Twelve-Step groups emphasize abstinence and have 12 core developmental “steps” to recovering from dependence.
Other elements of 12-Step groups include
- taking responsibility for recovery,
- sharing personal narratives,
- helping others, and
- recognizing and incorporating into daily life the existence of a higher power.
Participants often maintain a close relationship with a sponsor, an experienced member with long-term abstinence, and lifetime participation is expected.
Alcoholics Anonymous is the oldest and best known 12-Step mutual support group. There are more than 100,000 AA groups worldwide and nearly 2 million members.
The AA model has been adapted for people with dependence on drugs and for their family members. Some groups, such as Narcotics Anonymous (NA) and Chemically Dependent Anonymous, focus on any type of drug use. Other groups, such as Cocaine Anonymous and Crystal Meth Anonymous, focus on abuse of specific drugs. Groups for persons with co-occurring substance use and mental disorders also exist (e.g., Double Trouble in Recovery; Dual Recovery Anonymous).
Other 12-Step groups—Families Anonymous, Al-Anon/Alateen, Nar-Anon, and Co-Anon—provide support to significant others, families, and friends of persons with substance use disorders.
Twelve-Step meetings are held in locations such as churches and public buildings. Metropolitan areas usually have specialized groups, based on such member characteristics as gender, length of time in recovery, age, sexual orientation, profession, ethnicity, and language spoken. Attendance and membership are free, although people usually give a small donation when they attend a meeting.
Meetings can be “open” or “closed”?that is, anyone can attend an open meeting, but attendance at closed meetings is limited to people who want to stop drinking or using drugs.
Although meeting formats vary somewhat, most 12-Step meetings have an opening and a closing that are the same at every meeting, such as a 12-Step reading or prayer.
The main part of the meeting usually consists of
- members sharing their stories of dependence, its effect on their lives, and what they are doing to stay abstinent,
- the study of a particular step or other doctrine of the group, or
- a guest speaker.
Twelve-Step groups are not necessarily for everyone. Some people are uncomfortable with the spiritual emphasis and prefer a more secular approach. Others may not agree with the 12-Step philosophy that addiction is a chronic disease, thinking that this belief can be a self-fulfilling prophesy that weakens the ability to remain abstinent. Still others may prefer gender- specific groups.
Mutual support groups that are not based on the 12-Step model typically do not advocate sponsors or lifetime membership. These support groups offer an alternative to traditional 12-Step groups, but the availability of in-person meetings is more limited than that of 12-Step programs (see individual group descriptions below). However, many offer literature, discussion boards, and online meetings.
For People Who Have a Substance Use Disorder
Seek treatment. The first step to recovery is to decide to seek treatment. It’s hard for people to recognize or admit they have a problem, even when they are putting their lives – or the lives of others – at risk. It doesn’t help that the brain’s decision-making center is impaired when under the influence of drugs or alcohol. Treatment may mean medications, behavioral counseling, or a combination of the two.
