healthy man after sub-acute medical detox

12 Steps for Success

A Model of Recovery

What Are 12 Step Programs?

12 Step programs are a type of treatment for people with substance use disorders. Although the idea of the 12 step program was started by the founders of Alcoholics Anonymous (AA), there are now many more 12 Step programs that target various addictions such as Narcotics Anonymous (NA), Heroin Anonymous (HA), Gamblers Anonymous (GA) Cocaine Anonymous (CA) and Debtors Anonymous (DA). The basic idea behind the 12 Step model is that people can help each other to become sober and maintain sobriety by creating a community of people dealing with and addressing the same issues.

Supporting the Journey of Sobriety

This community comes together for regular meetings where they share their experiences and support each other in their journey to sobriety through the 12 Steps. There are no dues or membership fees, and AA is self-supported through member donations and contributions. AA is not allied with any sect, denomination, political group, organization, or institution, and the one requirement for membership is the desire to stop drinking.

12 Step Programs Are Peer-to-Peer support Networks

It is important to note that trained professionals are not required to run 12 Step programs. 12-step programs differ from rehabilitation programs and psychotherapy as they are a peer-to-peer network of individuals who are sharing their experiences. 12 Step programs do not offer professional treatment, and it is often beneficial to partake in medical treatment programs as well as 12 step programs. A common practice of 12 Step programs is to receive a sponsor, which is another experienced member of the group who offers personal guidance and support to you through the 12 Steps.

Doctors, therapists, and counselors will often refer people to a 12 Step program. Sometimes, a person may be ordered by the court to attend a 12 Step program. Therefore, although the 12 Step programs are not rooted in medical research, they are widely used. According to the Substance Abuse and Mental Health Services Administration, 12 Step models are used by approximately 74% of treatment centers.

What is the History of the 12 Step Model and Alcoholics Anonymous?

Meeting at the Oxford Group

The 12 Step model is based on the principles created by the founders of Alcoholics Anonymous. AA was founded by Bill Wilson, a New York stockbroker, and his physician, Bob Smith, in 1935 in Akron, Ohio. Both men were struggling with alcohol addiction. Before Bill and Bob met, they had both involved with a fellowship that emphasized spirituality in everyday life. The group was called the Oxford Group, and it was largely the reason that Bill was able to stop drinking and maintain sobriety.

The Oxford Group Wasn’t Enough for Bob

Although the Oxford Group was not quite enough to help Bob achieve sobriety, when he met Bill, everything changed. In Bill, he found someone who had been through the same thing as him and had managed to find sobriety. While Bob had never thought of alcoholism as a disease, Bill viewed is as a disease of the mind, emotions, and body. With Bill’s help and this new spiritual guidance, Bob was able to achieve sobriety as well. Shortly after this, both men began working with others at Akron’s City Hospital, where they helped one other patient achieve sobriety. They were not called Alcoholics Anonymous at the time, but Bill, Bob, and the patients at the hospital made up the first unofficial Alcoholics Anonymous group.

The AA Book

By 1939, two more groups had taken shape. In 1939, Bill published the groups founding textbook titled Alcoholics Anonymous. This book outlined the group’s philosophy and methods, which are now known as the 12 Steps. While the original 12 Steps held a strong religious component, today, most steps have been adapted to not include any one religion’s views but rather to express spirituality.

What are the 12 Steps of AA?

Although the 12 Steps of AA have also been amended to reflect secular values as well as other religious values, these are the original 12 steps as defined by Alcoholics Anonymous:

1. We admitted we were powerless over alcohol [or drugs], that our lives had become unmanageable.

2. We came to believe that a Power greater than ourselves could restore us to sanity.

3. We made a decision to turn our will and our lives over the care of God as we understood him.

4. We made a searching and fearless moral inventory of ourselves.

5. We admitted to God, to ourselves, and to another human being the exact nature of our wrongdoings.

6. We were entirely ready to have God remove all these defects of character.

7. We humbly asked Him to remove our shortcomings. 

8. We made a list of all persons we had harmed and became willing to make amends to them all.

9. Make direct amends to such people whenever possible, except when to do so would injure them or others.

10. We continued to take personal inventory and when we were wrong promptly admitted it.

11. We 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. 

12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to others with substance use issues, and to practice these principles in all our affairs. 

Adapting the Steps

Many groups have adapted the 12 Steps to reflect their religion or views or to reflect atheist values or secular values. Many 12 Step programs have removed the word God and replaced it with some sort of “higher power.”

What are the 12 Traditions?

While the 12 Steps are made and directed towards the individual, the 12 Traditions are focused on the group. These are the traditions that 12 Step groups adopt:

1. Our common welfare should come first; personal recovery depends upon AA unity. 

2. For our group purpose, there is but one untimate authority – a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern. 

