The first 12-step program was Alcoholics Anonymous (AA), founded in 1935; an array of 12-step groups following a similar model have since emerged and are the most widely used mutual aid groups and steps for maintaining recovery from alcohol and drug use disorders.
Well-supported scientific evidence demonstrates the effectiveness of 12-step mutual aid groups focused on alcohol and 12-step facilitation interventions. Evidence for the effectiveness of drug-focused mutual aid groups is promising.
Most people who define themselves as being “in recovery” have experience with 12-step-oriented mutual aid groups such as AA and Narcotics Anonymous (NA) and endorsement of abstinence as “essential” is most common among those who were affiliated with 12-step mutual aid groups.
These mutual aid 12-step groups are perhaps the best-known type of Recovery Support Services, and they share a number of features. The members share a problem or status and they value experiential knowledge— learning from each other’s experiences is a central element—and they focus on personal change goals. The groups are voluntary associations that charge no fees and are self-led by the members.
Beginning in the 1950s, the AA approach was adapted to illegal drugs by the founders of NA, and in later decades it was adapted to other drugs as well (e.g., Cocaine Anonymous, Marijuana Anonymous, Crystal Meth Anonymous). Alcoholics Anonymous and its derivative programs share two major components: A social fellowship and a 12-step program of action that was formulated based on members’ experiences of recovery from severe alcohol use disorders. These 12 steps are ordered in a logical progression, beginning with accepting that one cannot control one’s substance use, followed by abstaining from substances permanently, and transforming one’s spiritual outlook, character, and relationships with other people.
Members of 12-step mutual aid groups tend to have a history of chronic and severe substance use disorders and participate in 12-step groups to support their long-term recovery.
Research studying 12-step mutual aid groups, specifically those focused on alcohol, has shown that participation in the groups promotes an individual’s recovery by strengthening recovery-supportive social networks; increasing members’ ability to cope with risky social contexts and negative emotions; augmenting motivation to recover; reducing depression, craving, and impulsivity; and enhancing psychological and spiritual well-being. Thus, with perhaps the exception of spirituality, many of the same mechanisms of behaviour change thought to operate in professional treatments also appear to be important benefits of 12 step group participation.