Support Groups

Lauren Smith
Morgan Blair
Written by Lauren Smith on 09 September 2022
Medically reviewed by Morgan Blair on 27 November 2024

In addition to rehab, detox, professional therapy, and prescription medication, people with addictions frequently turn to each other, seeking emotional support, accountability, techniques for managing urges, and sober communities. Mutual aid fellowships, such as the 12-step programs pioneered by Alcoholics Anonymous (AA) and secular alternatives, offer free, community-based, confidential meetings to help people reach recovery and stay on the right path.

Key takeaways:
  • The National Institute on Drug Abuse (NIDA) says support groups can “complement and extend” the benefits of professional, clinical treatment.
  • Most addiction experts argue that, while support groups can help some people maintain sobriety, they’re not enough at the outset of recovery, especially for people with co-occurring mental health conditions, physical dependence on the substance, and other complex histories.
  • 12-step programs are a step-by-step journey to addiction recovery, modeled on Alcoholics Anonymous and anchored by anonymous and confidential support meetings.
A group of people sitting, gesturing with their hands.

What are support groups?

Support groups are networks of peers trying to overcome a common struggle—in this case, addictions to alcohol, drugs, and other harmful behaviors. At meetings, participants learn and share techniques for managing cravings, offer each other accountability and emotional support and create a new sober social fabric for their lives.

The National Institute on Drug Abuse (NIDA) says support groups can “complement and extend” the benefits of professional, clinical treatment. Support groups are typically free or low-cost, readily available in local communities, and held weekly or even daily. In-patient rehabs and therapists often encourage patients to attend support group meetings alongside and after their treatment.

Some support groups cater to specific populations—women, veterans, LGBTQ+ people, seniors, and people with disabilities—and address their common vulnerabilities and struggles.

Active engagement in support groups, including 12-step programs, has been found to be a solid predictor of recovery and long-term abstinence. One study found that, among participants in the peer recovery services at one Portland, Oregon organization, 85% reported not using drugs or alcohol in 30 days. In a survey of active members of Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), 45% and 55%, respectively, reported more than five years of abstinence, while an additional third had been sober for one to five years.

However, these studies are self-selecting, and dropout rates from support groups are high. One study found that 40% of attendees of a 12-step program dropped out within the first year. Another put the attrition rate even higher: just 8% of people who initially attended Gamblers Anonymous meetings remained in the program and were abstain after a year. Success rates were found to be higher when participants are simultaneously in professional therapy and their family members were in complementary support groups such as Al-Anon and Nar-Anon.

Most addiction experts argue that, while support groups can help some people maintain sobriety, they’re not enough at the outset of recovery, especially for people with co-occurring mental health conditions, physical dependence on the substance, and other complex histories.

Where do support group meetings take place?

Support group meetings are usually held in unaffiliated community spaces such as churches, community centers, libraries, and schools—accessible spaces that can be rented cheaply.

Do you have to pay to attend support groups?

Most peer support groups, especially those based in the community, are free to attend.

Voluntary donations will be accepted during or after meetings to cover the rental of the space and materials. Part of the ethos of these programs is being self-supporting: they want to run entirely on member donations and not draw on outside funding. However, you’ll never be required to pay.

Some app-based treatment services, which include online support groups, charge a download or monthly subscription fee.

What is a 12-step program?

12-step programs are a step-by-step journey to addiction recovery, modeled on Alcoholics Anonymous and anchored by anonymous and confidential support meetings.

Since the founding of AA in the 1930s, the 12-step model has been deployed to tackle other substance and behavioral addictions, including:

  • Narcotics Anonymous (NA)
  • Cocaine Anonymous
  • Crystal Meth Anonymous
  • Marijuana Anonymous
  • Gamblers Anonymous
  • Overeaters Anonymous
  • Sex Addicts Anonymous
  • Debtors Anonymous

Most employ the 12 steps laid out in the 1930s by AA founders. Guided by the steps, participants

  • admit their powerlessness over the addiction.
  • turn to God or another higher power to free them from addiction.
  • examine their character flaws and past mistakes.
  • make amends for those mistakes to the people around them.
  • bring this message to other addicts.