3. The only requirement for AA membership is a desire to stop drinking. 

4. Each group should be autonomous except in matters affecting other groups or AA as a whole. 

5. Each group has but one primary purpose – to carry its message to who others who still suffer from substance abuse.

6. An AA group ought never endorse, finance, or lend the AA name to any related facility or outside enterprise, lest problems of money, property, and prestige divert us form our primary purpose. 

7. Every AA group ought to be fully self-supporting, declinging outside contributions. 

8. Alcoholics Anonymous should remain forever nonprofessional, but our service centers may employ special workers. 

9. AA, as such, ought never be organized; but we may create service boards or committees directly responisble to those they serve.

10. Alcoholics Anonymous has no opinion on outside issues; hence, the AA name ought never to be drawn into public controversy. 

11. Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio, and films. 

12. Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities. 

What to Expect at 12 Step Meetings?

12 Step meetings vary from group to group. However, many things are common worldwide that may be expected when attending a first meeting.

Where the Meeting Takes Place

Meetings are typically held in churches, community centers, or other similar buildings. You might notice people outside of the room making coffee or chatting. Sometimes groups will sign attendance sheets or court cards for people who request it. Sometimes new members will receive a book with the names and numbers of people in the group who you can call if you need help. People volunteer to put their numbers in the book and are genuinely wanting to help.

The Meeting Itself

Meetings begin with the chairperson reading the Preamble and then leading the Serenity Prayer. Afterward, 12 Step literature, such as the 12 Steps and 12 Traditions, will be read out loud. Meetings are usually discussion meetings or speaker meetings. During discussion meetings, members take turns sharing while speaker meetings have one or more people sharing for longer periods. The meeting might be a Step meeting where the whole meeting focuses on one of the 12 steps, or it might be more a general shared discussion.

During the meeting, people will share their experiences, starting by introducing themselves as “Hello, my name is (first name), and I’m an alcoholic.” Everyone else responds by saying, “Hello (first name).” When they finish sharing, the other members thank them for sharing. At the end of the meeting, members will often gather in a circle and end with a short prayer or reading. The prayers are spiritual and not religious (unless they have been adapted to a particular religion).

Speaking at the Meeting

Since nonmembers are often allowed to attend meetings, they are asked not to share due to time constraints, but they are welcome to listen. Members usually share once per meeting and will often be asked to share for five minutes or less so that everyone has a chance to share.

Members are encouraged to avoid “crosstalk,” which means replying to someone else’s comment or experience. Rather, the point is to share your own experience. This doesn’t mean that you can’t have discussions with members before or after the meeting. Having private side conversations is discouraged as it is distracting to other people, as are phone calls and text messages.

For New Members 

New members can pick up a white chip, which means they want to stop drinking. As people progress through sobriety and reach different milestones or anniversaries, they will receive chips for staying sober. New members are encouraged to listen closely to see if there are any members that they can relate to who would make a good sponsor.

Newcomers are usually asked to introduce themselves by their first name and are welcome with a hug or handshake and a welcome key-tag. Introductions are mandatory, but don’t feel pressure to speak if you don’t want to. Everyone there is in the same boat as you,  so don’t be shy about introducing yourself either.

How Long are 12 Step Meetings?

Most 12 Step meetings last for about an hour. Some might be longer or shorter, depending on what type of meeting it is or how many people are attending. Some meetings may include speakers that share for longer periods of time, and during other meetings, everyone who wants to shares for about 5 minutes or less. You will also notice that people often arrive early or stay late and mingle, have some coffee, and prepare for the meeting.

How Long Does it Take to Finish the 12 Steps?

There is no set length of time that it should take to get through the 12 step models of recovery. Everyone’s road to recovery will be different. Some people might attend meetings for weeks, for months, and even for years.

90 in 90

Sponsors typically encourage new members to attend 90 meetings in 90 days. While at first you might think wow, that’s a meeting every day for 90 days, there is a purpose behind it. The first 90 days are the hardest part of recovery and when you are the most vulnerable to relapse, so having that daily support and accountability helps to fight through the hardest part.

Coming to a meeting every day and working towards sobriety together with other people who are also struggling is a great motivation for maintaining sobriety. Of course, relapse is a normal part of the recovery process, and there should be no shame or embarrassment in relapsing.

Who are the Members of AA?

