12 Step Programs
A Comprehensive Guide
For many decades, 12 step programs have been helping people in their recovery journeys. Individuals with drug and alcohol use disorders need an integrated treatment approach, and 12 step programs are a vital part. People with loved ones struggling with substance abuse can also find support and hope with specialized 12 step programs.
Steps Towards Successful Recovery
Accept the presence of an alcohol or drug problem, and that it’s time for a change.
The first step for change is to realize that there is something that needs changing. It could be that you see how your drug or alcohol use is affecting those around you. Or maybe your loved ones have approached you with their concerns. No matter how you come to your decision, the important thing is that you decided it was time to make a change and stop abusing substances.
Decide what treatment program is the best fit: residential, outpatient, or a 12 step program.
Once you have made the decision to change, the next choice is deciding how to reach your goals. Determining the best type of program you’ll need to get started with depend upon the severity, length, and substances of abuse. There are three main choices:
Residential: Inpatient rehab takes place in a treatment facility where you live during treatment in the program. Stays can range from 30 days up to 90 days or longer if needed. Inpatient drug or alcohol rehab provides a high level of structure and supervision around the clock. It also removes the people, places, and things that triggered substance use while sobriety is its most vulnerable.
Outpatient: Outpatient treatment can take place in several different settings: individual and group meetings in a treatment facility, private counseling sessions, and sober living homes. Some outpatient treatment services also include higher levels of care including intensive outpatient treatment (IOP) and partial hospitalization programs (PHP).
12 step Programs: Many inpatient and outpatient treatment programs include 12 step groups. Standalone fellowships, like AA and NA, offer free drug and alcohol treatment via 12 step programs. AA and NA have a vast network of meetings in the U.S. that meet seven days a week. See the section below entitled “Finding an AA or NA Meeting” for more information.
Gather support from family, friends, and people in recovery.
The more support you have during your recovery journey, the better it will be. Ask those close to you for their support. Explain why you are entering rehab and what treatment program you’ve chosen. Trying to hide or isolate yourself from friends and family during recovery can make things more difficult. Isolation also cuts off valuable support resources from others that can make recovery easier.
Maintain abstinence by controlling triggers and cravings.
It’s important to manage sobriety by controlling the triggers and cravings that could lead to a relapse. First, avoid the people, places, and things that could offer temptations to use. Second, the develop the tools to manage stress so that there is a lower temptation to use when you feel life’s pressures.
Build a renewed life by finding new hobbies, volunteering, and working on new goals in your life.
Sobriety is a new lease on life. Re-engage with the activities and hobbies that you used to like to do, or volunteer to help others. Service to others can give you renewed meaning and purpose in your life. Set new goals for yourself and develop a plan to meet them. Working towards new goals is a source of hope and inspiration.
Don’t let a relapse discourage you. Get your recovery back on track with a plan.
If you do have a relapse, don’t be discouraged. Giving up will undo all the great progress you’ve made so far. Immediately reach out for help to a loved one or a counselor. Most aftercare plans have provisions for relapse, so if yours does, refer to it. You can get back on the road to recovery.
Take part in an aftercare program.
Closely follow your aftercare plan to help avoid a setback. An integral part of aftercare can be free-of-charge 12 step meetings at AA and NA.
Alcohol Abuse by the Numbers
Alcohol use disorder (AUD) is a serious problem in our nation. The 2017 National Survey on Drug Use and Health reported that:1
More than 14 million adult Americans ages 18 and older had AUD. Of these, 9 million were men, 5.1 million were women. And only 6.5% of American adults with AUD in the past year received specialized treatment.
About 443,000 American youths ages 12-17 had AUD. Of these, 184,000 were males, 259,000 were females. Only a little more than 5% of youths with AUD in the past year received treatment.
About 88,000 people die each year from alcohol-related causes. This makes alcohol the third leading preventable cause of death in the USA. In 2014, alcohol-impaired driving deaths accounted for a third (31%) of all driving-related fatalities.
What are the 12 Steps of AA?
In 1935, Bill W. (Bill Wilson) and his friend Dr. Robert Holbrook Smith (Dr. Bob) founded the first AA fellowship. In 1939, they published the book Alcoholics Anonymous. Also known as the “Big Book,” it is the cornerstone text that has helped countless people recover from alcohol addiction.2 The original 12 Steps were included in this text.
The Original 12 Steps Were...
Admit that you are powerless over alcohol and that life has become unmanageable.
Believe that a higher power can restore your sanity.
Admit that you are powerless over alcohol and that life has become unmanageable.
Decide to turn your will and life over to the care of God.
Make a searching and fearless moral inventory of yourself.
Admit to your higher power and to another person an inventory of your wrongs.
Be entirely ready to have God remove all these defects of your character.
Humbly asked God to remove your shortcomings.
Make a list of all persons you have harmed, and be willing to make amends to all of them.
Make direct amends when possible, but do not if doing so would harm them.
Keep on with taking a personal inventory; promptly admit your wrongs.
Strengthen your bond with God through prayer and meditation. Pray only for knowledge of His will for you and the power to carry that out.
Having had a spiritual awakening because of these steps, try to carry this message to other alcoholics. Practice these principles in all of your affairs.
The Origin & History of the Original 12 Steps
The Twelve Steps originated in Alcoholics Anonymous(AA). AA is an organization that offers free support groups for people who want to recover from alcohol abuse issues, although other groups have also been inspired from AA.
