Secular Alternatives to Alcoholics Anonymous (AA)
Mutual support groups are a helpful way for people in addiction recovery to obtain guidance and support from others who have been in their shoes. While many people benefit from 12-step groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), not everyone agrees with the concept of a “higher power,” or they may not feel comfortable with the spiritual components of 12-step groups. If this describes you but you are still interested in participating in a self-help group, secular alternatives may be more appropriate for your needs.
History of 12-Step Programs
Twelve-step groups first began in 1935 through a collaborative effort from Bill W. and Dr. Bob S., the founders of AA. As individuals struggling with alcoholism, they felt that the available options for recovery were not sufficient for their needs. The two collaborated and ended up forming the world’s first 12-step group and compiling the 12 steps of recovery in the “Big Book” in 1938.1,2
Research has shown that 12-step groups can produce positive outcomes for people in addiction recovery. One clinical review published in the journal Social Work and Public Health reports that the average length of abstinence reported by AA and NA members is more than 5 years, which suggests that long-term abstinence is possible with longer-term participation in these groups.3 Further research has shown the benefits of mutual support groups in general. The results of an evaluation of a mutual aid support group for people with severe mental illness explains that people who participate in mutual support groups highly value the experience and collaborative nature of these groups.4
Before AA, mutual support groups included the Washingtonians and other temperance-based movements in the U.S. around the mid-1800s.1 Other groups evolved after 1945 that split with the ideas put forth by AA and spread throughout the US and Europe, but as a report in Addiction Research states, it is difficult to find any example of a mutual self-help group that has not been positively or negatively influenced by AA in some way.1 This includes groups such as the Swedish Links movement and the French mutual-help movement Vie Libre. However, this report also explains that as alternatives to AA have evolved, they have adopted certain components of the AA philosophies and rejected others.1
The rationale behind mutual support groups for addiction is that people benefit from the group meetings and mutual support offered by these groups as a way to remain abstinent and prevent relapse.5
Religion and Mutual-Aid Support Groups
Religion and spirituality have been frequently linked with recovery throughout history, but AA is arguably the most well-known of the spiritually-based support groups. This largely came about due to the influence of the Oxford Group, a Christian evangelical movement that was popular in the early 20th century, on helping Bill W. and Dr. Bob S. achieve sobriety.6 These two men adopted the tenets of the Oxford Group to form the 12 steps of AA.6
The reasoning behind the intertwining of faith and recovery is that people can find the power to affect individual change through divine intervention, God, or—as is commonly referred to in AA—a higher power. People submit themselves to the higher power and turn their lives over to “God.”6 One study suggests that religious beliefs and spirituality can play a powerful role in recovery.7 It states that faith helps to protect people from substance abuse by providing a religious framework, participation in organized activities that can help people cut down on or stop using substances, and the power of a personal relationship with God.7
Many studies show that religious or spiritual beliefs and practices result in lower levels of substance abuse and can help reduce the likelihood of using drugs or alcohol.7 The intensity of a person’s involvement with their religion or spirituality has also been shown to have a positive impact on health and behavior.7
How Effective Are These Types of Programs?
Research on the effectiveness of 12-step groups has been mixed. One review explains that there is no experimental evidence to show the effectiveness of AA or 12-step type groups.8 However, other research has shown that 12-step groups can be effective in helping people achieve and maintain sobriety and prevent relapse.8 The positive results of different studies shows that AA and NA participation can produce an increased likelihood of abstinence which can last for 16 years or more, help to improve a person’s psychosocial functioning (meaning their ability to function in society and their overall mental health), and help people experience higher levels of self-efficacy (meaning the way a person feels about their ability to achieve goals and succeed in life).3
However, research has also shown that 12-step groups are not appropriate for everyone and that alternatives to 12-step groups can be as effective in providing mutual support benefits to people in recovery.9
Alternative Mutual Support Groups to AA
SMART Recovery is a free, secular, mutual support group that does not rely on the concept of a higher power but rather promotes the idea of self-empowerment. SMART Recovery does not use the terms “addict” or “alcoholic” and focus on helping people develop coping skills as a way of promoting positive change.10
Meetings are structured and focused on the present. SMART Recovery does not focus on the past, because they believe that there is nothing you can do to change it.10 This may be a benefit for some people, especially those who do not want to dredge up the past, but it could be a potential disadvantage if you have unresolved issues from the past that are affecting your drinking or substance use in the present. In addition, there are no sponsors in SMART Recovery, so this can be a pro or a con depending on your personal preference, as some people prefer to work through issues on their own while others may benefit from the one-on-one support of a sponsor.