You might be wondering, who are the members of AA? in 2014, Alcoholics Anonymous conducted a membership survey of 6,000 AA members from the U.S. and Canada. This survey revealed some interesting facts about AA. Here are the statistics:1


  • Male 62% 62%
  • Female 38% 38%


  • White 89% 89%
  • Hispanic 3% 3%
  • Black 4% 4%
  • Native American 1% 1%
  • Asian 1% 1%
  • Other 2% 2%


  • Under 21: 1% 1%
  • 21-30: 11% 11%
  • 31-40: 14% 14%
  • 41-50: 21% 21%
  • 51-60: 28% 28%
  • 61-70: 18% 18%
  • Over 70: 7% 7%

Marital Status

  • Married/Life Partner 41% 41%
  • Single 32% 32%
  • Divorced 21% 21%
  • Other 6% 6%

Length of Sobriety

The average length of members’ sobriety is 10 years. 

  • Less than 1 year: 27% 27%
  • 1-5 years: 24% 24%
  • 5-10 years: 13% 13%
  • 10-20 years: 14% 14%
  • Over 20 years: 22% 22%

Meeting Attendance

Members attend an average of 2.5 meetings a week


  • Members that have a sponsor 82% 82%
  • Members that get a sponsor within the first 90 days 74% 74%

How Many People are in AA?

AA membership has grown significantly since its inception in 1935. While AA does not officially keep records of members, there are estimates as to how many groups exist and how many people are members worldwide.

  • In 1935, there were two members, Bill and Bob, and no groups yet.2
  • By 1940, there were 50 groups and 1,400 members.
  • In 1950, there were 3,527 groups and 96,475 members
  • In 1960 there were 8,615 groups and 162,037 members
  • In 1970 there were 16,459 groups and 311,450 members
  • In 1980 there were 42,105 groups and 907,575 members
  • In 1990 there were 93,914 groups and 2,047,469 members
  • In 2000 there were 100,766 groups and 2,160,013 members
  • In 2010 there were 107,976 groups and 2,057,672 members
  • In 2018 there were 125,352 groups and 2,130,419.3

From 2 members in 1935 to over 2 million members today, AA has grown exponentially.

Narcotics Anonymous

The 12 Steps of NA

The 12 Steps of Narcotics Anonymous (NA) are essentially the same as AA but with slightly different wording to reflect drug addictions rather than alcohol addiction. This is the rewording of the first step, and the remaining steps are identical to the 12 steps of AA.

The 12 Traditions of NA?

Again, the 12 traditions of NA are the same as for AA but with slightly different wording. The traditions emphasize group unity and working together towards a common goal.

Unity is Key

Our common welfare should come first; personal recovery depends on NA unity.

For our group purpose, there is but one ultimate authority—a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern. The only requirement for membership is a desire to stop using.

Running the Group

Each group should be autonomous except in matters affecting other groups or NA as a whole. Each group has but one primary purpose—to carry the message to those who still suffer with substance use disorder.

An NA group ought never endorse, finance, or lend the NA name to any related facility or outside enterprise, lest problems of money, property, or prestige divert us from our primary purpose.

Group Finances and Leadership

Every NA group ought to be fully self-supporting, declining outside contributions. Narcotics Anonymous should remain forever nonprofessional, but our service centers may employ special workers.

NA, as such, ought never be organized, but we may create service boards or committees directly responsible to those they serve.

Maintaining the Purpose of NA

Narcotics Anonymous has no opinion on outside issues; hence, the NA name ought never to be drawn into public controversy.

Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio, and films. Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities.

Would you benefit from NA?

Although the Diagnostic and Statistical Manual of Mental Disorders outlines the official criteria for diagnosing someone with an substance use disorder, the Narcotics Anonymous approved literature outlines 29 questions to help you to determine whether or not you might benefit from NA. All of the questions are yes or no questions, and they are as follows:

The First 10 Questions

  1. Do you ever use alone?
  2. Have you ever substituted one drug for another, thinking that one particular drug was the problem?
  3. Have you ever manipulated or lied to a doctor to obtain prescription drugs?
  4. Have you ever stolen drugs or stolen to obtain drugs?
  5. Do you regularly use a drug when you wake up or when you go to bed?
  6. Have you ever taken one drug to overcome the effects of another?
  7. Do you avoid people or places that do not approve of you using drugs?
  8. Have you ever used a drug without knowing what it was or what it would do to you?
  9. Has your job or school performance ever suffered from the effects of your drug use?
  10. Have you ever been arrested as a result of using drugs?

The Next 10 Questions

  1. Have you ever lied about what or how much you use?
  2. Do you put the purchase of drugs ahead of your financial responsibilities?
  3. Have you ever tried to stop or control your using?
  4. Have you ever been in a jail, hospital, or drug rehabilitation center because of your using?
  5. Does using interfere with your sleeping or eating?
  6. Does the thought of running out of drugs terrify you?
  7. Do you feel it is impossible for you to live without drugs?
  8. Do you ever question your sanity?
  9. Is your drug use making life at home unhappy?
  10. Have you ever thought you couldn’t fit in or have a good time without drugs?

