12-Step Programs: 12 Steps to Recovery from Addiction
What is the 12-Step Program?
The 12-Step program, first developed and used by Alcoholics Anonymous, is a structured approach designed to help individuals overcome addictions and compulsions. The basic premise of this model is that people can help one another achieve and maintain abstinence from substances, 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.
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 in the program. Many addiction treatment programs offer alternatives to the 12-Step methodology for those who prefer a more secular foundation for treatment.
12-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 (SAMHSA) in its National Survey of Substance Use from 2023, 12-Step models are utilized by nearly 50% of treatment centers nationwide.1
What are the 12 Steps of AA?
The 12 Steps, as outlined in the original Big Book and presented by Alcoholics Anonymous, include the following:2
- We admitted we were powerless over alcohol—that our lives had become unmanageable.
- Came to believe that a Power, greater than ourselves, could restore us to sanity.
- Made a decision to turn our will and our lives over to the care of God as we understood Him.
- Made a searching and fearless moral inventory of ourselves.
- Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- Were entirely ready to have God remove all these defects of character.
- Humbly asked Him to remove our shortcomings.
- Made a list of all the persons we had harmed, and became willing to make amends to them all.
- Made direct amends to such people wherever possible, except when to do so would injure them or others.
- Continued to take personal inventory, and when we were wrong, promptly admitted it.
- Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
- Having had a spiritual awakening as a result of these steps, we tried to carry this message to those with an alcohol use disorder and practice these principles in all our affairs.
The History of the 12 Steps of AA
The Creation of the 12 Steps
- Wilson wrote his program in what has become known as the Big Book.
- The steps were developed through synthesizing concepts from a few other teachings he had encountered, including a 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 with the same addiction struggles.3
The Role of the Big Book
- 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 mutual-help and self-help programs designed to help drive behavioral change.
Programs Inspired by AA
Although it began with Alcoholics Anonymous (AA), the 12-Step model isn’t just for alcohol. Over the years, it has been adapted over the years to help people facing all kinds of challenges—from drug use and gambling to food-related struggles and codependency. Groups like Narcotics Anonymous (NA) and Cocaine Anonymous (CA) are just a few examples of how the model has expanded. What ties them all together is a shared foundation: peer-led recovery, connection through shared experience, and a structured path forward.
The 12-Step Practice
The basic premise of the 12-Step model is that people can help one another achieve and maintain abstinence from the substances to which they are addicted. They can do this through meetings in which they share their experiences and support each other in the ongoing effort of maintaining abstinence.
The 12-Step philosophy emphasizes certain fundamentals, including:4
- The importance of accepting addiction as a disease that can be stopped but never eliminated
- Enhancing individual maturity and spiritual growth.
- Minimizing self-centeredness
- Providing help to others who are addicted by sharing recovery stories in group meetings, sponsoring new members, etc
How Long Does the 12–Step Program Take?
The average length of time it takes for someone to work through the 12-Step program varies. 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.
For many people, 12-Step meetings become a key part of their long-term recovery or aftercare plan. Some continue participating in meetings for years—or even a lifetime—as a way to maintain connection, structure, and support in recovery.
Overall, the focus of working through the 12 steps in any 12-Step program shouldn’t be on the amount of time it takes, but on how deeply you engage with the step work and apply it to improve your daily life.
Does AA Work?
Alcoholics Anonymous and other 12-Step programs regularly conduct surveys to assess demographic characteristics and to determine the length of their members’ abstinence.
These studies indicate that participation in AA, NA, or CA is associated with a greater likelihood of abstinence, improved psychosocial functioning, and greater levels of self-efficacy.4
Research also shows that beginning 12-Step participation while in treatment is associated with better outcomes. Additionally, consistent, early, and frequent attendance/involvement is associated with better substance use outcomes. That said, AA success rates may vary between individuals.
The Importance of Active Participation
Active engagement is preferred over merely attending meetings. This more involved participation can help with relapse prevention.4
Examples of active engagement include:
- Doing service at meetings
- Reading 12-Step literature
- Doing ‘step work’
- Getting a sponsor
12-Step Programs for Co-Occurring Disorders
There is some evidence that individuals with co-occurring substance use and mental health disorders can benefit from 12-Step involvement. However, specialized support groups, such as Dual Recovery Anonymous, may be more beneficial for individuals with co-occurring disorders.4
When Do I Need a 12-Step AA Program?
You may need a 12-Step program if you suffer from a substance use disorder or struggle with substance use of any kind. If you’re unsure whether a 12-Step program is right for you, talk to your therapist, doctor, or addiction care specialist, who can provide tailored insight for you and your needs.
That being said, there is never harm in attending a 12-Step meeting. However, it’s important to note that every meeting is different, and some may better align with your personality and goals than others. You may need to try several before finding the one or ones that feel like the right fit.
