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12-Step Programs

One of the most widely known addiction treatment methods is the 12-step recovery program. It is probably the most covered addiction treatment modality in mainstream media. This is, perhaps, due to the fact that 12-step is the longest-standing method of modern addiction treatment, beginning more than 80 years ago.

Twelve-step programs have been applied to more than a dozen forms of addiction including everything from gambling to shopping addiction. The effectiveness of the 12-step methodology has been studied and reviewed often. Though we learn more about addiction every year, these programs seem to remain a cornerstone of addiction treatment.

But how do 12-step programs work and are they as effective as more modern addiction treatment modalities? Learn more about this time-honored addiction treatment style and how it finds its place in the continuum of care.

What Is a 12-Step Program?

Twelve-step recovery programs are addiction treatment methods that use the 12-step model of addiction recovery, which is generally defined as a commitment to abstain from drugs through spiritual growth and support from peers. The 12-steps involve admitting the need for help with a substance abuse issue, relinquishing control of your addiction to a higher power, accepting help with achieving abstinence, examining your flaws and past transgressions, and seeking to make amends for the mistakes of your past. Spirituality, peer mentorship, and honesty are major components of most 12-step programs.

Twelve-step programs are one of the most widely used addiction recovery methods in the world. Many treatment centers adopt the principles of 12-step treatment to help clients in recovery. Programs can also be used as a support group and continued treatment for people who have already gone through treatment and want help maintaining their sobriety.  

The History of 12-Step Programs

The first 12-step program started in 1935 directly follow the temperance movement and prohibition. Alcoholics Anonymous offered alcoholics a brotherhood with which to combat the disease of addiction through the recognition of your need for help and spiritual growth. Before AA was founded, the widely accepted method to respond to alcoholism was through punitive actions. Alcoholics who could not function would be thrown in jail to sober up. Alcoholism was seen as a moral failing or a bad habit that needed to be corrected by the law. Around the beginning of the 20th century, the idea of addiction as a disease, rather than a moral failing, began to gain ground.

Addiction as a Disease

However, addiction as a disease wasn’t necessarily a completely new concept at the time. In 1784, a doctor named Benjamin Rush described alcoholism as a “disease induced by vice” in his study titled, Inquiry into the Effects of Ardent Spirits on the Human Mind and Body. He even conceptualized specialized “sober houses” to help care for people struggling with alcoholism.

However, the temperance movement of the 1800s gained political clout that would culminate in the complete prohibition of alcohol in 1920. The movement was furthered by women in the Women’s Christian Temperance Union in the late 1800s and early 20th century. The movement was primarily a reaction to increased public health issues and domestic violence associated with alcohol. During the criminalization of addiction, wealthy people would go to hospitals to “dry out” while poorer people would be thrown in asylums or prison.

However, by the end of prohibition, one man would go on to start one of the largest and most significant alcohol treatment programs in the world.

Bill Wilson and the Oxford Group

Bill Wilson was a Wall Street businessman with a promising career that was cut short by alcoholism. Wilson went through several stays in hospitals and began to seek help from a local Christian fellowship called the Oxford Group. The group was organized to help men who were looking for help overcoming sin and character flaws in their lives, and Wilson attended a few times to address his problem with alcohol. However, it wasn’t until a dramatic spiritual awakening that he began attending the Oxford Group’s meetings regularly.

During his time in the Oxford Group, he began working with more who saw the group’s standards of honesty, purity, unselfishness, and love as an answer to their substance use problems. While on a business trip, he met Dr. Bob Smith in 1935 and worked with him to achieve his own sobriety from alcohol.

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Alcoholics Anonymous Begins

After Wilson was criticized by other members of the Oxford Group for focusing too exclusively on alcoholism, the rift led to Wilson and Smith starting their own group, which would come to be known as Alcoholics Anonymous.

In 1939, Wilson wrote the first edition of AA’s guiding manual also titled, Alcoholics Anonymous, or better known as the “Big Book.” The book outlines the 12 principles of the program and the 12 steps to sobriety. It also offers a myriad of guiding advice to people working through the program.

Today, 12-step programs have spread all over the world. They have been applied to many other forms of addiction, starting with Narcotics Anonymous in 1953 and then dozens more.

How 12-Step Programs Work

Though there are several 12-step programs that cover a variety of addiction types, most of them stick fairly closely to the original 12 steps and traditions that were originally created by Bill Wilson and Bob Smith in the 1930s. The program works by building up your spiritual health and connecting you with peers that know what you are going through. The following are some of the means by which 12-step programs help members to achieve and maintain sobriety:

The 12 Steps

The 12 steps are outlined in the “Big Book” and are designed to guide you through a process of acceptance and spiritual growth. Most 12-step programs from Alcoholics Anonymous to Workaholics Anonymous use the same 12-steps down to the exact wording. Typically, the type of addiction is the only difference between one group’s steps and another’s. Here are the 12-steps as they are written for Alcoholics Anonymous:

  1. We admitted we were powerless over alcohol—that our lives had become unmanageable.
  2. Came to believe that a Power greater than ourselves could restore us to sanity.
  3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
  4. Made a searching and fearless moral inventory of ourselves.
  5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
  6. Were entirely ready to have God remove all these defects of character.
  7. Humbly asked Him to remove our shortcomings.
  8. Made a list of all persons we had harmed and became willing to make amends to them all.
  9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
  10. Continued to take a personal inventory and when we were wrong promptly admitted it.
  11. 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 alcoholics and to practice these principles in all our affairs.

