Your Guide to 12-Step Drug and Alcohol Rehab Programs

Table of Contents

  1. What are 12-step programs?
  2. The 12-Steps from AA
  3. How do 12-Step Programs work?
  4. Effectiveness of 12-Step Programs
  5. What Training Is Required for Staff for 12-Step Programs?
  6. Where Can I Find 12-Step Programs?

In the United States, many public and private substance abuse treatment programs incorporate the 12-step philosophy as part of a comprehensive plan to achieve successful sobriety. There are also many stand-alone 12-step groups that make free treatment accessible to those who need it.

What Are 12-Step Programs?

12-step programs consist of mutual support for recovery from the members of the group. Familiar 12-step based programs that you’ve probably heard of include Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). Treatment centers also use the 12-step philosophy in their programs.

One study found that 12-step programs are one of the recovery pathways most frequently mentioned by the research participants, with 45 percent citing 12-step programs as important to their recovery. 1 The Substance Abuse and Mental Health Services Administration (SAMHSA) reported in its 2017 National Survey of Substance Abuse Treatment Services that 12-step models are used by 73 percent of treatment centers. 2

Twelve-step programs are built upon the 12 principles developed by the founders of Alcoholics Anonymous. These principles have been customized for treating many other substance abuse and behavior disorders as a viable pathway to recovery. 1

History of 12-Step Programs

AA is an organization that started in 1935 as a fellowship centered on helping people who had the desire to stop drinking alcohol. AA’s two original members, Bill W., a stockbroker, and Dr. Bob, has grown to a worldwide organization with more that 73,000 groups. 3 In the United States and Canada, it’s estimated that there are currently 800,000 members.

Twelve-step-based programs have been the most commonplace model of treatment for nearly three decades, but is the one modality of treatment that has the least research data. One reason for this lack of statistics is that 12-step programs place a major emphasis on anonymity.

In 1938, the founders of AA wrote the 12 Steps, and they originally appeared in the Big Book, an AA publication. In AA, staying sober is maintained by applying the 12 Steps philosophy and by sharing experiences with others who have suffered similar problems.

By the 1980s, the 12 Steps were the cornerstone of mostly all substance abuse treatment programs.

The 12 Steps from Alcoholics Anonymous

The 12 steps establish that people struggling with substance abuse problems need to attend meetings that are designed to provide group members with support for getting and staying sober, building a social network, and to follow a set of 12 guiding principles (the steps) for recovery. 4 The general recovery guidelines based on the 12 principles has been reduced to a 12 Step “six pack”: don’t use substances, attend meetings, don’t hesitate to ask for help, find a sponsor, join a group and stay active.
The full 12 steps originally written by AA’s founders are:
  1. Admit you are powerless over drugs and alcohol
  2. Believe in a higher power that can help with recovery
  3. Turn over control to your higher power
  4. Must take a moral inventory of yourself
  5. Admit your wrongdoings
  6. A readiness to have the higher power correct any flaws in your character
  7. Ask the higher power to remove those flaws
  8. Create a list of people you have harmed
  9. Make amends to those individuals
  10. Continue taking personal inventory and admitting when wrong
  11. Seek awareness and communication with your higher power
  12. Carry the 12 Steps message to others who need it

How Do 12-Step Programs Work?

Twelve-step programs are the primary basis of treatment for many, and for some it’s the only source of behavior change. Twelve-step programs are also used as supplements to formal treatment or as a form of continuing care and community support following treatment. Twelve-step groups are highly accessible and are free to attend worldwide, so they serve as an important and readily available resource in substance abuse recovery. The majority of 12-step-based programs focus on the first five steps during primary treatment, and the remaining steps are utilized during aftercare. 3

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Misconceptions About 12-Step Programs

There are several misconceptions about the 12-step philosophy. 8

If a substance abuser admits he or she is powerless, he or she is no longer responsible for his or her actions.

Powerlessness is more about continuing to abuse substances with the knowledge that it’s harmful, and the person continues to use drugs or alcohol despite this harm. It’s not about a lack of responsibility. Admitting powerlessness helps to remove shame, blame and guilt, which often prevents people struggling from addiction from seeking help.

