What are Alternatives to 12-Step Programs?

For more than 80 years, 12-step programs have been nearly synonymous with addiction recovery. Since its founding in 1935, Alcoholics Anonymous (AA) has set the standard for 12-step programs. Now, similar 12-step groups provide support for a range of compulsions, from drugs to sex to gambling. While these support groups have helped many people achieve sobriety or otherwise improve their lives, there are other options available for those looking to address their addiction in a group setting.

Effectiveness of 12-Step Programs

Many have questioned whether 12-step programs can lead to long-term recovery from addiction. However, a 2014 membership survey conducted by Alcoholics Anonymous found that of the more than 6,000 members, 22% had maintained their sobriety for 20 or more years.

Nonetheless, the question has remained: does AA help people more than other forms of peer support? Quantifying how effective different treatments are for recovery can be challenging. A 2020 review looked at more than 25 existing studies and 10,000-plus participants from previous inquiries. It found that attendance at an AA meeting did lead to longer periods of sobriety than other forms of peer support.

The studies used various means of determining the effectiveness of AA, including:

  • How long participants abstained from alcohol
  • How much they reduced their drinking
  • Whether or not they continued drinking
  • The consequences of their drinking
  • The health care costs from their drinking

The review found that attending AA meetings was better than no help and other forms of intervention in the majority of the research studies. Research also showed that AA attendance resulted in health care cost savings. One of the studies reviewed indicated that a person attending AA meetings and 12-step facilitation counseling lowered their mental health care costs by as much as $10,000.

This overarching review of so many AA-related studies did not include other forms of 12-step programs, but it does suggest that the same conclusion is possible for people attending related 12-step programs.

Advantages and Disadvantages to 12-Step Programs

Recovery is not a one-size-fits-all solution. Some paths work for some, but certainly not all. There is always trial and error that often occurs when an individual determines the best way for them to live a substance-free life.

When evaluating 12-step programs, take a clear-eyed look at both the pros and cons that these types of gatherings offer. Advantages to participating in a 12-step program include:

  • They offer a community of other sober people. For many people, a strong network of other individuals who understand what they are experiencing and can support their sobriety goals can be extremely helpful.
  • They are available at multiple locations. It is easy to find a 12-step program because almost every city or town offers a meeting. As a result, help is always convenient and easy to find.
  • They can renew someone’s commitment to stop using substances. Each visit to a 12-step meeting can serve as a renewal of the person’s commitment to maintaining their sobriety.
  • They impart structure. Boredom can lead to cravings, especially during the early days of sobriety, but 12-step meetings give someone a place to be and a way to limit their unstructured time.
  • They allow attendees to be of service. Part of the sober journey is helping others, and 12-step programs are a great way to focus on another person and assist them in their sober journey.

While many may find regular attendance at 12-step meetings keeps them focused on sobriety, others may not find the programs as helpful for different reasons, including:

  • They rely on a higher power. For anyone that is not religious, it may be off-putting how much 12-step programs base their guidance on recognizing a higher power.
  • They don’t address the physical aspect of recovery. Withdrawal and detox are critical components of a person’s recovery from drugs or alcohol that are not addressed by 12-step programs.
  • They don’t focus on empowerment. The reasons why people drink vary. For example, many men and women drink to numb emotional pain, so they may benefit more from programs that teach them how to cope with trauma.

Alternatives to 12-Step Programs

If a person in recovery is interested in investigating options other than a 12-step program, there are several national organizations that offer alternative approaches. These include LifeRing, Refuge Recovery, SMART Recovery, SOS (Secular Organizations for Sobriety/Save Our Selves), Women for Sobriety, and Moderation Management.

Unlike 12-step programs, these groups generally don’t incorporate a strong religious element. In addition to offering a secular option, many of these groups do not view the person dealing with addiction as powerless over substances. These groups also are less rigid and more open to change than traditional 12-step programs. Finally, many of these alternatives do not view addiction as a lifelong battle requiring regular attendance at meetings. They focus on helping people in the present.

While these recovery support groups share some similarities, they are not the same. Here’s an overview of each 12-step program alternative:


LifeRing views anyone struggling with addiction as having two selves: an “addict” self and a “sober” self. The program helps people strengthen the sober side of their nature by finding their own inner strength and self-control. LifeRing meetings focus on the present and urge attendees to leave the past behind.

Refuge Recovery

Refuge Recovery uses principles found in Buddhism to teach individuals skills like mindfulness and meditation to help manage addiction. Like the 12 steps, Refuge uses an “eightfold path” that guides individuals through the recovery process. However, unlike 12-step programs, Refuge encourages individuals to incorporate these principles into their entire life to provide guidance and support beyond their addiction.

SMART Recovery

SMART Recovery is centered on a four-point plan, which are:

1. Obtaining and maintaining motivation

2. Learning to manage urges

3. Handling emotions, thoughts, and behaviors

4. Finding and striking balance in life

Attendees learn tools and undertake homework to help them work through the four points.

Anyone with any type of addiction can attend SMART meetings. The aim of the program is to help attendees find the internal motivation they need to create and maintain positive change in their life, including long-term sobriety.

SOS (Secular Organizations for Sobriety/Save Our Selves)

Attendance at an SOS (Secular Organizations for Sobriety/Save Our Selves) meeting only requires a commitment to continued abstinence. In addition to being secular, SOS is not based on any other type of recovery program. In fact, the program is continually evolving and adapting as new research and information become available. The group’s main focus is on sobriety, responsibility, and confidentiality, with members working together to hold each other accountable and to improve their quality of life via long-term sobriety.

Women for Sobriety

Founded in 1976, Women for Sobriety is the first program exclusively for women. The program curriculum is based on 13 acceptance statements that focus on positivity, personal responsibility, and emotional growth. The overarching goal of the program is to aid women in changing their negative thought and behavior patterns to achieve recovery and lead healthier and happier lives.

Moderation Management

Moderation Management takes a slightly different approach by encouraging people to change risky drinking habits and promote a healthy lifestyle without requiring abstinence from alcohol. Members are allowed to choose if they want to abstain from alcohol or drink in moderation. Then they go through nine steps. These are focused on taking responsibility for their actions, recognizing harmful drinking patterns, and addressing problem drinking. For those that choose to drink in moderation, the group asks them to set limits on their drinking, not drink every day, pursue hobbies unrelated to drinking, and not take risks when drinking.

While 12-step programs remain better known than other alternatives, anyone pursuing sobriety should explore their options, especially if past 12-step programs have not felt like a good fit for them. For more than 40 years after AA’s founding, there were few other options available for peer-based recovery. Today, there are.

A 2018 study examined a group of 600 individuals with alcohol use disorder (AUD), dividing them by the type of peer support group they participated in the most. The researchers checked in with participants after six months and after 12 months, evaluating their ongoing involvement in the groups as well as their substance use outcomes. The researchers concluded that outcomes for attendees to Women for Sobriety, LifeRing, and SMART were as good as those from 12-step groups.

Because not every program will work for every person, having the option to pursue alternative options means more people will have a higher chance of achieving long-term sobriety, whether through a 12-step program or something else. Recovery is the desired outcome. How an individual achieves that goal is up to them.

Lasting Recovery is here to help with evidence-based and wellness-focused therapeutic techniques designed to address the disease of addiction on multiple levels.

Speak to one of our trained staff members to learn how you can overcome issues with drug or alcohol addiction in your life.

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