The first few steps involved self-examination and admitting the need for help. One of the most common roadblocks to treatment that is the belief that they are not addicted and if they are, they’ll deal with on their own. “I can stop whenever I want.” However, the first few steps are about giving up that idea and accepting that true change will come from outside yourself.

The first few steps also help advance your readiness to change from pre-contemplation or contemplation to preparation. By turning over control to a higher power you relinquish the idea of self-control in addiction. By admitting the nature of your wrongs to another person, you invite accountability into your fight against addiction.

The second half of the steps are about identifying moral shortcomings and seeking to make amends for them. Through prayer and meditation, you will continue to pursue contact with God and his will for your life.

The final step is about helping others in the same way people helped you through the process while continuing to safeguard your sobriety and spiritual growth.

Meetings are a major facet of 12-step programs. If you were hoping to simply read through the Big Book at hope and move through the steps on your own, that’s not really what 12-step programs are about. Meetings help members connect with people who can truly empathize with what they are going for through. There are open meetings, which anyone who is interested can attend, including friends and family members. There are also closed meetings that are exclusively for people who are there seeking to address from whatever form of addiction the program caters to.

Depending on the size of the 12-step program you are in, there are often meetings all over the country. For instance, AA and NA have meetings in most major cities in the U.S. However, your home group is typically the foundation of your experience in a 12-step recovery program. A home group is a local meeting that you regularly attend.

Sponsors are experienced 12-step program members that have most likely completed all 12-steps of the program. They continue to pursue steps 11 and 12 by remaining in the program and helping to mentor others on their 12-step journey. When you enter a 12-step program you can choose a mentor or one might be recommended to you.

Your mentor can help you through the process but they may also help you with a variety of other needs, even general life advice like balancing a budget or looking for a job. If you feel like you would like a different sponsor, most programs allow you to switch at any time.

The Spirituality of 12-Step Programs

Spirituality is an important aspect of 12-step programs, so much so that people often wonder if 12-step is a religion in itself or even a cult. However, although many 12-step programs have some of the Christian traditions of the Oxford Group infused into its DNA, most only acknowledge a vague sense of spirituality and a higher power, as opposed to a specific religion. These programs aim to be accessible to everyone who needs help, so they avoid making express political and religious alignments as much as possible.

However, spirituality apart from specific religion is a big part of 12-step programs. If you are not a spiritual person, Wilson addresses the roadblock to 12-step recovery in the chapter of the “Big Book” called “We Agnostics.” In it, he says, “To us, the realm of spirit is broad, roomy, all inclusive; never exclusive or forbidding to those who earnestly seek. It is open, we believe, to all men.”

Are 12-Step Recovery Programs Effective?

These programs are a tried-and-true approach to addiction support, helping many over the year. However, modern addiction treatment involves multidisciplinary approaches to the full range of needs a person with a substance use disorder might have. Plus, everyone is different and their addictions reflect this difference.

Some just present with substance abuse problems while others have comorbid mental issues like depression. AA or NA might not be the complete package that some people in recovery are looking for. However, it is a tremendous tool for spiritual and social needs. For that reason, 12-step programs are commonly used to help maintain sobriety after treatment is completed, and it’s clear that 12-step programs continue to have a place in modern addiction treatment.

Starting Your Road to Recovery

Twelve-step programs are just one of the many options you have for alcohol or drug addiction treatment. If you are looking for a way to escape the oppressive cycle of active addiction, call the addiction specialists at Arete Recovery at (855) 781-9939 or contact us online to learn more about your treatment options.

Whatever you’re are struggling with, your treatment should be tailored to your specific needs. Addiction is a chronic disease that affects the brain. It’s very difficult to beat on your own. But, even though it is a long-lasting disease like diabetes, with similar relapse rates, it is treatable. Learn more about how 12-step programs or other treatment options can help.


Addiction as a Disease: The Birth of a Concept. (n.d.). Retrieved April 11, 2018, from

Alcoholics Anonymous. (n.d.). The Twelve Steps of Alcoholics Anonymous. Retrieved April 11, 18, from

Miller, M., MD. (n.d.). American Society of Addiction Medicine. Retrieved April 11, 2018, from

Treatment, C. F. (1970, January 01). Appendix G Stages of Change. Retrieved April 11, 2018, from

WE AGNOSTICS I – Alcoholics Anonymous. (n.d.). Retrieved April 11, 2018, from

Wilson, B. & Cohen, A. (2015). Alcoholics Anonymous: The original big book, 12 steps, guides, and prayers, the story of how many thousands of men and women have recovered from alcoholism. New York. Twelve Step Study Guides Publishing. from

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