Members meet regularly to learn how to apply the 12 steps to their lives and share their personal experiences of addiction and recovery.

Newcomers are guided by a sponsor, someone who has maintained sobriety for an extended period and can offer personalized advice and accountability.

AA and NA support groups

AA and NA are the most widely available addiction support groups in the world. More than 123,000 AA groups meet in around 180 countries. Each week more than 70,000 NA meetings are held in 144 countries. Anecdotally, the programs claim to have helped hundreds of thousands of addicts, with some maintaining sobriety for decades.

However, 12-step programs aren’t for everyone. Although they aren’t affiliated with religions and members are welcome to substitute “Higher Power” for God, some people find spirituality off-putting. Others don’t like the portrayal of addiction as a disease that can be managed but never cured or the encouragement to attend meetings for many years. AA and NA groups in some locations may emphasize complete abstinence and discourage the use of medication such as methadone or naltrexone.

Can you attend support group meetings online?

Many support groups hold virtual meetings. Since the coronavirus pandemic, more groups are offering this option and more participants are comfortable with the video conferencing software it requires.

Virtual meetings make support groups accessible to people with disabilities, people living in remote areas, and others who can’t easily get to face-to-face meetings. With online meetings going on around the world at all hours, you can also find one that fits into your schedule.

Online meetings are most commonly held over Zoom and occasionally alternatives such as Skype, WhatsApp, or Microsoft Teams. Efforts have been made to preserve anonymity: users are identified only by their first names and screenshots and recording are prohibited.

Support groups for alcohol addiction

These support groups help those suffering from alcohol addiction (some also help with other substance use disorders)

Alcoholics Anonymous (AA)

Alcoholics Anonymous is the original addiction support group, its model was emulated to cure addictions to everything from drugs to gambling to binge eating. There are 71,000 AA groups in the United States and Canada, including 1,500 in correctional facilities. In total, these groups boast 1.3 million members.

SMART Recovery

SMART Recovery—or Smart Management and Recovery Training—is a secular program that teaches participants evidence-based strategies from CBT and motivational interviewing to liberate themselves from addiction. SMART Recovery holds that addiction isn’t a lifelong disease but rather a behavioral problem that can be corrected and left behind. Through SMART Recovery meetings, literature, and workbooks, participants build their motivation to change, defuse urges, manage difficult emotions, and plan for and lead a balanced, healthy life. More than 3,500 SMART Recovery meetings are held every week around the world.

Secular Organisations for Sobriety (SOS)

Also known as Save Our Selves, SOS was founded in the 1980s by James Christopher as a secular alternative to AA. Uncomfortable with AA’s emphasis on God and spirituality, Christopher devised a program that emphasized rational thinking and self-empowerment. SOS views addiction as a cycle of learned habit, chemical need, and denial. To unwind this cycle, participants daily acknowledge their addiction, accept it, and prioritize sobriety as the primary issue of their life. Meetings are regularly held to educate participants on the SOS method and offer them peer support.

Women for Sobriety (WFS)

Women for Sobriety is a non-religious alternative to 12-step programs for women, founded in 1975 by Jean Kirkpatrick following her failure to maintain sobriety while in AA. WFS holds low self-esteem is the root cause of addiction in many women. AA, which emphasizes powerlessness, humility, and accounting for wrongs, can exacerbate these women's problems. Instead, WFS encourages women to take responsibility for themselves, view themselves not solely as addicts but rather as competent women, and leave their guilt behind. It builds their self-value and promotes behavior change through positive thinking, encouragement, dynamic group meetings, and by “letting the body help,” with relaxation, exercise, meditation, and improved nutrition. Today more than 300 WFS meetings are regularly held in the United States and Canada.