Does American Addiction Centers Offer 12-Step AA Programs?
Yes, all American Addiction Centers (AAC) rehab locations offer 12-Step programming as a therapy modality for addiction treatment. To learn more about AAC’s various treatment centers throughout the country, call .
Variations of the 12 Steps of AA
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 more. Many groups, like Narcotics Anonymous, use the steps exactly as they were conceived by AA. Others have modified the steps to fit the needs and cultures of the individuals in it. For example, a group specifically for Native American/Alaska Native people combined the 12 Steps with teachings of the Native American/Alaska Native Medicine Wheel, Cycle of Life, and the Four Laws of Change to create a culturally-appropriate 12-Step program for Native American/Alaska Native men and women.
The 12 Steps with Other Treatments
Many treatment centers, including AAC, incorporate 12-Step facilitation therapy alongside other evidence-based approaches in addiction treatment. As an active engagement strategy, 12-Step facilitation therapy is designed to increase the likelihood that individuals participating in it during formal treatment continue in aftercare to help sustain recovery.5
Mutual-help groups, such as 12-Step programs, provide an extra layer of community support that helps people stay connected as they move from formal treatment back into everyday life—and continue in recovery long-term.5
Alternatives to the 12-Step Model
Some people don’t connect with the 12-Step model because they’re uncomfortable with the idea that recovery means admitting they can’t control their addiction on their own. Instead, they may prefer approaches that focus on personal choice and control, supported by evidence that people can take an active role in managing their own recovery.
Programs based on this active control model include groups like SMART Recovery. SMART Recovery and similar groups use a peer-sharing model but don’t rely on the idea of surrender. Instead, they promote empowerment of the individual to exercise control over the treatment of and recovery from addiction.
Getting Help for Alcohol Addiction
As previously mentioned, 12-Step models are often utilized as one component in an individual’s customized treatment plan. Treatment takes place in a variety of settings, and the one that’s right for you depends on your individual needs.
Residential Rehabilitation
Residential treatment programs, sometimes referred to as inpatient treatment programs, provide the highest level of rehab services for individuals suffering from alcohol or drug addiction. Residential programs are offered at professional rehab facilities, providing a safe, substance-free environment free from triggers where individuals can focus completely on their recovery. Programs often start with medically managed detox and require individuals to live on-site for the duration of the program. Residential rehab may include medical care, mental health services, administration of medications, group and individual counseling, behavioral therapy, experiential workshops, mutual-help groups, and wellness and fitness activities.
Outpatient Rehabilitation
Outpatient alcohol treatment programs vary in intensity and hours but allow individuals to live at home or in a sober living environment and attend treatment sessions at the facility. This also allows them to continue to fulfill responsibilities such as work, school, and family obligations. Programs can last for several months and may include individual and family counseling, behavioral therapy, and mutual-help groups.
Faith-Based Rehabilitation Programs
Many faith-based organizations offer alcohol addiction programs, some of which are low-cost or free. These programs typically do not require participants to subscribe to a specific religious belief. One of the larger organizations providing spiritual-based residential rehabilitation for individuals struggling with drug or alcohol addiction is the Salvation Army.6 These programs provide a safe and sober living environment, food, holistic work therapy, leisure time activities, group and individual counseling, spiritual direction, and important life-skills development.
Government-Based Programs
Several federal and state-funded programs can help individuals access drug and alcohol rehab services. These options vary based on eligibility, location, and facility availability.
Medicare and Medicaid
Medicare and Medicaid are federal and state-funded health insurance programs that offer alcohol and drug treatment assistance to those in need. Eligibility requirements vary by state, and some rehab facilities may not accept Medicaid or Medicare as a form of payment, but many do.
State-Funded Rehab Programs
State-funded alcohol addiction treatment programs are funded by tax dollars and vary by state. Some may only offer short-term rehab (consisting primarily of detoxification), while others may provide long-term treatment that includes residential care. Treatment waiting lists can be weeks or months long, and enrollment in most state-funded treatment services typically requires proof of residence and income.
Veterans Affairs (VA) Rehab Programs
The Department of Veteran’s Affairs (VA) provides eligible Veterans the opportunity to participate in rehabilitation programs that are offered at VA medical centers and clinics. These programs are free and include various forms of treatment such as detoxification, rehabilitation, and psychiatric care.7
The Path to Recovery from Addiction
Evidence shows that research-based treatment programs that are customized to an individual’s needs are the most effective. Contact your primary care physician, mental healthcare professional, or addiction care specialist to find the treatment modality and level of care best suited for you and your needs. Call AAC at (866) 352-7901 to speak to a knowledgeable and compassionate admissions navigator who will listen to you, answer your questions, explain your treatment options, and help you begin your path to recovery.
