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Summary Article: Twelve-Step Programs
from Drugs in American Society: An Encyclopedia of History, Politics, Culture, and the Law

Twelve-step programs use a set of principles commonly derived from the original program of Alcoholics Anonymous (AA). In 1939, AA produced its Twelve Steps to recovery based on a series of specific principles that Bill Wilson (1895–1971) and Bob Smith (1879–1950), the alcoholic founders, developed to help guide other drinkers through recovery. With membership requiring only a desire to quit drinking, the AA program transformed alcoholism treatment and helped millions of formerly hopeless alcoholics recover permanently. The focus of treatment is simple: in coming together in fellowship, members share their hope, strength, and experience to help others stop drinking and regain their physical, mental, and spiritual health.

Rather than a prescription for recovery, the Twelve Steps are principles that guide members seeking to address their addiction. AA's Twelve Steps, which other programs have adapted to their purposes, are as follows:

  1. We admitted we were powerless over alcohol—that our lives had become unmanageable.

  2. Came to believe that a Power greater than ourselves could restore us to sanity.

  3. Made a decision to turn our will and our lives over to the care of God as we understood Him.

  4. Made a searching and fearless moral inventory of ourselves.

  5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

  6. Were entirely ready to have God remove all these defects of character.

  7. Humbly asked Him to remove our shortcomings.

  8. Made a list of all persons we had harmed, and became willing to make amends to them all.

  9. Made direct amends to such people wherever possible, except when to do so would injure them or others.

  10. Continued to take personal inventory and when we were wrong promptly admitted it.

  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.

  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.

There is usually a strong focus on spiritual growth that, for some, is a religious journey. For others, the experience is embodied in the program's philosophy of reaching out to other addicts through fellowship and service, a healing and maturing process that takes place over a lifetime and is considered critical to recovery. Many Twelve-Step members who resist the religious perspective have found that their desire to be free of addiction can be a viable substitute for the higher power or deity to whom other members might direct their appeals and prayers. Exploring the Twelve Steps together and sharing common experiences have been shown to create a solid support structure on which millions of former and current members have been able to rebuild their lives.

Recognizing that any organization, no matter how loosely structured, must have a central philosophy and a governing framework, AA developed a set of Twelve Traditions; these were designed to prevent the development of a hierarchical power structure among members or service personnel and to reinforce the unifying, egalitarian spirit of local AA groups. These too have been adapted by other 12-step programs, and state:

  1. Our common welfare should come first; personal recovery depends upon AA unity.

  2. For our group purpose there is but one ultimate authority—a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.

  3. The only requirement for AA membership is a desire to stop drinking.

  4. Each group should be autonomous except in matters affecting other groups or AA as a whole.

  5. Each group has but one primary purpose—to carry its message to the alcoholic who still suffers.

  6. An AA group ought never endorse, finance, or lend the AA name to any related facility or outside enterprise, lest problems of money, property, and prestige divert us from our primary purpose.

  7. Every AA group ought to be fully self-supporting, declining outside con-tributions.

  8. AA should remain forever nonprofessional, but our service centers may employ special workers.

  9. AA, as such, ought never be organized; but we may create service boards or committees directly responsible to those they serve.

  10. AA has no opinion on outside issues; hence the AA name ought never be drawn into public controversy.

  11. Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio, and films.

  12. Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities.

The traditions ensure that the organizations can provide an accessible, safe, therapeutic environment in which addicts find acceptance, support, and fellowship, and thus they represent a form of group therapy that has saved millions from the ravages of addiction.

Frequent meetings of AA generally consist of sharing experiences and wisdom as well as readings from Alcoholics Anonymous (also called The Big Book), the organization's basic text. Other groups operate similarly, with readings from the original Big Book along with group-centered literature.

Although modern research into the neurobiology of addiction has shown that medications and other forms of counseling such as cognitive behavioral therapy also produce effective results, 12-step organizations have a very important—in some cases essential—role in helping addicts take critical steps toward recovery and maintenance of long-term sobriety.

See also: Addiction; Alcohol Use; Alcoholics Anonymous; Alternative Addiction Treatment; Recovery; Smith, Robert Holbrook; Treatment; Wilson, William G.

Further Reading
  • Alcoholics Anonymous. http://www.alcoholics-anonymous.org.
  • Carnes, Patrick. 1993. A Gentle Path Through the Twelve Steps. Hazelden Foundation Center City MN.
  • Frequently Asked Questions of Clutterer's Anonymous. https://sites.google.com/site/clutterersanonymous/Home/frequently-asked-questions.
  • The Tools and Principles of Workaholics Anonymous.” http://www.workaholics-anonymous.org/page.php?page=toolsandprinciples.
  • Tools of Recovery of Overeater's Anonymous.” http://www.oa.org/newcomers/tools-of-recovery/#literature.
  • Kathryn H. Hollen
    Copyright 2014 by Nancy E. Marion and Willard M. Oliver

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