- The success of AA launched numerous versions of the support network, including Narcotics Anonymous, Gamblers Anonymous, Sexaholics Anonymous, and Overeaters Anonymous, all of which utilize the 12-step program
- The 12 steps of Alcoholics anonymous aim to help addicts recover from destructive, compulsive, and unregulated behaviors and restore or instill manageable routines and order into their lives
- While the 12-steps were founded and based on a spiritual principle of religious organizations, The world and AA have come a long way since and The Steps have moved in accordance to be applicable to everyone. The word god was at one point replaced with ‘Higher Power’ so as to not alienate those without religious beliefs
Alcoholics Anonymous (AA) has been going for over 80 years and their 12 step program has become synonymous with addiction recovery the world over.
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Where do the 12 steps of AA come from?
The concept of alcoholism as an illness may not seem like a bold idea today but in 1939, when the book Alcoholics Anonymous: The Story of How More than 100 Men Have Recovered from Alcoholism was published, many people believed addiction was a choice. Today, researchers agree that there are aspects of addiction that reflect it is a disease that some are more susceptible to, especially if they have a family history of mental illness, addiction, or trauma. [1, 2]
The publication not only launched Alcoholics Anonymous (AA) as a globally recognized institution and changed the way addiction was thought of, it also introduced the 12-step model of recovery into the public arena and led to Alcoholics Anonymous world services becoming renowned. The success of AA launched numerous versions of the support network, including Narcotics Anonymous, Gamblers Anonymous, Sexaholics Anonymous, and Overeaters Anonymous, all of which utilize the 12-step program. 
Despite its worldwide recognition, the twelve-step program remains somewhat of a mystery to those outside of the world of addiction recovery. Even within the recovery world, some people believe AA and NA are religious programs and don’t want to participate in them because they aren’t religious.  In reality, these programs only ask for people to identify some kind of ‘higher power’, and aren’t necessarily spiritual or religious in nature. 
Below we explore the 12-step AA program, how they work, why they are so successful in helping recovering addicts maintain sobriety, and why they haven’t changed in over 80 years.
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What are the 12 steps of AA?
The 12-steps act as a set of guiding principles for people in recovery from an alcohol addiction to use when combating their problems. They help with acceptance, introspection, moral discipline, and helping others overcome addiction. The standard representation of the 12-steps of AA is as follows:
- Step 1 of AA: We admitted we were powerless over alcohol—that our lives had become unmanageable.
- Step 2 of AA: Came to believe that a Power greater than ourselves could restore us to sanity.
- Step 3 of AA: Made a decision to turn our will and our lives over to the care of God as we understood Him.
- Step 4 of AA: Made a searching and fearless moral inventory of ourselves.
- Step 5 of AA: Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- Step 6 of AA: Were entirely ready to have God remove all these defects of character.
- Step 7 of AA: Humbly asked Him to remove our shortcomings.
- Step 8 of AA: Made a list of all persons we had harmed, and became willing to make amends to them all.
- Step 9 of AA: Made direct amends to such people wherever possible, except when to do so would injure them or others.
- Step 10 of AA: Continued to take personal inventory and when we were wrong promptly admitted it.
- Step 11 of AA: 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.
- Step 12 of AA: 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.
What is the purpose of the Twelve Steps?
The 12 steps of Alcoholics anonymous aim to help addicts recover from destructive, compulsive, and unregulated behaviors and restore or instill manageable routines and order into their lives. Each of the steps reinforces the idea that addiction has extremely damaging effects on a person, and provides them with the beliefs, skills, and supports to overcome this issue and get their lives back. 
Some of the purposes of the 12 steps include:
Overcoming denial of the addiction
Develop a community of sober supports
Learn skills and knowledge from others in recovery
Understand and address the root causes of addiction
Working to recognize the negative impacts addiction has had on a person
Develop faith and hope to begin the recovery process
Develop confidence in oneself to overcome the addiction
Repair broken relationships and right problems caused during active addiction
Help others in recovery by mentoring, supporting, and guiding them
How does it work?
The 12 step model has helped many people overcome addictions to drugs, alcohol, and other destructive behaviors. It works by helping people gain knowledge, insight, faith, confidence, skills, and support from others. It also works by helping people have guiding principles to rely on during times when they are tempted to return to the addiction.
Why does it work?
