Some of the most widely accessible recovery resources in the United States are 12-step fellowships, such as Narcotics Anonymous (NA) and Alcoholics Anonymous (AA). Narcotics Anonymous was formed in the early 1950s in Southern California.3 NA is a recovery program adapted from Alcoholics Anonymous and based on the 12 steps. The main distinction from AA is that NA members classify themselves as “addicts” and identification is all-inclusive to any mood or mind-altering substance.3 NA was born because addicted people were unable to talk openly about their specific problems in AA meetings, where the words “sober” and “clean” clashed. The NA literature refers to alcohol as a drug and deals with the illness of addiction, whereas AA focuses primarily on alcoholism. NA’s mission is to provide a context where addicts can help one another stop using drugs and find a new, healthy way to live. The only requirement for NA membership is a “desire to stop using drugs.”3
Originating in Los Angeles, NA grew quickly and is now a worldwide organization, with meetings spread across North and South America, the Middle East, Europe, Australia, New Zealand, and Russia.3 A total of 67,000 NA meetings occur weekly in 139 countries and NA literature is available in 49 different languages.3 Statistically, NA’s gender ratio is 59% male and 41% female.3 NA is not restricted to any political or geographic boundaries, nor is it limited to any one faith, dogma, or philosophy.2 The main tenets of NA are based upon three basic features: Unity, Service, and Recovery (meetings, service work, and the 12 steps), as depicted by NA’s triangular emblem. The NA program is a set of spiritual principles used to recover from addiction.
NA’s 12 steps begin with “We” instead of “I.” The purpose of this is to demonstrate how program members recover together and to highlight the importance of community.
The 12 steps of Narcotics Anonymous are as follows:2
The 12 steps are positive tools that help make recovery possible.2 Working the 12 steps of recovery is a cornerstone of most, if not all, 12-step programs. Generally, members will look for a sponsor with whom they feel comfortable being rigorously honest with. Twelve-step work may involve writing assignments, taking inventory, making lists of persons/places harmed, and making direct amends. Steps 10, 11, and 12, also known as the maintenance steps, are practiced daily. You can work through the 12 steps at your own pace or as negotiated between you and your sponsor.
The 12 traditions of NA are to the group what the 12 steps are to the individual. The NA 12 traditions are as follows:7
The 12 traditions are the guidelines that keep the NA fellowship alive. They are a set of standards to be followed by the group so that internal dealings are smooth and effective and NA’s mission can be carried out. The 12 traditions are spiritual tools used to interact with other people harmoniously. NA members vote on certain topics in meetings, and often a group conscience is necessary. The 12 traditions help keep everyone on the same page. They also protect the NA fellowship as a whole, so that outside forces cannot interfere.
Twelve-step programs like NA, during and after treatment, are a cost-effective and useful approach to promoting recovery from drugs and other substances.1 Based on a survey conducted in 2015, the average length of continuous clean time in NA is 8.32 years.3 Research shows that attendance of 3 or more NA meetings per week are associated with complete abstinence and optimal outcomes.4 Results from the survey confirmed that people were 4.1 to 8.6 times more likely to stay abstinent by continuously attending 12-step meetings and remaining involved.4 Another study found that individuals who consistently attend NA meetings have higher abstinence rates than those who do not participate in the 12-step program.5 The more meetings someone attends in the first 6 months after seeking treatment the more likely they are to be clean at 6-month follow-up.5
Belief in the 12-step ideology, specifically that moderate use of drugs is not an option, is the greatest factor of abstinence regardless of how many NA meetings individual people attended.5 People receiving individual counseling are more active in self-help groups, such as NA.5 A person’s ability to remain clean is also dependent on the user’s non-drug dependent “clean” network; the environment and social circle impact a person’s recovery.6
Religiousness has specific denominational attributes because it involves an organized system of worship and doctrine shared within a group. Spirituality is generally thought of as more open, inclusive, and universal than religiousness and is a subjective experience; people create their own spiritual constructs. Additionally, many spiritual activities are independent from religion. NA members have varying concepts of a Higher Power; members may choose their Higher Power to be God, the program itself, the group, or anything else. It just has to be something they strongly believe in. Even atheists have found a place in the NA fellowship. The point is that members should remain open-minded, regardless of religious beliefs and limitations.
NA’s concept of a Higher Power provides a positive outlook and instills faith in something bigger than self-reliance. Before NA, for many people struggling with addiction, self-sufficiency and the ability to stop using drugs had failed. A belief in a Higher Power enables people to practice spiritual principles and is the basis for getting and staying clean. The member chooses a personal concept of a Higher Power; religion may or may not influence that decision.