Celebrate Recovery

Celebrate Recovery is a “Christ-centered” 12-step recovery program to help people overcome their “hurts, hang-ups, and habits,” including addiction, anxiety, eating disorders, co-dependency, and other compulsive behaviors. Celebrate Recovery claims to work through 35,000 churches in ten countries and to have reached more than five million people.

Moderation Management (MM)

Most support groups advocate complete abstinence from alcohol and other mind-altering substances. Moderation Management is different, helping people change their relationship with alcohol, avoiding harmful behaviors and consuming in moderation. MM acknowledges that it’s not the right choice for every problem drinker. Around a third of those who join MM decide to be abstinent and are directed to online groups of “MMabsers." But many members can significantly reduce the role alcohol has in their life while still enjoying the occasional drink.

Al-Anon

Al-Anon is a network of mutual aid meetings for the family and friends of problem drinkers, complementary to but independent from AA. Members accept their powerlessness over the addict and strive to improve their own lives by following a 12-step program and regardless of whether the alcoholic is still drinking. Al-Anon meetings are held in more than 130 countries.

Support groups for drug addiction

Many of the above support groups also cater to drug use disorders. Here are some support groups that solely serve those with drug addictions:

Narcotics Anonymous (NA)

Narcotics Anonymous was founded in 1953 to guide people with drug addictions through 12 steps closely modeled on AA’s program. Its meetings are open to anyone with a “desire to stop using” drugs. As with AA, recovery begins with an avowal of powerlessness before the addiction and surrender to a healing God.

Cocaine Anonymous

Cocaine Anonymous is a fellowship of people struggling with cocaine addiction and helping each other through a twelve-step program based on AAs. Cocaine Anonymous meetings are held in 30 countries and online.

Nar-Anon

As Al-Anon is to AA, Nar-Anon is to NA. That is, Nar-Anon is a mutual aid society and 12-step program for the loved ones of people with drug addictions. It helps them manage the stress and emotions of living in close proximity to addiction, stop trying to solve the addict’s problems and internalize their guilt and shame, and attain peace for themselves.

Support groups for behavioral addictions

Addiction specialists now recognize that behaviors, much like substances, can hijack and deform the brain’s reward systems. Support groups and 12-step programs are available to help people overcome addictions to a range of compulsive behaviors.

Gamblers Anonymous

Gamblers Anonymous is a 12-step program and mutual-aid society for compulsive gamblers, closely modeled on AA and running since 1957. Participants admit their powerlessness over their gambling, seek help from a higher power, make amends for their wrongs, and work toward abstinence.

Overeaters Anonymous

Overeaters Anonymous is a community of people seeking to recover from compulsive eating and other compulsive food behaviors, with a 12-step program and 6,500 face-to-face and virtual meetings in 35 countries.

Sex addiction

There are several 12-step programs for people suffering from compulsive sexual and/or romantic behaviors: Sex Addicts Anonymous, Sex and Love Addicts Anonymous, Sexaholics Anonymous, and Sexual Recovery Anonymous.

In most, members create a personal definition of sexual sobriety, abstaining from behaviors they have identified as harmful to them. These may include infidelity, risky sex, one-night stands, compulsive attraction to unattainable or abusive partners, co-dependent relationships, and the use of sex workers. Members work toward developing healthy and committed relationships.

Porn addiction

As with sex addiction, porn addiction can affect how the individual perceives sexual activities and may lead to unhealthy attitudes towards them. The support groups for sex addiction mentioned above can also help with porn addiction and Pornography Addicts Anonymous can help those who wish to speak with others who have the same affliction.

Mental health support groups

The peer group model is also used by people struggling with depression, anxiety, PTSD, and eating disorders.

Many of these people—around 18% of the 42 million Americans with mental health conditions—also abuse substances, often to self-medicate. These dual diagnoses can complicate treatment for both their mental health condition and addiction and may make them poor fits for standard 12-step meetings. Two self-help and mutual aid programs target just that population.

