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Drug Rehabs with Twelve-Step Programs

Last updated on: Saturday, 4 May 2024

12-step drug rehab in Canada provides traditional counseling methods that utilize Alcoholics and Narcotics Anonymous literature and practices. When considering a Twelve-step treatment facility, it is important to understand that most centers use a faith-based approach. If you or your loved one are not religious, the 12-step model may not be the right fit.


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The 12-step philosophy and methodologies created by Alcoholics Anonymous is the most utilized drug rehabilitation method in Canada. The twelve-step program was first developed and used by Alcoholics Anonymous and created by recovering alcoholics. The model’s basic premise is that people can help one another achieve and maintain sobriety. However, healing comes about when the individual surrenders to a higher power. Twelve-step treatment programs remain one of the most recommended forms of drug rehab in Canada.

In 1938, Alcoholics Anonymous originated the idea for the 12-step model when founder Bill Wilson developed the process. He wrote about how the positive effects experienced when people struggling with alcohol addiction shared their stories. The program was written in what is now known as the Big Book. The 12 steps were developed through synthesizing concepts from other teachings Bill Wilson had encountered. The original 12 steps came from a Christian spiritual inspiration-seeking help from a higher power and peers.

Originally, the Big Book was a guide for people who could not attend Alcoholics Anonymous fellowship meetings. However, it soon became a model for the program in general. Today, the 12 steps have been adopted as a model for a wide range of addiction peer support and self-help programs designed to drive behavioral change. Alcoholics Anonymous in Canada expanded to create Narcotics Anonymous, Cocaine Anonymous, or Gamblers Anonymous, and many others. Twelve-step drug rehab programs provide counseling support and other social services to address all aspects of substance abuse.

Additionally, 12-step drug rehab programs help individuals who are spiritual or those who have no spiritual grounding. Traditionally, 12-step treatment programs follow a spiritual path to recovery. However, it is often left to the individual to define a higher power because many people do not identify as spiritual. The core belief that shapes twelve-step drug rehab programs are that willpower alone may not achieve lasting sobriety; reaching out for help from others must replace self-centred attitudes and beliefs. Long-term recovery involves a process of spiritual renewal. In addition, much of the therapy emphasizes accepting the need for abstinence and surrendering to engage in the program to achieve lasting sobriety.

When are Twelve Step Drug Rehabilitation Programs the Best Option?

Twelve-step facilitation methods are utilized at numerous drug rehab and treatment programs across Canada. When asking if 12-step treatment is the best option, there are some things to consider. Usually, the addict has likely never attended a drug rehab program or 12-step meeting, and this was the first option they came across. Twelve-step treatment is beneficial for people with short-term or long-term drug addiction problems. Someone who is uncertain about what drug rehab approach to take may benefit from attending a 12-step drug rehab program.

The purpose of drug rehabilitation is to help the person stop the use of drugs and alcohol and heal them physically, mentally, and spiritually. If a twelve-step drug rehab program can accomplish this, then it becomes the best option for the addict to consider. According to the National Institute on Drug Abuse, twelve-step facilitation therapy is an active engagement strategy. The process is designed to increase the likelihood of a substance abuser becoming affiliated with and actively involved in 12-step help groups.

Additionally, becoming involved with 12-step help groups promotes abstinence from drugs and alcohol. There are three key ideas with 12-step facilitation. The first is acceptance, and this includes the realization that drug addiction is a chronic, progressive disease that the individual has no control over. Their life has become unmanageable because of drugs and willpower alone is insufficient to overcome the problems. Not every individual accepts that drug addiction is a lifelong disease. The disease model is part of the 12-step philosophy. However, numerous drug rehab programs in Canada recognize that drug addiction is not a disease and an addict is not an addict all their life.

Secondly, through 12-step facilitation, the individual must surrender, and this involves giving oneself over to a higher power. The individual must accept a fellowship and support structure of other recovering addicted individuals and follow the recovery activities laid out by the 12-step program. Finally, the individual must have active involvement in 12-step meetings and related activities. Committing to the true nature of a 12-step drug rehab program is not for everyone. Nevertheless, they are good options for someone who has never been to drug rehab and can only access local 12-step meetings, drug rehab programs, or support groups.

Ask a Professional

  • Do 12-step drug rehab programs work?