The Final 9 Questions

  1. Have you ever felt defensive, guilty, or ashamed about your using?
  2. Do you think a lot about drugs?
  3. Have you had irrational or indefinable fears?
  4. Has using affected your sexual relationships?
  5. Have you ever taken drugs you didn’t prefer?
  6. Have you ever used drugs because of emotional pain or stress?
  7. Have you ever overdosed on any drugs?
  8. Do you continue to use despite negative consequences?
  9. Do you think you might have a drug problem?

Answering the Questions

Members in recovery created these questions in Narcotics Anonymous. Answering these questions as honestly as possible will help you to determine whether or not you have a problem. It is emphasized that the only person who can determine if you would benefit from NA is you.

The number of questions that you answer ‘yes’ to are not as important as looking at how the addiction has impacted your life and how you feel about it. Although it might be easy to look at the questions and make excuses for why they may or may not apply to you, the first step to recovery is admitting there is a problem.

What is Al Anon?

Although most people have heard of Alcoholics Anonymous, not as many have heard of Al Anon. Al Anon is a program that is for friends and family who might be affected by an alcoholic in their life. Addiction is sometimes said to be a “family disease,” meaning that it can be very difficult for people whose loved ones are struggling with alcoholism. It’s common when a loved one is dealing with a substance use disorder to find benefit from a recovery program as well, leaning on the support of other people whose friends or family might be struggling with an addiction.

Al Anon was founded by Lois Wilson, Bill Wilson’s wife in 1951. She found that even after Bill stopped drinking, her problems did not go away. She had adjusted so much of her life and the way she interacted with the people around her that she had to undo a lot of the habits that had helped her to cope with her husbands’ addiction. Interestingly, Al Anon focuses on the same 12 Steps as those who are in AA, but instead of the focus being on quitting drinking or substance use, the focus is more on changing patterns of thinking.

What to Expect at Al Anon Meetings?

Al Anon meetings are similar to other 12 step meetings in that a support group helps to guide recovery. The meetings are about helping you and are not about finding ways to help your loved one with substance use issues.

During meetings, the chairperson typically chooses a topic related to the experience of having a friend or family member with alcoholism. Examples of topics include acceptance, dealing with anger, control issues, dealing with change, fear of abandonment, forgiveness, and honesty. Members might also be asked if there are any topics that they would like to discuss.

Similar to other 12 Step Programs, participation during the meeting is voluntary, and meetings are anonymous. There are no fees or dues, and the program is not affiliated with any religion or organization.

Online Al Anon Meetings

With the rise in modern technology and how busy people are, there are also online al anon meeting options. The options include email groups, chat meetings, and telephone meetings. These are a good option for those who might not have time to travel to and from meetings or who prefer to not participate in in-person meetings.

How Effective Are 12 Step Programs?

Because of the anonymous nature of the program and a lack of formal, it is hard to identify how effective 12 Step programs really are. Some people swear by them, and others say they don’t work. So what is the truth? Almost everyone can agree that having a community of people going through the same suffering as you that support you and help to hold you accountable is helpful when going through any hard time. There is a reason that there are so many support groups out there: grief groups, medical support groups, weight loss groups, mental health groups, and more.

What is the Success Rate of AA?

 Alcoholics Anonymous itself claims that the success rate is about 50%, with another 25% staying sober after several relapses. This would mean that up to 75% of its members stay abstinent. Other addiction specialists estimate that the success rate is between 8% to 12%.4

A long-term study done by the National Institute on Alcohol Abuse and Alcoholism showed that at the 8-year follow up, 46% of those who partook in a formal medical treatment were still abstinent, while 49% of people who joined AA were abstinent.5 The results concluded that for some people, AA can be a source of recovery but that those who partake in both AA and formal treatment have the best chance at recovery.

How Many People Drop Out of AA?

So while the research does show different numbers, there are many success stories coming from AA, and its worth trying out for anyone who is struggling. Some people struggle with how spiritual the program is and prefer a more formal treatment option. For many others who feel isolated and alone, the spirituality of the group can be helpful. That being said, approximately 40% of people are said to drop out of AA within the first year, which could also contribute to lower rates of success.

Recovery, Relapse, and Prevention 

While many people think that simply not using drugs or not drinking alcohol means that someone has recovered, that is not necessarily true. Staying sober is not the only component of treatment. When someone suffers from an addiction, many parts of their life are impacted. They may be battling depression, anxiety, or other mental health issues and will need to address all of those problems to truly recover. On top of that, it is completely normal that members will relapse, often many times, before achieving long term abstinence.

The journey to recovery looks different for everyone, and there is no one way to achieve full recovery. Many sober people find it helpful to continue to attend 12 Step programs at least every once in a while to maintain accountability and to stay strong. Staying sober is a lifelong process and is never truly ‘complete.’

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