Anonymous (NA)
- Dual Diagnosis Anonymous (DDA)
- SAHMSA. (2013). National Survey of Substance Abuse Treatment Services.
- Alcoholics Anonymous. (2021). The 12 steps.
- Alcoholics Anonymous. (2022). A.A. Timeline.
- Breanna Joy McGaffin, Frank P. Deane, Peter J. Kelly, & Joseph Ciarrochi. (2014). Flourishing, languishing and moderate mental health: Prevalence and change in mental health during recovery from drug and alcohol problems.
- Alcoholic Anonymous World Services, Inc. (1976). Alcoholics Anonymous.
- Whitmont, Edward C. (1969). The Symbolic Quest. Princeton, N.J.: Princeton University Press.
- Laudet, A. B., Magura, S., Cleland, C. M., Vogel, H. S., Knight, E. L., & Rosenblum, A. (2004). The effect of 12-step based fellowship participation on abstinence among dually diagnosed persons: a two-year longitudinal study. Journal of psychoactive drugs, 36(2), 207–216.
- Scientific American. (2011). Does Alcoholics Anonymous Work?
- National Institute on Drug Abuse (NIDA). (2018). Types of Treatment Programs.
- The Salvation Army. (2019). Combat Addiction.
- U.S. Department of Veteran’s Affairs. (2019). Veterans Alcohol and Drug Dependence Rehabilitation Programs.