12-Step Programs explained

The original 12-Step program was founded as means to help suffering alcoholics find a means of attaining ongoing sobriety. AA (Alcoholics Anonymous) as it is known was founded back in 1935 by Bill W and Robert S (Dr. Bob). AA is now a worldwide fellowship including a well established fellowship here in South Africa.

Since the inception of AA, many other variants of the 12 step process of recovery have been created, most notably NA which deal with addiction to substances including alcohol and drugs both street and prescription. Each fellowship has its companion fellowships AL-ANON and NAR-ANON which help families and friends who are in relationship with Alcoholics and Addicts.

There are other “Anonymous” programs that focus on variety of  eating disorders, co-dependancy and gambling disorders.

These programs centre on the process of recovery from the life long diseases of alcoholism and addiction and place at its centre the process of working the 12 instructional steps, the building of a relationship with a higher power or God of one’s own understanding and carrying out this process through regular interaction with other members through meetings. Meetings are run by members for members and it is stated in the literature of the respective fellowship’s that “The only requirement is a desire to stop drinking (AA) or Using (NA)”

Groups are completely autonomous, free of charge and do not involve medical practitioners or healthcare professionals.

Below is an article published by Medical News Today (full unedited article at 12 step program: Origin, how it works, and more (medicalnewstoday.com)

This article discusses the 12-step program in more detail, including its history, how it works, its effectiveness, and the possible risks. It also lists similar organizations and provides resources for getting help.

What is the 12-step program?

The 12-step program is a strategy that aims to help people recover from alcohol use disorder, substance use disorder, and other forms of addiction. Members of the programs run them, and they involve low or no costs. They are available in many communities.

Each program follows 12 standard steps. Below are the 12 steps of AA, which all the other programs adopt, making only minor variations to address their specific purpose:

1. We admit that we are powerless over alcohol and that our lives have become unmanageable.
2. We believe that a power greater than ourselves can help us.
3. We decide to turn our wills and lives over to the care of a higher power, whatever that may be.
4. We make a searching moral inventory of ourselves.
5. We admit to a higher power, ourselves, and another person the exact nature of our wrongs.
6. We are ready to have a higher power remove these defects in character.
7. We humbly ask the higher power to remove our shortcomings.
8. We make a list of people we have harmed, with whom we are willing to make amends.
9. Whenever possible, we make amends to these individuals.
10. We continue to take a personal inventory and promptly admit when we are wrong.
11. We ask for the knowledge of a higher power’s will for us and the strength to carry it out.
12. We try to carry this message to other people with alcohol use disorder and practice these principles in all our affairs.

According to researchTrusted Source, a person can distill the 12 steps into six phases, which include:

• refraining from drinking or misusing drugs
• going to meetings
• asking for help
• getting a sponsor
• joining a group
• becoming active

People typically use the programs as an add-on to treatment or as a form of continuing support following treatment.

Origins and history

An older 2010 studyTrusted Source notes that the first 12-step program, AA, began in 1935. AA’s cofounders were Bob Smith, a surgeon from Ohio, and Bill Wilson, a New York City stockbroker and entrepreneur. Wilson was the first person whom Smith helped recover from alcohol use disorder.

AA now has almost 2 million members around the world, with groups in 180 countries. More than 1.2 million members are in the United States.

Later in the 20th century, other programs followed, and the founders modeled them after AA.

NA emerged in the 1950s. As of 2010, it had almost 200,000 members in the U.S., along with groups in 130 countries.

Older research from 2013Trusted Source reports that Cocaine Anonymous launched in 1982. As of 2013, it had about 30,000 members and 2,000 groups globally.

Today, a broad array of 12-step programs addresses mental health conditions and potentially dysfunctional behaviors. Examples of these include:

• Debtors Anonymous
• Eating Disorders Anonymous
• Gamblers Anonymous
• Workaholics Anonymous

How does it work?

EvidenceTrusted Source states that a key feature involves the provision of support, or a social network, to help people remain substance-free or achieve other behavioral goals. In fact, it appears that the so-called fellowship, or social benefit, is one of the aspects of the program that most closely links to abstinence.

Membership in one of the groups changes a person’s social network. It reduces the number of people in their life who engage in substance misuse while increasing those who abstain from it. This social shift results in decreased exposure to activities and behaviors relating to substance use and increased opportunities to take part in unrelated activities.

The bonding among group members is another factor that underlies the program’s effectiveness. Bonding leads to the provision of role models for attaining abstinence and fosters goal directedness.

How effective is it?

StudiesTrusted Source show that the programs are as effective as other nonmedical treatments, such as cognitive behavioral therapy (CBT), for alcohol use disorder. However, researchers have not carried out studies comparing them with medication, which remains the gold standard in most cases of alcohol use disorder.

The research from 2013Trusted Source looked at data that indicated the effectiveness of the programs. It found that the medium length of abstinence among AA and NA members is longer than 5 years. Better outcomes are associated with:

• regular, early, and frequent attendance of meetings, such as attending three per week
• beginning the programs while in treatment
• engaging in other program activities, such as calling other group members or performing a service at a meeting

In other words, a link exists between the degree of involvement in the program and positive outcomes. Despite this association, it is not a cause-and-effect relationship.

What are the risks or negative aspects?

12-step programs have few risks. However, there are some possible negatives worth considering.

One is that some people might not feel comfortable with religion or spirituality. Rather than accepting the concept of powerlessness and surrendering to a higher power, they might prefer the idea of taking action and responsibility themselves. Another possible downside is the lack of trained professionals leading the groups.

11 (eleven) former AA members. Although these individuals said that they experienced some positives through AA membership, they also felt that they had remained a part of the AA because it had indoctrinated them into “a particular way of understanding themselves.” The researchers concluded that there is a large disparity between the reality that AA members experience and the “idealistic principles” of the AA.

Other similar organizations and program

Other organizations that aim to help people attain abstinence from unhealthy behaviors include:

• Alcoholics Anonymous
• Narcotics Anonymous
• Cocaine Anonymous
• Overeaters Anonymous
• Sex and Love Addicts Anonymous
• Gamblers Anonymous

The following programs seek to help family members or friends of people with substance use disorders or other problematic patterns of behavior:

• Adult Children of Alcoholics & Dysfunctional Families, a program that seeks to help those who grew up in households where they experienced neglect, abuse, and trauma
• Nar-Anon, a program for family members of individuals with substance use disorders
• Gam-Anon, a program for family members and friends of people with a compulsive gambling problem

Learn more about support groups here.

Seeking help for addiction may seem daunting or even scary, but several organizations can provide support. If you believe that you or someone close to you is struggling with addiction, you can find the programs mentioned in this article via their websites.

In South Africa

Narcotics Anonymous: www.na.org.za

Alcoholics Anonymous: www.aasouthafrica.org.za

Summary

Alcoholics Anonymous developed the first 12-step program, but such programs now exist in many different forms.

The 12-step program is a strategy for overcoming alcohol use disorder and other substance use disorders. It uses 12 distinct steps to guide people toward recovery.

There is limited research into its effectiveness, but one drawback is that it relies on people effectively surrendering themselves to a higher power. People who are not religious or spiritual may struggle with this concept.

That said, there are an estimated 2 million AA members worldwide, with even more people belonging to similar organizations. Many individuals have found success in treating their substance use disorders with the 12-step program.

People interested in partaking should speak with a relevant organization or healthcare professional about ways in which to treat and manage their substance and alcohol use disorders.

With thanks to Medical News Today.