Introduction

Recovery-oriented mutual self-help groups can aid recovery from substance use disorders (SUDs) and facilitate personal growth through self-exploration and peer support. Although these groups are not a part of professional treatment, they can provide a rich source of support for recovery and complement other treatment. Mutual self-help groups provide a forum and opportunity for individuals in recovery to connect with others who have similar experiences and goals, allowing them to build relationships within a substance-free support network. These groups are typically free, anonymous, and easily accessible; as such, these groups can be readily available over the long-term trajectory of recovery. Mutual self-help groups include a variety of programs, with 12-step programs (e.g. Alcoholics Anonymous, Narcotics Anonymous,) and Self-Management and Recovery Training (SMART Recovery) being the most common.

Clinicians who are knowledgeable about community-based recovery programs may be more successful in referring patients to these programs.¹ Different meetings have different “energies” or dynamics to them, and clinicians should encourage patients to attend several different meetings to identify the ones that feel most comfortable for them or where they find connection with the other members.² It may be helpful to inform patients that each meeting is unique and has its own character; if a patient has a negative experience in a particular meeting, he or she should try attending one or more different meetings to find the ones that feel “right.”

Twelve-Step Recovery Programs

Twelve-step recovery programs involve meetings in various public settings and follow “12 steps” (refer to Resource Box 1, below) that guide individuals in their recovery. These programs are described as fellowships of individuals who share their strength, hope, and experience with those who would like to stop drinking and/or drug use. Alcoholics Anonymous (AA) is the largest 12-step program that addresses alcohol use; Narcotics Anonymous (NA) is the second largest 12-step program, focused on substance use (any kind of substance use, including alcohol).³ Twelve-step meetings are free and usually readily available, often multiple times per day (into the night), depending on geographic location. Meetings also are available online. Meetings generally run from 60 to 90 minutes and are chaired by a 12-step group member. During the meeting, members who choose to do so share experiences—one person at a time—related to their recovery, while others in the group listen. Public sharing of experience is voluntary—some members find benefit in just listening. An individual can become a member of a 12-step program simply by expressing a desire to stop using.³