Originally proposed by Alcoholics Anonymous (AA) as a method of recovery from alcoholism, the Twelve Steps were first published in a book titled Alcoholics Anonymous in 1938 or 1939, compiled by several founding (and anonymous) members of the fledgling group.

AA’s 12-step model has been adopted by numerous self-help groups dedicated to treating all sorts of addictions, including but not limited to:

  • Food and eating addictions
  • Gambling and debt addictions
  • Addictive relationship issues
  • Sex and love addictions
  • Drug addiction, through the well-known Narcotics Anonymous.



Twelve-step programs owe their widespread availability to several factors:

  • 12-step programs are the oldest organized substance abuse rehab programs, and hence have become widely known.
  • Many are free, based entirely on self-help and volunteerism
  • Where programs are notfree, coverage by health insurance or state or municipal funding is sometimes available
  • Newer — and often more workable — drug rehab models are not free.


Many 12-step programs that deal with abstinence also offer modified programs for friends and families of addicts to help with “co-dependence” issues, and what are called “enabling” issues, where others contribute in some way to “enabling” and prolonging someone else’s addiction.



According to recent studies, 12-step programs suffer from a high attrition rate, although many people do achieve permanent sobriety.

There also is substantial criticism and resistance to 12-step programs’ insistence on belief in God and spirituality. Any workability 12-step programs may have is dependent on such beliefs, and on an addict’s personal submission to a “higher power”.

The best-known 12-step drug rehab program is Narcotics Anonymous. It uses the same 12 steps developed over 70 years ago by Alcoholics Anonymous, changing only the word “alcoholism” to “addiction”:

  1. We admitted that we were powerless over our addiction, that our lives had become unmanageable.
  2. We came to believe that a Power greater than ourselves could restore us to sanity.
  3. We made a decision to turn our will and our lives over to the care of God as we understood Him.
  4. We made a searching and fearless moral inventory of ourselves.
  5. We admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
  6. We were entirely ready to have God remove all these defects of character.
  7. We humbly asked Him to remove our shortcomings.
  8. We made a list of all persons we had harmed, and became willing to make amends to them all.
  9. We made direct amends to such people wherever possible, except when to do so would injure them or others.
  10. We continued to take personal inventory and when we were wrong promptly admitted it.
  11. We 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 a result of these steps, we tried to carry this message to addicts, and to practice these principles in all our affairs.



It is important to remember that before embarking on any drug rehab program, an addict requires detox, the “drying-out” period during which the body adjusts to doing without the substance of addiction. It is this difficult and uncomfortable process that causes most addicts to fail to achieve sobriety and enter rehab.

Detoxing from many drugs can also be more than just difficult, it can be a risk to health and life. The safest approach is to choose a medical drug detox program, usually a few days or a little longer, where patients are medically supervised 24/7 and assisted through the detox by experienced experts.