The Steps encourage the practice of honesty, humility, acceptance, courage, compassion, faith, forgiveness, and self-discipline-pathways to positive behavioral change, emotional well-being, and spiritual growth. These principles also help people to make other changes in their lives including improving relationships, taking accountability, working towards goals, and recognizing and taking action to improve their lives, behavior, and circumstances.
Is it necessary to be religious to follow the 12 steps?
In short, no. While the 12-steps of AA were founded and based on a spiritual principle of religious organizations, The world and AA have come a long way since and The Steps have moved in accordance to be applicable to everyone. The word god was at one point replaced with ‘Higher Power’ so as to not alienate those without religious beliefs.
Though some may still feel religious connotations around these words, Higher Power is meant to represent a power greater than one's own ego as opposed to any deity or metaphysical being. It can be a concept, the universe, the world around us, fate, karma, the recovery group itself, or anything the person using the 12-steps deems to be greater than themselves. It is a very personal thing and everyone's interpretation of the Higher Power is different. 
How long does it take for the Twelve Steps to work?
There is no direct timeline to the Twelve Steps and everyone goes through them at different speeds. Though they are meant to be addressed in sequential order, there is no correct way to take on each step and the order is often down to the individual's current position and mindset. Some people may require more time on an individual step or need a break after a, particularly challenging one. Some people will adjust their lives to the point where they no longer need the steps, whereas others adopt them as a way of life that they constantly work on.
Pros of the Twelve Steps
- Widely recognized and established
Connects people in recovery to an active support network
Instills positive values, morals, and principles that can help boost motivation
There are many groups and meetings all over the country
There’s no cost other than what you donate, making it accessible to all
Proven to be effective in helping people overcome addictions
Can be combined with other treatment options
Can help to prevent relapse
Does not have a time limit
- Meetings are available in most places in the US and abroad
Is not led by a licensed or trained professional
Cons of the Twelve Steps
Not good for those who don’t like group settings
Is not led by a licensed or trained professional
Does not count as ‘formal treatment’ for addiction
Discourages the use of any substances, including prescribed medications
Does not address co-occurring health or mental health issues
Is not confidential so there is no guarantee for privacy/anonymity
People in small communities may feel exposed when going to meetings
Some people require more intensive treatment for their addictions
Some people don’t like the sole focus on sobriety
Meeting size, structure, and quality can vary depending on the group
People wanting to moderate/cut back may not find support within these communities, which are sobriety-focused
Alternatives to a 12-step program
The Substance Abuse and Mental Health Services Administration (SAMHSA) identifies many national groups that offer an alternative approach to the Twelve Steps. These groups are secular in nature, emphasize internal control, evolve with changing research in the field of addiction, and generally oppose labels that define past behavior. The SAMHSA list includes the following:
Self-Management and Recovery Training (SMART Recovery): Emphasis on learning how to cope with urges and cravings, based on cognitive behavioral therapy and motivational interviewing. Established in 1994.
Secular Organizations for Sobriety (SOS): Develop strategies to achieve and maintain sobriety (abstinence) from alcohol and drug addiction, food addiction, etc. Established in 1985.
LifeRing Secular Recovery: The focus here is on the three Ss: sober, secular, and self-directed. Established in 2001.
Moderation Management: Designed for those who think their drinking has become a problem and want to moderate it before it gets out of control. Focus on 30 days of abstinence and guidelines about moderate drinking. Established in 1994.
Women for Sobriety: Focus on positive thinking, personal responsibility, embracing the future (rather than dwelling on past mistakes). Established in 1976.
Refuge Recovery: This organization is grounded in the belief that “Buddhist principles and practices create a strong foundation for a path to freedom from addiction. This is an approach to recovery that understands: All individuals have the power and potential to free themselves from the suffering that is caused by addiction,” according to refugerecovery.org.
The Wellbriety Movement: Advocating for Native American Recovery and Wellness, this movement carries the message of cultural knowledge about recovery for individuals, families, and communities.
12 step meetings like AA and NA can be great options for people in recovery from an addiction, and new groups are created all the time to focus on specific types of problems and addictions. While these meetings have helped many people get and stay sober, they may not be for everyone. Some people require more intensive addiction treatment or may want to combine support groups with therapy, medication, or rehab. Others will want alternatives to 12 steps and may benefit from seeking out other support groups for people in recovery.