To go to 12-step meetings, you need to believe in God or religion.

The 12-step philosophy was created from a Christian perspective. AA also refers to “God or a higher power”. Despite this, it’s not necessary for a member of AA or any other 12-step program to believe in religion or God. Your “higher power” can be God, but it can also be the universe, nature, or the power that people coming together in a meeting can create.

AA and other 12-step programs have too many rules and requirements.

While the original AA 12 Steps are the recommended framework for recovery, there is also the distilled version we mentioned earlier that’s commonly used, making it less stringent and more flexible.

Substance abusers simply substitute meetings for taking drugs or drinking.

If a person finds meetings useful for recovery, they’re encouraged to attend as often and as long as possible. While many go to meetings frequently in the beginning, many decrease attendance over time. If some are substituting meetings for using drugs or alcohol, their active participation in meetings is much healthier and more productive than an active addiction.

Recovery is not only stopping destructive behaviors, it’s also about changing your life, and 12-step programs can be effective in helping you do so.

Effectiveness of 12-Step Programs

A study was conducted in 2013 that looked at the effectiveness of 12-step interventions for substance abuse disorders (SUDs). The researchers reported: 4
  • Longer-term abstinence is reachable and maintainable for people who regularly attend meetings.
  • Going to AA and NA meetings regularly increases the likelihood of remaining sober for longer, often for long periods of time upwards of 16 years.
  • Program participation improved social and psychological functioning.
  • Starting 12-step programs while in formal treatment, particularly attending group meetings conducted at the treatment program, and 12-step participation in an outside, stand-alone group while the person is in formal treatment are both associated with better outcomes.
  • Steady, early and frequent attendance (where individuals went to three or more meetings a week) is associated with better recovery outcomes.
  • Being highly involved in 12-step meetings and activities after formal treatment was found to be a valuable resource of support and continuing care. This support and care lead to less need of substance abuse treatment and mental health services, thus decreasing their associated costs.

What Training Is Required for Staff for 12-Step Programs?

While no formal training is required for staff regarding 12-step programs, the same study that measured its effectiveness also made several recommendations for staff who treat SUDs: 4

  • More professionals need to become more aware of the positive outcomes associated with the involvement in 12-step programs.
  • More training or information about 12-step groups is needed to dispel any commonly held misconceptions.
  • It’s recommended that staff attend local, standalone 12-step meetings and some that are readily available on the internet that are open to the public. Professionals who do so will then become more familiar with how groups work outside of formal treatment.

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Where Can I Find 12-Step Programs?

12-step programs are a part of almost all residential and outpatient formal treatment programs, as well as an integral part of formal aftercare treatment services. For information on standalone meetings, including those online, the AA website at is an excellent resource.

How Can I Use 12-Step Programs in My Life After Treatment?

After formal treatment is completed, it’s important to keep the 12-step philosophies in mind, whether it’s the full 12 Steps or the distilled version. Whichever works for you, it’s key to your successful sobriety to keep it foremost in your life.

Go to meetings, because the social connections you make will assist you in your recovery journey. The bonds you forge with others in recovery will become an important support network. When you’re engaging in fellowship with other people in recovery, you’ll learn effective coping skills and problem-solving strategies from your peers, be able to share experiences with them, and build your strength and hope.

Take the First Step in Recovery at Resolutions Behavioral Health

The important first step on the road to recovery is detoxification. Detox is the process where your mind and body are cleared of all substances. While the detox process doesn’t stop or heal your addiction, it’s the first stop for long-term success. Resolutions Behavioral Health provides medically supervised detoxifications for all types of substances. After detox, it’s time to choose either residential or outpatient treatment, so you’ll benefit from the counseling and therapy services they offer, helping to make sure you’ll enjoy lifelong recovery.

The staff at Resolutions Behavioral Health partners with leading treatment programs throughout the United States. Our partnerships provide treatment services in a secure environment, allowing you to focus on transformation and recovery. Our compassionate and knowledgeable staff helps you plan your recovery with the best facility that fits your needs.

If you or a loved one need help, call 949-217-9498 to speak with one of our admissions specialists today for a free and confidential assessment.