Quick Summary
- AA/NA: The most widely available peer support network in the world with 120,000+ groups in 180 countries. Built on the 12 Steps, a sponsor relationship, and spiritual (not necessarily religious) growth.
- SMART Recovery: Science-based, using CBT and motivational enhancement techniques. No sponsors, no steps, no spiritual component. Growing rapidly with 3,000+ meetings worldwide.
- Evidence: A 2020 Cochrane review found that AA/12-step facilitation produces abstinence rates equal to or better than other clinical interventions, particularly for alcohol use disorder.
12-Step Programs (AA, NA, CA)
Alcoholics Anonymous, Narcotics Anonymous, and Cocaine Anonymous follow the same 12-step framework: admitting powerlessness, seeking help from a Higher Power (self-defined), taking moral inventory, making amends, and carrying the message to others. The sponsor-sponsee relationship provides individual accountability. Meetings are free, require no registration, and are available in virtually every community. Criticism: the spiritual component alienates some atheist and agnostic individuals, and the "powerlessness" framing conflicts with some therapeutic models. Response: many groups have adapted. there are agnostic AA meetings in most major cities.
SMART Recovery
Self-Management and Recovery Training uses cognitive behavioral and motivational enhancement techniques—rooted in the same evidence-based therapy approaches used in clinical settings— across 4 points: building motivation, coping with urges, managing thoughts and behaviors, and living a balanced life. Meetings are facilitated (not "shared" like AA) and focus on building practical skills rather than telling stories. No sponsor system. No spiritual component. Online meetings available 24/7. Best for individuals who prefer a structured, evidence-based, self-empowerment approach.
Other Options
LifeRing Secular Recovery: Peer support without any spiritual framework. Focuses on the "Sober Self" concept. Celebrate Recovery: Christian-based 12-step program offered in 35,000+ churches. Refuge Recovery/Recovery Dharma: Buddhist-influenced mindfulness-based programs. Women for Sobriety: Specifically designed for women, addressing gender-specific recovery needs. Each has a different philosophy, but all share the core mechanism: accountability through community.
Frequently Asked Questions
Do I have to believe in God for AA?
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No. The "Higher Power" concept is intentionally vague and self-defined. Many AA members use the group itself, nature, or the concept of a power greater than their own willpower. Agnostic and atheist AA meetings exist in most major cities.
How often should I attend meetings?
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The common recommendation in early recovery is "90 meetings in 90 days." After the first year, frequency varies. some attend weekly, others several times per week. The key is consistency, not frequency.
Are online meetings effective?
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Yes. Research during and after COVID-19 showed online meetings provide comparable benefits to in-person meetings, particularly for accessibility. SMART Recovery and AA both offer robust online meeting schedules.
Sources
RehabSearch cites peer-reviewed research and recognized health organizations.
- Kelly JF, et al. "Alcoholics Anonymous and 12-Step Facilitation Treatments for Alcohol Use Disorder." Cochrane Database, 2020.
- SMART Recovery. "About SMART Recovery." smartrecovery.org.