    Yes, they have a long history of helping people overcome every form of drug addiction and substance use. Twelve-step drug rehab programs are successful because they create group support during treatment and recovery. However, 12-step drug rehab programs are not for everyone. An addiction assessment is the best way to determine if a 12-step program works.

  • Are group meetings part of the 12-step philosophy?

    Most group meetings involve 12-step facilitation therapy. However, many other forms of group support do not involve 12-step facilitation. For example, family support groups or peer support for recovering addicts. These types of group support may not incorporate the 12-steps as it is a different form of support and help.

  • Do all drug rehab programs include 12-step group meetings in treatment?

    No, not all drug rehab programs use 12-step group meetings or 12-step facilitation therapy. While 12-step is effective, it is not the right choice for every person. Private and public drug rehab centers offer other forms of counseling, such as behavioral therapies and experiential therapy.

  • What happens if a 12-step program does not work?

    The same approach should be taken as with any other drug rehab program; if it does not work, it is important to consider other options. Twelve-step facilitation is not for everyone. If it is not working out, work with the counselors and therapists to find another option.

  • Want to know more?

    The questions from DrugRehab.ca’s “Ask a Professional” are answered by Nickolaus Hayes. If you need further clarification on any of the questions above or have any other questions you can contact him directly at N.hayes@drugrehab.ca.

How Do Twelve Step Drug Rehab Programs Operate?

Twelve-step facilitation is a commonly used rehabilitation process. How twelve-step drug rehab programs operate is generally the same throughout Canada. Twelve-step drug rehab programs rely on the support model as a means for helping addicts address daily challenges and obstacles that recovery brings. Ongoing abstinence is the goal, and 12-step drug rehab programs work to decrease relapse rates while reducing the need for formal drug treatment services for their members. Someone who has completed a 12-step drug rehab program continues to attend 12-step meetings daily, weekly, or monthly.

Twelve-step drug rehab programs provide a structured long-term maintenance approach to maintaining abstinence day-to-day. Programs offer goal-orientated directives, emotional support, enjoyable drug-free activities, positive role models with experience in recovery, and personal development training. The 12-step philosophy encompasses a set of principles designed to undo the negative effects of addiction. In addition, programs provide a framework for developing a drug-free lifestyle. The areas that are emphasized throughout treatment are individual growth and maturity, spiritual development, accepting the disease aspect of addiction, helping others, and avoiding self-centeredness.

Twelve-step drug rehab programs use a support group environment and provide patients with a type of built-in social network. Typically, the 12-step process requires each group member to admit they are powerless over drugs and alcohol and take a moral inventory of one’s motivations and priorities. The process also requires each group member to admit the nature of any wrongs committed, identify and list the people harmed during their addiction, and make amends for wrongs done. The twelve steps are as follows:

Step 1 – We admitted we were powerless over alcohol – that our lives had become unmanageable.

Step 2 – Came to believe that a Power greater than ourselves could restore us to sanity.

Step 3 – Made a decision to turn our will and our lives over to the care of God as we understood Him.

Step 4 – Made a searching and fearless moral inventory of ourselves.

Step 5 – Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

Step 6 – Were entirely ready to have God remove all these defects of character.

Step 7 – Humbly asked Him to remove our shortcomings.

Step 8 – Made a list of all persons we had harmed and became willing to make amends to them all.

Step 9 – Made direct amends to such people wherever possible, except when to do so would injure them or others.

Step 10 – Continued to take personal inventory and, when we were wrong, promptly admitted it.

Step 11 – 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.

Step 12 – Having had a spiritual awakening due to these steps, we tried to carry this message to alcoholics and practice these principles in all our affairs.

Sponsorship is also part of most 12-step drug rehab programs. Sponsorship offers recovering addicts the opportunity to learn from the experiences of someone who worked the 12-step and maintained abstinence from drugs or alcohol. In addition, sponsorship provides friendship, guidance, support, acts as a sounding board, and offers understanding.

Generally, someone who is new to a 12-step drug rehab program is asked to maintain an open mind, attend meetings, and read AA literature. Overall, the rehabilitation process involves the initial drug assessment, detox, therapy, and aftercare support.

Information on Drug Rehab

Are There Alternatives to Twelve Step Drug Rehab Programs?