In the 1930s, Bill W. was a successful Wall Street executive who was also struggling with alcoholism. His friend was a member of the Oxford Group, a religious group that developed methods of self-improvement for sobriety. Their methods included admitting wrongs, making amends, self-inventory, and using meditation and prayer. The group was committed to delivering the message to other people.
Bill W. decided to try the Oxford Group’s methods after he was once again admitted to the hospital for drinking. He experienced a powerful spiritual experience, and his despair lifted. Bill stopped drinking. He dedicated the rest of his life to bringing the freedom and peace he had to other problem drinkers. The foundation for AA and the AA 12 steps was laid.
What is Al-Anon?
Al-Anon is a network of support groups for the families and friends of people who have alcohol abuse issues. Al-Anon members are people who need support when they have concerns about a loved one’s drinking problem. Many family members and friends of problem drinkers feel hopeless and isolated.
Going to Al-Anon meetings helps these individuals meet others in similar situations. Meetings are places to share experiences, feelings, and frustrations. It is also a place where participants learn how to find a better way in life whether their loved one is drinking or not.
How Long are Alcoholics Anonymous Meetings?
Typically, AA meetings last about an hour. Special topics, discussion, and other types of meetings may last longer.
What is NA?
Narcotics Anonymous (NA) is a fellowship of people for whom drug use has become a major problem. NA uses the same 12 step model from AA, but it has been enhanced and developed for individuals with different substance abuse problems other than alcohol. NA is the 2nd largest 12 step organization in the world after AA.3
What is Nar-Anon?
The NA equivalent of Al-Anon is Nar-Anon. Nar-Anon Family Groups are for people who have a feeling of desperation about an addiction problem of a loved one. Members are (or have been) in the same situation and have learned how to gain peace of mind. Support from other group members can help you cope with the difficulties of being close to someone who is struggling with addiction. Nar-Anon encourages people to attend as many meetings as they like.
Origin and History of NA
In 1953, Narcotics Anonymous was founded in California. One of its main founders, Jimmy Kinnon, found that he and other people with drug abuse problems could not identify with the people in AA who suffered from alcoholism. Also, AA was designed to help people with alcoholism, not those struggling with prescription or illicit drug abuse.
NA believes that the causes of alcohol abuse and drug addiction are basically the same. The difference is the approach from one of substance focus to one of behavior awareness.
What are the 12 Steps of NA?
The 12 Steps of NA are very similar to AA’s 12 Steps. The major difference is that AA mentions alcohol, and NA mentions addiction in the first step. It may seem like a slight difference, but it is significant. AA believes the lack of control is due to the alcohol (external). NA believes the lack of control is due to the addiction itself (internal).
How Long are Narcotics Anonymous Meetings?
NA meetings last anywhere from 60 to 90 minutes. Keep in mind that you can leave an AA or NA meeting anytime you want. No attendance is taken, and nothing prevents you from leaving when you like.
Substance Abuse Disorder
Substance abuse disorder (AUD) is another serious problem in our nation. According to research by National Institute on Drug Abuse(NIDA), more than 70,000 people died from a drug overdose in 2017.4
Here is a breakdown of U.S. overdose deaths by the top drugs involved:
Any opioids (prescription, illicit, and synthetic) - 47,600
Prescription opioids - 17,029
Heroin - 15,482
Fentanyl - 28,400
Cocaine - 13,942
Benzodiazepines - 11,537
Antidepressants - 5,269
Fellowship organizations like NA help large numbers of people who suffer with drug addiction-related problems.
What Can You Expect at Al-Anon and Nar-Anon Meetings?
It’s not unusual for people to be nervous about their first Al-Anon or Nar-Anon meeting. It is a difficult time in their lives. Remember that you can find support and understanding at meetings from people who are going through the same things you are. It helps to know what to expect in NA and AA meetings.
Almost everyone feels nervous or intimidated about attending their first meeting. You’re not alone in feeling this way. The roomful of people you’ll walk into who are just like you. They all are facing the same issues as you. They are also there in the hope that AA or NA will help.
You will not be singled out to speak without your consent. Your identity is confidential. You will never be asked about your personal details. Meetings begin with a reading of the Twelve Steps of Al-Anon and progress from there.
You Will Not Be
Singled out without your consent
Made to feel small because you have an alcohol or drug problem
Expected to share your life story
Expected to talk unless you choose to do so
Made to reveal your personal details for accountability
You Will Be Expected To
Sit and listen quietly
Freely have the coffee and snacks available
Take the NA and AA principles you've learned in meetings and apply them to your life
Keep your identity confidential for as long as you want
Come back and learn more
Usually, NA and AA meetings begin with a reading of the 12 Steps and the Serenity Prayer. Then, depending on the meeting type, different things will happen.
Some meetings have speakers or people who share their experiences. Others have topic discussions or have readings from chosen texts. Other meetings may be for men or women only.
Some group’s meetings are open to anyone. Others are closed (only those who have a desire to stop drinking or taking drugs may attend). Many meetings end with the Serenity Prayer.
Finding a Meeting That’s Right for You
One of the most accessible features of AA and NA is that they have meetings in almost every corner of the United States at different days and times
Al-Anon offers in-person as well as online meetings.
Find an Al-Anon Meeting: https://al-anon.org/al-anon-meetings/find-an-al-anon-meeting/
Find an Al-Anon Online Meeting: https://al-anon.org/al-anon-meetings/electronic-meetings/
The Journey to Recovery
The journey and recovery from alcoholism or addiction is never easy. It takes a toll on the person and the people around them. With the right help, recovery is possible. Find hope and a renewed meaning in life by developing a solid recovery plan. Doing so will help you or a loved one move forward on the journey of recovery.