Addiction isn't a choice. That statement may not seem groundbreaking today, but the idea of alcoholism as an illness was a new concept in 1939 when the book Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism was published.
Known as the Big Book of Alcoholics Anonymous, the publication changed the conversation about alcoholism and catapulted the Twelve Step model of recovery into the public's eye. The original AA model was later used to form other recovery programs to help people with different addictions and compulsive behaviors. The Twelve Steps were adopted nearly word-for-word by Al-Anon/Alateen, a program of recovery for the families and friends affected by a loved one's drinking (whether or not the alcoholic recognizes they have a drinking problem).
The Twelve Steps are a set of guiding principles in addiction treatment that outline a course of action for tackling problems related to alcoholism, drug addiction and behavioral compulsion.
Step 1: We admitted we were powerless over alcohol—that our lives had become unmanageable.
Step 2: Came to believe that a Power greater than ourselves could restore us to sanity.
Step 3: Made a decision to turn our will and our lives over to the care of God as we understood Him.
Step 4: Made a searching and fearless moral inventory of ourselves.
Step 5: Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
Step 6: Were entirely ready to have God remove all these defects of character.
Step 7: Humbly asked Him to remove our shortcomings.
Step 8: Made a list of all persons we had harmed, and became willing to make amends to them all.
Step 9: Made direct amends to such people wherever possible, except when to do so would injure them or others.
Step 10: Continued to take personal inventory and when we were wrong promptly admitted it.
Step 11: 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: 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.
Bill Wilson and Dr. Bob Smith, the two men who founded AA in 1935, drew their inspiration for the Twelve Steps from the Oxford Group. They believed that all problems rooted in fear and selfishness could be changed through the power of God by following the "Four Absolutes"—a moral inventory of "absolute honesty, purity, unselfishness and love"—and through public sharing/confession. The Twelve Steps and the fellowship of AA were founded and designed around those principles.
The purpose is to recover from compulsive, out-of-control behaviors and restore manageability and order to your life. It's a way of seeing that your behavior is only a symptom, a sort of "check engine" light to investigate what's really going on under the hood.
According to the American Society of Addiction Medicine, "Twelve Step facilitation therapy is a tried-and-true proven approach." (There's a reason, after all, why people still "work the Steps" more than 80 years later.) How does it work? People are encouraged to take an honest look at themselves, then deconstruct their egos and rebuild, little by little. Why does it work? The Steps encourage the practice of honesty, humility, acceptance, courage, compassion, forgiveness and self-discipline—pathways to positive behavioral change, emotional well-being and spiritual growth.
The Twelve Traditions are associated with the 12 Steps, but they’re not personal guidelines for the addict or alcoholic: they're general guidelines for healthy relationships between the group, members and other groups. According to AA, "[These] principles, which had emerged from strenuous group experience, were codified by Bill in what today are the Twelve Traditions of Alcoholics Anonymous. A successful formula for AA unity and functioning had been achieved and put into practice."
No. While it's true that the 12 Steps were originally based on the principles of a spiritual organization, the world isn't the same as it was in 1935 when AA and the 12 Step program were founded. The word "God" was eventually replaced with "Higher Power" to be more accessible to everyone, regardless of faith traditions or beliefs. A Higher Power doesn't have to be God; it could be nature, the universe, fate, karma, your support system, the recovery group itself, medical professionals or whatever you feel is outside of and greater than yourself/your ego. What you believe to be a Higher Power is a very personal thing.
Admitting powerlessness is not the same as admitting weakness. It means asking for help, leaning on others and relying on your support system. It means admitting—and accepting—that you're living with a disease that alters your brain. It might seem backward, but when you admit that you don't have power, you finally access the power you need.
With the Twelve Steps, there is no hard and fast timeline. The Steps are meant to be addressed in sequential order, but there's no one "right" way to approach them. Sometimes people need a break between Steps, sometimes people need to spend longer on one Step than another, some people never stop working the 12 Steps because they become part of life.
The Twelve Steps are widely known, established and organized. (It's one of the oldest programs around.)
Those struggling with substance abuse have access to a supportive network of peers.
It's easy to find a meeting where the Twelve Steps are practiced.
There's little to no cost to those in need—it's a free intervention to address a chronic disease.
Some people aren't interested in participating in group settings.
Due to the anonymous nature of the group, there's a lack of official shared success rates.
The Steps are criticized for not addressing the needs of those struggling with mental illness.
When the Twelve Steps were originally created, science had yet to prove a genetic link to addiction.
The Substance Abuse and Mental Health Services Administration has identified a number of alternative groups and approaches. 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 list includes:
Self-Management and Recovery Training (SMART Recovery)
Secular Organizations for Sobriety (SOS)
LifeRing Secular Recovery
Women for Sobriety
The Wellbriety Movement
Conduct your own research into each group’s strategies and guiding philosophies to find out which will best suit your needs.