The alternatives to 12-step drug rehab programs are any form of drug rehab that does not use 12-step facilitation. Other forms of behavioral therapy are common approaches. Behavioral therapies include cognitive behavioral therapy, contingency management interventions, motivational incentives, community reinforcement approaches, motivational enhancement therapy, and family behavior therapy. Other alternatives to 12-step facilitation are holistic drug rehab programs that take a whole-person approach.

Additionally, experiential therapy is standard, and this is a technique where patients use expressive tools or activities to re-enact and recreate situations from the past and present. Under the guidance of trained therapists, patients may use role-playing techniques, music, props, or art to identify what emotions they have that influence their success. Overall, no one form of substance abuse treatment is right for every person. The treatment settings and interventions should meet the needs of the person attending drug rehab.

What is the Success Rate of 12-Step Drug Rehab Approaches?

The success of a 12-step drug rehab program depends on many things. The process of the program determines how much-recovering addicts benefit from this line of treatment. Participation entails regular meeting attendance, reading 12-step literature, working each step, getting a sponsor, becoming a sponsor, and service work, such as helping set up and running meetings. Many studies support the efficacy of 12-step programs. According to some research, Alcoholics Anonymous participation is associated with fewer drinks and more abstinent days.

However, the most common criticism of 12-step programs concerns the variability in adherence to core tenets from group to group. Quality control measures are minimal, and there is no way to ensure that every group adheres consistently to all of its principles. The Cochrane Review from 2020 compared Alcoholics Anonymous and 12-step facilitation to other alcohol use disorder interventions at the 12-month follow-up. The randomized controlled trials indicated a 42% abstinent rate for Alcoholics Anonymous and 12-step facilitation treatments compared to 35% abstinent using non AA interventions.

Additionally, a longitudinal study of the comparative efficacy of Women for Sobriety, LifeRing, SMART Recovery, and 12-step groups suggested no differences in the efficacy of all the programs and groups. Adults struggling with alcohol addiction were surveyed at a six-month follow-up and twelve-month follow-up. The researchers noted that compared to 12-step members, those identifying SMART as their primary group at baseline fared worse across outcomes, and those affiliating with LifeRing showed lower odds of total abstinence.

However, the effects became nonsignificant when controlling for baseline alcohol recovery goal. Overall, the research suggested that any group differences were explained by the selection of those with weaker abstinence motivation. The success of 12-step facilitation depends on what the individual is willing to put into the treatment. Overcoming drug addiction takes work and time, and it does not happen quickly.

Common Terminology with Twelve-Step Drug Rehab

12 Steps
These are a set of guiding principles established by the founders of Alcoholics Anonymous in 1939. The steps outline the course of action that should be taken to overcome an addiction.
Alcoholics Anonymous
AA is the first every 12-step group and was founded by Bill Wilson and Dr. Bob Smith in 1935.
Big Book
The Big Book is titled Alcoholics Anonymous: The story of How Many Thousands of Men and Women Have Recovered from Alcoholism. It is the founding text of Alcoholics Anonymous.
Higher Power
This is a spiritual being or simply a power greater than the individual that can help the person overcome their drug addiction. This is the central part of the 12 steps.
Sponsorship is an important aspect of 12-step groups. A sponsor is a member who has been a part of the group for a long time and has been sober for a long time. Sponsors take on newcomers and guide and support them.




More Information

Marcel Gemme has been helping people struggling with addiction for over 19 years. He first started as an intake counselor for a drug rehabilitation center in 2000. During his 5 years as an intake counselor, he helped many addicts get the treatment they needed. With drug and alcohol problems constantly on the rise in the United States and Canada, he decided to use the Internet as a way to educate and help many more people in both those countries. This was 15 years ago. Since then, Marcel has built two of the largest websites in the U.S. and Canada which reach and help millions of people each year. He is an author and a leader in the field of drug and alcohol addiction. His main focus is threefold: education, prevention and rehabilitation. To this day, he still strives to be at the forefront of technology in order to help more and more people. He is a Licensed Drug and Alcohol Treatment Specialist graduate with Honours of Stratford Career Institute. Marcel has also received a certificate from Harvard for completing a course entitled The Opioid Crisis in America and a certificate from The University of Adelaide for completing a course entitled AddictionX: Managing Addiction: A Framework for Succesful Treatment.