Published: 02/14/2024 | Author: Kerry Nenn

What is “How it Works” in AA and NA?

He needed support. Jim had been trying to quit drinking for years – on his own. He had heard a lot about AA and decided to finally look into it. He wasn’t sure what these “12-Step” groups were all about, so he asked a friend. Jim’s friend told him to read “How it Works” in the Big Book chapter 5.

But what’s the Big Book? And what is this “how it works” section? Here’s what Jim discovered.

The Big Book

The Big Book is literally a book. First published in 1939, Alcoholics Anonymous outlines the entire AA program. It was written to explain how the founders of AA first got sober and provide steps for how others could do the same. It remains the basic text for AA groups today.¹

Big Book Chapter 5

Chapter 5 of Alcoholics Anonymous outlines the specific 12 Steps of the AA recovery program. This “how it works” section includes the steps that members of AA (and NA) take to obtain and maintain sobriety. This section of the book is often read at the start of AA or NA meetings. 

The 12 Steps in the Big Book chapter 5 are:²

1. We admitted we were powerless over alcohol — that our lives had become unmanageable. 
2. Came to believe that a Power greater than ourselves could restore us to sanity. 
3. Made a decision to turn our will and our lives over to the care of God as we understood Him. 
4. Made a searching and fearless moral inventory of ourselves. 
5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs. 
6. Were entirely ready to have God remove all these defects of character. 
7. Humbly asked Him to remove our shortcomings. 
8. Made a list of all persons we had harmed, and became willing to make amends to them all. 
9. Made direct amends to such people wherever possible, except when to do so would injure them or others. 
10. Continued to take personal inventory and when we were wrong promptly admitted it. 
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. 
12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

These steps work through six basic phases:³

• Abstaining from drinking or using drugs
• Attending meetings
• Asking for help
• Getting a sponsor
• Joining a group
• Becoming active (giving back/sponsoring others)

How It Works

After reading the Big Book chapter 5, Jim had a better understanding of AA and how it works. But he still wondered two things: 

1. How Do AA Meetings Work?

Jim wanted a bit more info before going to an AA meeting. How much do they cost? Where are they held? What happens at the meetings? He sat down with a friend who has been attending AA for years and got the full scoop:

Cost: AA is free. Members may be asked to make a small donation to help pay for coffee or snacks.

Location: 12-Step meetings take place in a variety of settings. Common locations include addiction treatment facilities, churches, community centers, and sober living homes. 

Format: Members often sit in a circle. The meeting starts with members taking turns sharing their names and acknowledging their addiction or sharing why they came to the meeting. The rest of the meeting consists of members sharing their stories of addiction and recovery. Meetings may also involve reading text from the Big Book. Everyone is encouraged to join in the sharing process, but no one is ever forced to talk. It is always acceptable just to listen and observe.

Commitment: The time it takes to complete the 12 Steps varies by individual. Some people stay in AA or NA for a short period, while others continue to attend meetings for years. Once they complete the Steps, many members remain active and involved to receive ongoing support and help others. For newcomers like Jim, it is usually recommended that they initially attend 90 meetings over the course of 90 days.

2. Does It Work?

Research has shown that yes, AA/NA does work.

• Participation is associated with a greater likelihood of abstinence, improved psychosocial functioning, and greater levels of self-efficacy.³
• Joining a 12-Step group while in treatment is associated with better treatment outcomes.³
• Frequent attendance and involvement in AA/NA is associated with better substance use outcomes.³

Why It Works

Jim was excited to learn that AA has a track record of success. But he was still curious why it works.

It turns out, the fellowship, or social support, that AA/NA provides is a main contributor to its success.⁴ Joining a group changes your social network. It brings more people into your life who don’t use substances, and, as you spend more time in those circles, you spend less time with others who use substances. 

As you make this social shift, you’re less likely to participate in activities related to substance use, and you participate in more activities that don’t. Plus, as you bond with others in the group, you find role models, support, and encouragement to maintain sobriety. 

Next Steps

Jim was hopeful about the support available through AA and decided to find a local meeting to attend.

If you or someone you love is experiencing a substance use disorder, help is available. Call 866-968-5444Who Answers? today to learn about your treatment options. Visit AA.org to find AA near you or get the Meeting Guide app.

Sources:

1. The big book. (n.d.). Alcoholics Anonymous. Retrieved January 31, 2024, from https://www.aa.org/the-big-book
2. How it works. (n.d.). Alcoholics Anonymous. Retrieved January 31, 2024, from https://www.aa.org/how-it-works
3. Donovan, D. M., Ingalsbe, M. H., Benbow, J., & Daley, D. C. (2013). 12-step interventions and mutual support programs for substance use disorders: An overview. Social Work in Public Health, 28(3–4), 313–332. https://doi.org/10.1080/19371918.2013.774663
4. West, M. (2022, May 11). What to know about the 12-step program. Medical News Today. https://www.medicalnewstoday.com/articles/12-step-program#what-it-is