Dual Diagnosis Anonymous

Dual Diagnosis Anonymous is a support group especially designed for people with severe and persistent mental health and/or substance use challenges and their families. DDA follows a “12 plus 5” step model. The extra five steps guide participants through accepting their mental illness, becoming open to medication, therapy, and other clinical interventions, and working toward a healthy life. DDA hosts meetings in primarily Oregon but also in seven other U.S. states and the UK.

Dual Recovery Anonymous

Dual Recovery Anonymous is a 12-step self-help program for people who want to stop using alcohol and drugs and manage their emotional and psychiatric illnesses in healthy and constructive ways. 

Finding support groups near you

To find support groups and other addiction treatment options near you, click here.

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Resources:

  1. National Institute on Drug Abuse. (2020, June 1). Principles of Effective Treatment.
  2. Wallace, S. (2016, September). Benefits of peer support groups in the treatment of addiction. Substance Abuse and Rehabilitation, Volume 7, 143–154.
  3. Armitage, E. V., Lyons, H., & Moore, T. L. (2010, July 8). Recovery Association Project (RAP), Portland, Oregon. Alcoholism Treatment Quarterly, 28(3), 339–357.
  4. Ingalsbe, M. H., Benbow, J., & Daley, D. C. (2013, May). 12-Step Interventions and Mutual Support Programs for Substance Use Disorders: An Overview. Social Work in Public Health, 28(3–4), 313–332.
  5. Kelly, J. F., & Moos, R. (2003, April). Dropout from 12-step self-help groups: Prevalence, predictors, and counteracting treatment influences. Journal of Substance Abuse Treatment, 24(3), 241–250.
  6. Stewart, R. M., & Brown, R. I. F. (1988, February). An Outcome Study of Gamblers Anonymous. British Journal of Psychiatry, 152(2), 284–288.
  7. A.A. Around the World. Alcoholics Anonymous.
  8. Narcotics Anonymous World Services. (2018). NA World Services Annual Report 2017–2018. https://www.na.org/admin/include/spaw2/uploads/pdf/reports/ar/2018/AR_2018_WB_Note.pdf
  9. Andersen, K. J., & Kallestrup, C. M. (2018, June 27). Rejected by A.A. The New Republic.
  10. Alcoholics Anonymous General Service Office. (2022, January). Estimates of A.A. Groups and Members as of December 31, 2021. Alcoholics Anonymous.
  11. Principles and Positions. SMART Recovery.
  12. Secular Organization for Sobriety. (2002). SOS: The Sobriety Priority [Pamphlet].
  13. Women for Sobriety. (2022, May 15). New Life Program.
  14. Celebrate Recovery. Saddleback Church.
  15. Moderation Management. (2021, March 22). About Moderation ManagementTM (MM) – Our Support Community Overview.
  16. Fellowship of Narcotics Anonymous. (2008). Narcotics Anonymous Basic Text (6th ed.). Narcotics Anonymous World Services, Inc.
  17. Cocaine Anonymous World Services, Inc. About C.A. - For the Public. Cocaine Anonymous.
  18. Nar-Anon Family Groups. (2014). Affected by a Loved One’s Addiction? [Pamphlet].
  19. Gamblers Anonymous International Service Office. About Us. Gamblers Anonymous.
  20. Working the Program. Overeaters Anonymous.
  21. SAA Program Info. Sex Addicts Anonymous.
  22. Dual Diagnosis Anonymous. The DDA 12 Steps Plus 5. Dual Diagnosis Anonymous UK.
  23. Dual Recovery Anonymous World Network Central Office. Dual Recovery Anonymous – a 12 Step Fellowship. DRA Online Resource Center.

Activity History - Last updated: 27 November 2024, Published date:


Reviewer

Morgan Blair

MA, LPC

Morgan is a mental health counselor who works alongside individuals of all backgrounds struggling with eating disorders. Morgan is freelance mental health and creative writer who regularly contributes to publications including, Psychology Today.

Activity History - Medically Reviewed on 18 September 2022 and last checked on 27 November 2024

Medically reviewed by
Morgan Blair

Morgan Blair

MA, LPC

Reviewer

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