All About the Twelve Steps

If you compare the number of people with a drug or alcohol addiction to those struggling with cancer, you will find that the value is more than double. About 23 million people in the United States have a substance use disorder, and there are 55,000 Alcoholic Anonymous meeting groups with a total attendance of about 1.2 million. Many others participate in one of the 11,000 drug rehabilitation programs. Among the numerous alcohol and drug treatment facilities across the country, there is one type of program you are bound to encounter: a 12-Step program. The Twelve Steps have proven to be very popular because they are highly effective and accessible in communities in the U.S. and around the world. Many who have been trying to get sober or recover will report experiencing a complete about-face in their lives. The Twelve Steps have thus become a cornerstone of transformation in substance use recovery. 

Background on Its Evolution

In the summer of 1935, a man named Bill Wilson had been detoxing in a Manhattan drug rehabilitation center when he came to a revelation about his own addiction. Then and there the Twelve Steps were born. “The Big Book” was written to pass on the principles of the program to others. The Twelve Steps originally served as the foundation for Alcoholics Anonymous (AA). Later on, other support groups – Narcotics Anonymous (NA), Cocaine Anonymous, Gamblers Anonymous, Overeaters Anonymous and Emotions Anonymous – adopted them, too.

It may come as a surprise that Wilson was not a medical doctor, nor did he have any formal training in psychology or addiction treatment. Instead, he formulated the Twelve Steps from his personal transformation and value framework rooted in philosophy and religion. Although the Bible inspired his work greatly – God and a higher power are frequently referenced – you do not have to be religious to participate or reap the benefits of the program. 

Letting the Principles Guide You

The Twelve Steps consist of twelve actionable principles that will guide you in your sobriety journey. To give you some idea, the first principle is: “We admitted our powerlessness over our illness, or drugs and alcohol—that our lives had become unmanageable.” The last is: “Having had a spiritual awakening as the result of these steps, we tried to carry this message to drug and alcohol addicts, and to practice these principles in all our affairs.” These guidelines have been condensed into an easy-to-remember list of six: abstain from alcohol and drug use, attend meetings, ask for help, acquire a sponsor, join a group and get active.

The underlying philosophy views the path of recovery in a particular way. It accepts addiction as a disease that can be treated but not cured. As a result, the process of self-betterment through “enhancing individual maturity and spiritual growth, minimizing self-centeredness, and providing help to other individuals who are addicted” is ongoing. You can help others by sharing your stories in meetings or becoming a sponsor to new members. 

As a part of accepting addiction as a disease, you also admit to your powerlessness over drugs and alcohol. According to the Twelve Step philosophy, this is where recovery begins. Doing step-based work creates an opportunity for you to admit wrongdoings, identify who you may have hurt along the way and redeem yourself. You will sincerely and earnestly identify your morals and start to live by them. All of this healing work is done in 12-Step meetings with others who have also pledged to better their lives. Community members encourage each other to remain substance-free. This support system can be just what some need to find the motivation to press on.

The Effectiveness of 12-Step Programs

 It would be erroneous to propose that the Twelve Steps can and will work for every person. Addiction is individualized and can be complicated by a person’s circumstances and past trauma. Nevertheless, the Twelve Steps have proven to be highly transformational for many of the people who have participated. Some studies have found that early participation in groups like AA and NA while in addiction treatment leads to an increased likelihood of abstinence for as long as 16 years and improved psychosocial functioning and self-efficacy. Involvement that is consistent and frequent was also cited as an important variable for success.

In a Stanford Medicine Newsletter published March 11, 2020, the results of a comprehensive review of 35 studies are discussed. The journal article involved analyzing the work of 145 scientists who were studying alcohol addiction in 10,080 patients. The researchers determined that AA was almost always more effective than psychotherapy in helping individuals refrain from drinking. The researchers attribute its effectiveness to the emotional support and practical tips received through social interaction. Additionally, surrounding yourself with people who have the same life goals as you can act as a positive and motivating influence to keep you on track. This is why the Twelve Steps work!

Millions of people attend anonymous meetings for drug and alcohol addiction. Much of the work done within these groups is based on the guidelines of the Twelve Steps. The Twelve Step perspective is that the recovery process starts when you accept you are powerless over your addiction. While not right for everyone, this program has proven to be highly transformational for the many who have participated. Casa Palmera is a fully licensed treatment facility located in West L.A. We have experience in treating a variety of addictions and co-occurring mental health conditions. Casa Palmera is one of a few centers in the area that uses the principles of 12-Step programs as a foundation for clinical values. We pride ourselves in this, as the Twelve Steps have helped many people in this country and others find peace and freedom from addiction. Contact us today to learn more about our approach and how it can change your life.


This blog is for informational purposes only and should not be a substitute for medical advice. We understand that everyone’s situation is unique, and this content is to provide an overall understanding of substance use disorders. These disorders are very complex, and this post does not take into account the unique circumstances for every individual. For specific questions about your health needs or that of a loved one, seek the help of a healthcare professional.