Do 12 Step Programs Work?

Twelve-step programs have become an integral part of the addictions treatment process, from detox treatment on through to the post-treatment stages of recovery. Unlike treatment services administered through rehab facilities, 12 Step programs take an informal approach in terms of relying on group members to support and guide one another through the ups and downs of recovery.

According to the U. S. Department of Veterans Affairs, an estimated nine percent of American adults have attended an Alcoholics Anonymous meeting at some point in their lives. While many may turn to 12 Step programs for day-to-day support, not everyone views this line of treatment as effective.

Do 12 Step programs actually work? As addiction has remained an ongoing problem within most every modern-day society, data on 12 Step program adherence and recovery outcomes abound. Ultimately, whether or not a person benefits from a 12 Step program depends on the amount of effort he or she puts into it.

How Do 12 Step Programs Work?

Purpose of 12 Step Programs

Twelve-step programs rely on the support group model as a means for helping recovering addicts address the daily challenges and obstacles that recovery brings. With ongoing abstinence as the primary goal, 12 Step programs work to decrease relapse rates while reducing the need for formal drug treatment services for their members.

Overall, 12 Step support groups provide:

  • A structured, long-term maintenance approach to maintaining abstinence on a day-to-day basis
  • Goal-oriented directives
  • Emotional support
  • Enjoyable drug-free activities
  • Positive role models with experience in recovery
  • Personal development training
  • A safe environment to talk about difficult emotional issues

In effect, the practice of attending support group meetings teaches those in recovery to use something or someone else as a means for changing how they feel rather than relying on the effects of drugs and alcohol.

The 12 Step Program Philosophy

The 12 Step philosophy encompasses a set of principles designed to undo the negative effects of addiction, while providing a framework for developing a drug-free lifestyle, according to the National Center for Biotechnology Information. Areas emphasized throughout include:

  • Individual growth and maturity
  • Spiritual development
  • Accepting the disease aspect of addiction as a condition that can never be eliminated from one’s life
  • Helping others in their recovery efforts
  • Avoiding self-centeredness

The use of a support group environment provides recovering addicts with a type of built-in social network made up of like-minded individuals who share similar life experiences and goals. The 12 steps per se represent 12 actual steps to be taken in consecutive order, each of which enables a person to work through particular issues or obstacles on their recovery path.

The 12 Step process requires each group member to:

  • Admit his or her powerlessness over addictive substances
  • Take a moral inventory of one’s motivations and priorities
  • Admit the nature of any wrongs committed against others
  • Identify and list the people harmed during the course of addiction
  • Make amends for wrongs done

Overall, the 12 steps become guiding principles for managing addiction in a person’s day-to-day life.


As one of the pillars of the 12 Step program, sponsorship offers recovering addicts the opportunity to learn from the experiences of someone who’s worked the 12 steps and maintained abstinence on a long-term basis. As a person works through the 12 steps, a sponsor provides:

  • Friendship
  • Guidance
  • Support
  • Acts as a sounding board
  • Understanding

In effect, the sponsor leads by example, sharing experiences had in recovery and passing along insights to help a person maintain ongoing abstinence on a day-to-day basis.

12 Step Program Outcomes

12 step program

Regular meeting attendance is crucial to 12 step program effectiveness.

More than anything else, actual participation in the 12 Step program process determines how much recovering addicts benefit from this line of treatment. Participation entails:

  • Regular meeting attendance
  • Reading 12 Step literature
  • The actual working of the steps
  • Getting sponsor
  • Becoming a sponsor
  • Service work, such as helping with meeting setup and running meetings

In general, active participation in the program increases the likelihood of successful recovery outcomes. Over time, those who take active roles in the program develop the types of habits and routines that make a drug-free lifestyle possible.

Treatment Effectiveness

Traditional drug treatment programs incorporate 12 Step program principles as a central component within the treatment process. Many addicts first encounter 12 Step support groups within detox treatment programs. Likewise, residential, inpatient and sober home programs all include support group work as part of their treatment services.

According to the National Institute on Drug Abuse, 12 Step programs can actually enhance the therapeutic benefits derived from standardized treatment approaches. Comparison studies show people who attend 12 Step support group meetings while in treatment maintained abstinence for considerably longer time periods than those who took part in only drug treatment or support group work.

Addiction Severity Outcomes

In cases of severe or long-term addiction, the effects of drugs and alcohol diminish the brain’s functional capacity leaving addicts unable to carry out daily living activities, such as holding down a job or maintaining a home. Amazingly, participation in 12 Step programs have been shown to be of greater benefit for people struggling with severe forms of addiction compared to people with mild to moderate addiction problems.

Studies tracking 6-month outcomes between these groups show better recovery outcomes for those dealing with severe addiction problems. In effect, regular attendance at twelve-step program meetings provided needed structure, socialization and helped greatly in developing coping skills for managing drug-using behaviors.

Dual Diagnosis Outcomes

It’s not uncommon for people coming off long histories of drug abuse to develop full-blown psychological disorders on top of severe addiction problems, also known as dual diagnosis conditions. In terms of regular participation in 12-Step programs, studies show people dealing with just addiction as well as dual diagnosis patients maintained regular attendance at support group meetings. Follow-up studies also show both groups showed a higher likelihood of ongoing abstinence at the one-year, two-year and five-year marks.


In spite of the structured format that characterizes the 12 Step program model, very few rules apply in terms of who can and cannot participate. Members choose to attend meetings according to their schedules and also choose to do the steps at their own pace.

Likewise, relapse episodes do not disqualify a person from membership. Ultimately, the effectiveness of the 12 Step approach depends on the person and the amount of effort he or she is willing to put into working the program.

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