The Role of 12-Step Programs in Recovery from Alcohol Use Disorder (AUD) and Substance Use Disorder (SUD)

12 step programs group
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When someone thinks of quitting alcohol or drugs, nine times out of ten the first thing that pops into their mind are 12-step programs such as Alcoholics Anonymous (AA). That’s because when AA began in the 1930s, it was the first organized system created by alcoholics, for alcoholics, to help them quit drinking alcohol. AA was not the first organized movement to help people with problem drinking – those appeared in the 19th century – but it was the first that sought to help people through community and fellowship.

Whereas the early temperance and abstinence movement sought to remove people with drinking problems from society and place them in reformatories, sober houses, or homes for inebriates in order to treat them for their disease, the founders of AA realized the best way for a person to stop drinking was to welcome them to a supportive group of like-minded individuals who shared one common goal: to achieve sobriety through abstinence from alcohol.

That’s how the community support model of treatment for addiction began.

It’s the same Twelve Step model is in use around the world today. AA has chapters in almost every country, and a global membership of over two million people. Experts debate AA’s effectiveness, and research over the past fifty years shows mixed results. Some studies say AA works, some say AA doesn’t work, and others say AA works in combination with other treatments, such as lifestyle changes, therapy, and in some cases, medication. However, the latest research on AA, published by Stanford University in 2020 – which included data from 27 studies containing over 10,000 participants – concludes that AA and other Twelve Step programs are more effective than other established treatments for increasing abstinence from alcohol.

How Do Twelve Step Programs Work?

During a Twelve Step recovery program, people participate in group meetings with others who are in recovery from an alcohol or substance use disorder. There a Twelve Step support groups for intoxicants other than alcohol: Narcotics Anonymous (NA) and Cocaine Anonymous (CA) are two of the most well-known. While NA and CA are not identical to AA, they follow the same general pattern. Members meet regularly – sometimes as often as twice a day – to share their experiences and discuss their successes and challenges in recovery. With group help and support, they work their way through each of the twelve steps. To learn more about what each step entails, visit the Alcoholics Anonymous website.

The Power of Community

One thing people learn when they enter treatment for AUD or SUD is that recovery is a lifelong journey. In comparison to their entire life, the time they spend in treatment is relatively short. That’s why treatment centers focus on building simple, effective, and durable skills that people in recovery can learn quickly and use right away. That’s also why community support programs like AA are almost always a part of treatment for alcohol and substance use disorders. When people enter treatment, they often need to rebuild their lives from the ground up. This means creating an entirely new social network and learning ways to socialize and have fun that don’t revolve around alcohol or drugs.

Community support groups provide both: a group of people with shared values – sobriety and abstinence – and a group of people with whom they can socialize without feeling left out because they don’t drink or do drugs.

Here’s a definition of recovery developed by the National Institute of Health (NIH):

“A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.”

The NIH identifies four components that support a life in recovery, one of which is community, which they define as:

“Relationships and social networks that provide support, friendship, love, and hope.”

Community support groups provide those relationships and those networks. They provide the love and hope that helps people through hard days, and helps them celebrate recovery and sobriety milestones. Participating in community support groups does not mean people in recovery have to become outgoing, talkative socialites. It simply means that if they add people in recovery to their social network – even just one – they increase their chances of achieving sustained sobriety.