Research has shown SMART Recovery to be an effective option for helping individuals recover from heavy drinking.11
LifeRing is a free, secular, abstinence society based on social reinforcement. It was founded in 2001 to provide mutual support and fellowship to people in recovery from alcohol and drug abuse. According to their website, LifeRing provides a safe, nonjudgmental meeting space based on the 3-S philosophy, which includes Sobriety, Secularity, and Self-help. People may or may not refer to themselves as “alcoholics” or “addicts” within the group.12,13
They explain that their groups are different from AA because they believe the ability to become sober lies within the individual regardless of whether you believe in a higher power. Group meetings are based on the topic of “How was your week?” where each person reports on highlights of their week and plans for the future and receives applause for their efforts. LifeRing can be good for people who prefer to not talk all the time about their history of drug or alcohol abuse but can be a negative for the same reason, especially if their history is something they have not yet processed. In addition, LifeRing does not use sponsors, which can be a con for people who need extra support and guidance. 13
One clinical review indicates that participants in LifeRing groups appear to be less likely to adhere to the stringent recovery goal of complete abstinence and that these groups may be a good alternative for those who are not religious or spiritual and not yet ready to commit to total sobriety.9
Secular Organizations for Sobriety (SOS)
Secular Organizations for Sobriety (SOS) is a free, self-supporting secular network of “autonomous, non-professional local groups” that aims to help people who abuse alcohol or drugs and other substances (like food) achieve sobriety and freedom from their addictions. It is based on individual contributions and does not receive outside funding. SOS relies on the concept of self-empowerment and gives the individual total responsibility for achieving abstinence. Drinking and using drugs are not seen as options, as the goal is complete sobriety; this can be a con for those who are not quite ready for total sobriety. While there are no sponsors, the support of the group is seen as an integral part of recovery.14
SOS groups are anonymous. You do not have to provide your name or other identifying information, which can be especially beneficial if you are someone who prefers privacy, and names are never provided to outsiders.
Moderation Management (MM) offers multiple support options, including face-to-face meetings, video and phone meetings, chats, and private online support communities to people who want to change their relationship with alcohol. It does not require sobriety and recognizes that quitting alcohol may not be the right choice for everyone. This can be beneficial for people who don’t want to stop drinking but want to cut down or limit their alcohol use. Around 30% of MM members ultimately choose abstinence.15
A study in the Journal of Consulting and Clinical Psychology examined the benefits of a web-based protocol called Moderate Drinking (MD) combined with use of the online resources of MM as opposed to the use of MM’s online resources alone. The results found that people who participated in both protocols had better outcomes than those who relied on MM alone, suggesting that a combination of approaches may be most beneficial for those who want to try MM.16
A paper published in Psychiatric Services argued that MM may be inappropriate as a long-term solution for sobriety, as most MM members have less severe addictions, high levels of social support, and little interest in abstinence-oriented interventions.17
HAMS: Harm Reduction for Alcohol
HAMS is a peer-led support and informational group for people who want to stop drinking alcohol and achieve sobriety. They provide support through an online forum, a chat room, an email group, a Facebook group, and live meetings. HAMS is based on the concept of harm reduction, meaning a set of practical strategies designed to help minimize the harm caused by alcohol use. It is a nonjudgmental approach that focuses on making small steps toward sobriety, so this can be a benefit for people who want to be able to drink occasionally, as it does not require complete abstinence and accepts that recreational alcohol use is a part of the modern world.18 Live meetings are run by facilitators from HAMS, with groups being free, or led by professionals who may charge a fee.19
One study of harm reduction programs in general for alcohol abuse showed that they can be effective for minimizing heavy drinking occasions.20 Another study of harm reduction practices showed that they have “considerable promise” in the prevention of alcohol-related problems and can be beneficial for helping people define and attain their own goals regarding alcohol use.21
Women for Sobriety
Women for Sobriety (WFS) is an abstinence-based self-help organization designed to help women find their path to recovery from drug or alcohol addiction through self-discovery and sharing experiences, hope, and encouragement with other women. They offer a variety of recovery tools, such as outreach, peer-support forums, mutual aid groups, and a chat room. This can be a beneficial group for women who feel more comfortable in the presence of other females, as the group believes that they require a different type of program and that self-help groups are not equally effective for women and men.22
One study found that addiction recovery interventions designed for women should take into account their specific needs, such as normalization and structure, biopsychosocial-spiritual safety, and social connection to be effective, and these are needs that are taken into account by WFS.23 The National Institute on Drug Abuse points out that women face unique issues in recovery and that recovery progresses differently for women than men.24 WFS may be a good option for women seeking a secular support group that relies on the support of other women in recovery and that acknowledges the different issues faced by women with addictions.
