How Do 12 Step Groups Help Addicts With Treatment And Recovery?

Cocaine. Marijuana. Crystal meth. Heroin. Sex. Gambling. Food. It all started with Alcoholics Anonymous, but there are now 12-step groups for every conceivable addiction under the sun, and even for some things that wouldn't really fall under addiction — such as for underearners and people living in clutter. 

If you're struggling with an addiction and you are committed to achieving remission, someone will suggest a 12-step group — one that starts with the name of the thing you're addicted to and ends with "Anonymous" — to you. And if you have an addicted relative, there are 12-step groups just for you, too.  

How do 12-step programs for addiction recovery work? What you need to know about the 12 steps

Alcoholics Anonymous emerged to help sober alcoholics in the earlier half of the twentieth century, but the organization wasn't done developing. Co-founder Bill Wilson held the opinion that, to best help addicts, the group needed a system and a program — something concrete for members to cling onto during hard times. This culminated with the famous "Big Book", published in 1939. 

Though the original 12 steps of recovery have since been reworded and aren't identical within every single group, they remain largely the same:

• Step 1 requires the addict to admit they are powerless in the face of their addiction and that their life has become unmanageable. 
• Step 2 involves accepting the idea that a "higher power" — who may be referred to as God, or not — can "restore" the addict "to sanity". 
• Step 3 is the addict's decision to turn their lives over to God (or a higher power). 
• Step 4 requires the addict to face their failings and create a "moral inventory".  
• Step 5 asks the addict to admit the exact nature of those failings to God (or a higher power), themselves, and another human. 
• Step 6 has the addict declare their willingness to have God or a higher power remove those moral failings. 
• Step 7 involves asking God or a higher power to take the addict's shortcomings away. 
• Step 8 asks addicts to make a list of people they have wronged. It additionally specifies that the person has to be ready to make amends. 
• Step 9 is the step of actually making those amends, unless doing so would harm the wronged person or someone else. 
• Step 10 essentially means continuing to look the wrongs a person does in the eye, and to admit being at fault whenever they are. 
• Step 11 involves prayer and asking of God or the higher power to grant the addict the knowledge to understand God's will for them and the strength to do God's will. 
• Step 12 is a spiritual awakening, a commitment to all these prior steps, and the resolve to share these steps and this path with other addicts. 

The 12 steps are, as you can see, deeply spiritual — and if we're going to be honest, religious — in nature. Groups adapted to agnostics and atheists do exist, but the whole foundation of these groups is deeply Christian. These 12 steps have given recovering addicts hope and motivation for a very long time, and there is no doubt that they have helped a portion of those who attend Alcoholics Anonymous and its numerous sister groups stay sober and clean.

Beyond the 12 steps: What actually happens during meetings?

Meetings are led by a group member — this may be decided beforehand, or the person may volunteer on the spot — and begin with a prayer or meditation. Members can then share the nature of their addiction and talk about themselves a bit; this is the classic "My name is Steve, and I'm an alcoholic" portion of the meeting. This is followed by readings from 12-step literature, a discussion of another book, a speaker, or a topic discussion. Members then have the chance to share challenges they may be facing, and the group meeting finishes with another prayer or meditation. 

Sponsors and chips are two other key parts of 12-step groups.

A sponsor is an experienced member who has been in remission for a good amount of time and has reached the end of the 12 steps. Less experienced members can be coupled with a sponsor, who can help them get used to the group, give them advice, and be there in times of need. A sponsor can be incredibly helpful, improving addicts' chances of staying sober or clean. They are, however, not trained professionals. 

The chips are essentially a form of contingency management — tokens addicts receive for staying clean and sober for a certain period of time. Research has shown this to be motivating. Fall off the wagon, however, and you start from scratch. For some people, this can can have a very demotivating effect. 

How well do 12-step programs work for recovering addicts?

To give it to you straight — it's not clear how well 12-step programs work, despite the fact that even many doctors would recommend them to recovering addicts or those hoping to become recovering addicts. Some studies show that attending a 12-step program significantly increases a person's odds of reaching remission from addiction and staying there, while others even come to the conclusion that attending a 12-step program leads to worse outcomes than not being in treatment at all. 

Research is, however, clear on some things:

• Motivation plays a key role in addiction recovery. That is, to stay clean or sober, a person has to want it. For some, the 12 steps may help with motivation. If that's you, attending a 12-step program could very well be the right fit for you. 
• Social support greatly increases the odds of long-term remission from addiction. There's no doubt that 12-step programs feature people who understand what you are going through, because they are in the same boat or have been. These programs may also help you make sober and clean social contacts.