. Room, R. (1996). Mutual help movements for alcohol problems in an international perspective. Addiction Research, 6, 131-145.
. Center for Substance Abuse Treatment. (1999). Treatment of adolescents with substance use disorders. (Treatment Improvement Protocol series, No. 32.) Chapter 4—Twelve-step-based programs.
. 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.
. Hyde, B. (2013). Mutual aid group work: Social work leading the way to recovery-focused mental health practice. Social Work with Groups, 36(1), 43-58.
. Melemis, S. M. (2015). Relapse prevention and the five rules of recovery. The Yale Journal of Biology and Medicine, 88(3), 325–332.
. Atkins, R. G., Jr, & Hawdon, J. E. (2007). Religiosity and participation in mutual-aid support groups for addiction. Journal of Substance Abuse Treatment, 33(3), 321–331.
. Grim, B. J. & Grim, M. E. (2019). Belief, behavior, and belonging: How faith is indispensable in preventing and recovering from substance abuse. Journal of Religion and Health, 58(5), 1713–1750.
. Mendola, A. & Gibson, R. L. (2016). Addiction, 12-Step programs, and evidentiary standards for ethically and clinically sound treatment recommendations: What should clinicians do? AMA Journal of Ethics, 18(6), 646–655.
. Zemore, S. E., Kaskutas, L. A., Mericle, A. & Hemberg, J. (2017). Comparison of 12-step groups to mutual help alternatives for AUD in a large, national study: Differences in membership characteristics and group participation, cohesion, and satisfaction. Journal of Substance Abuse Treatment, 73, 16–26.
. SMART Recovery. About SMART Recovery.
. Hester, R. K., Lenberg, K. L., Campbell, W. & Delaney, H. D. (2013). Overcoming addictions, a web-based application, and SMART Recovery, an online and in-person mutual help group for problem drinkers, part 1: Three-month outcomes of a randomized controlled trial. Journal of Medical Internet Research, 15(7), e134.
. LifeRing. (2020). About LifeRing.
. LifeRing. (2020). Frequently asked questions (FAQs).
. Secular Organizations for Sobriety. An overview of SOS.
. Moderation Management. Moderation Management Overview.
. Hester, R. K., Delaney, H. D. & Campbell, W. (2011). ModerateDrinking.Com and moderation management: Outcomes of a randomized clinical trial with non-dependent problem drinkers. Journal of Consulting and Clinical Psychology, 79(2), 215–224.
. Humphreys K. (2003). Alcohol & drug abuse: A research-based analysis of the Moderation Management controversy.Psychiatric Services, 54(5), 621–622.
. HAMS. (2019). HAMS: Harm reduction for alcohol.
. HAMS. (2015). HAMS: Harm reduction for alcohol: Live HAMS meetings.
. Single E. (1996). Harm reduction as an alcohol-prevention strategy. Alcohol Health and Research World, 20(4), 239–243.
. Neighbors, C., Larimer, M. E., Lostutter, T. W. & Woods, B. A. (2006). Harm reduction and individually focused alcohol prevention. The International Journal on Drug Policy, 17(4), 304–309.
. Women for Sobriety. About Women for Sobriety.
. Kruk, E. & Sandberg, K. (2013). A home for body and soul: Substance using women in recovery. Harm Reduction Journal, 10(39).
. National Institute on Drug Abuse. (2020). DrugFacts: Substance use in women: Sex and gender differences in substance use.